Differences in vitamin D concentration between metabolically healthy and unhealthy obese adults: Associations with inflammatory and cardiometabolic markers in 4391 subjects

• Published in: Diabetes & metabolism Vol. 40; no. 5; pp. 347 - 355
• Main Authors: Esteghamati, A, Aryan, Z, Nakhjavani, M
• Format: Journal Article
• Language: English
• Published: Paris Elsevier Masson SAS 01.11.2014; Masson
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Biomarkers - blood; Blood Pressure; Body Mass Index; C-Reactive Protein - metabolism; Cardiovascular Diseases - blood; Cardiovascular Diseases - physiopathology; Cardiovascular Diseases - prevention & control; Cross-Sectional Studies; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinology & Metabolism; Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Fibrinogen - metabolism; Glycated Hemoglobin A - metabolism; Homocysteine - blood; Humans; Inflammation - blood; Inflammation - physiopathology; Insulin Resistance; Internal Medicine; Iran - epidemiology; Lipids - blood; Liver - enzymology; Male; Medical sciences; Metabolic diseases; Metabolic syndrome; Metabolic Syndrome - blood; Metabolic Syndrome - physiopathology; Metabolic Syndrome - prevention & control; Middle Aged; Miscellaneous; Obesity; Obesity - blood; Obesity - epidemiology; Obesity - physiopathology; Other metabolic disorders; Vitamin D; Vitamin D - analogs & derivatives; Vitamin D - blood; Waist Circumference; triglyceride; CRP; NAFLD; non-alcoholic fatty liver disease; HTN; C-reactive protein; LDL-C; ALP; low-density lipoprotein cholesterol; homoeostasis model assessment; DM; ALT; diabetes mellitus; Metabolic syndrome; HDL-C; Vitamin D; MHO; high-density lipoprotein cholesterol; alanine transaminase; alkaline phosphatase; BMI; Obesity; AST; the metabolic syndrome; metabolically healthy obesity; MUO; body mass index; MetS; TG; HbA 1c; metabolically unhealthy obesity; HOMA; FPG; fasting plasma glucose; aspartate transaminase; glycated haemoglobin; hypertension; HbA1c; Endocrinopathy; Micronutrient; Human; Association; Diabetes mellitus; Nutrition disorder; Metabolic diseases; Cardiovascular disease; Nutritional status
• ISSN: 1262-3636; 1878-1780
• DOI: 10.1016/j.diabet.2014.02.007

Abstract Aim This study aimed to compare concentrations of serum 25-hydroxy vitamin D and inflammatory markers in metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO), and to determine whether the relationship between vitamin D levels and both cardiometabolic and inflammatory markers differs between MHO and MUO. Methods This cross-sectional study comprised 4391 obese subjects aged > 18 years. A panel of cardiometabolic and inflammatory markers, including anthropometric variables, glycaemic indices, lipid profiles, liver enzymes, homocysteine, C-reactive protein (CRP), fibrinogen and serum 25-hydroxy vitamin D levels, was investigated. All cardiometabolic and inflammatory markers in MHO and MUO as well as in vitamin D deficiency were compared. Results Prevalence of MHO was 41.9% in our obese subjects using International Diabetes Federation criteria. Considering insulin resistance and inflammation, the prevalence of MHO was 38.4%. Individuals with MHO had significantly higher vitamin D concentrations compared with MUO, and this difference in vitamin D status persisted after accounting for BMI and waist circumference. Subjects with MHO had significantly better metabolic status, lower liver enzymes, lower inflammatory markers and higher serum 25-hydroxy vitamin D than those with MUO. Associations between vitamin D levels and inflammatory and cardiometabolic markers differed according to MHO/MUO status. Among MUO subjects, vitamin D deficiency was associated with higher liver marker and homocysteine levels. Serum vitamin D was negatively associated with fasting plasma glucose and HbA1c in MHO only. Conclusion Serum 25-hydroxy vitamin D levels were lower in MUO vs MHO, and reduced vitamin D concentrations were more strongly associated with cardiometabolic and inflammatory markers in MUO than in MHO subjects. These findings suggest that a deficiency in vitamin D could be a key component of MUO.