Abstract
Objectives
To describe the 25(OH)D status in Spanish obese postmenopausal women and men ≥ 50 years, to compare their results with those of the overweight or normal weight population, and to determine whether differences are observed between both sexes and with seasonal variation throughout the year.
Patients and Methods
We studied 2597 subjects (1826 postmenopausal women and 771 men ≥ 50 years). Serum concentrations of 25(OH)D, intact parathyroid hormone (PTH), aminoterminal propeptide of type I collagen (PINP), and C-terminal telopeptide of type I collagen (CTX) were determined by electrochemiluminiscence (Elecsys 2010, Roche). Bone mineral density (BMD) was measured by DXA. Participants were divided according to body mass index (BMI) groups (normal ≥ 20 and < 25 kg/m2, overweight ≥ 25 and < 30 kg/m2, or obese ≥ 30 kg/m2).
Results
Obese people had lower serum 25(OH)D values (20.9 ± 8.2 ng/ml) than overweight (23.3 ± 8.8 ng/ml; p < 0.0001) or normal-weight subjects (24.4 ± 8.9 ng/ml; p < 0.0001). They have also lower levels of both PINP and CTX. In contrast, PTH concentrations and BDM values were higher in obese individuals. When stratifying by sex, the difference in serum concentration of 25(OH)D remained significant in women, but not in men, persisted throughout the year, and was inversely correlated with BMI and waist circumference.
Conclusions
Despite lower serum 25(OH)D concentrations and higher PTH levels, obese and overweight women have higher lumbar spine and hip BMD and lower bone remodeling markers than normal weight women, suggesting that low serum 25(OH)D levels do not negatively affect bone health.
Similar content being viewed by others
References
Baskin ML, Ard J, Franklin F, et al. Prevalence of obesity in the United States. Obes Rev. 2005;6(1):5–7.
Zheng W, McLerran DF, Rolland B, et al. Association between body-mass index and risk of death in more than 1 million Asians. N Engl J Med. 2011;364(8):719–29.
Berghofer A, Pischon T, Reinhold T, et al. Obesity prevalence from a European perspective: a systematic review. BMC Public Health. 2008;8:200.
Flegal KM, Carroll MD, Kit BK, et al. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010. JAMA. 2012;307(5):491–7.
Rokholm B, Baker JL, Sorensen TIA. The leveling off the obesity epidemic since the year 1999 – a review of evidence and perspectives. Obes Rev. 2010;11(12):835–46.
Gutiérrez-Fisac JL, Guallar-Castillón P, León-Muñoz LM, et al. Prevalence of general and abdominal obesity in the adult population of Spain, 2008–2010: the ENRICA study. Obes Rev. 2012;13(4):388–92.
Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357(3):266–81.
Beydoun MA, Boueiz A, Shroff MR, et al. Associations among 25-hydroxyvitamin D, diet quality, and metabolic disturbance differ by adiposity in adults in the United States. J Clin Endocrinol Metab. 2010;95(8):3814–27.
McKenna MJ. Differences in vitamin D status between countries in young adults and the elderly. Am J Med. 1992;93(1):69–77.
Spiro A, Buttriss JL. Vitamin D: An overview of vitamin D status and intake in Europe. Nutr Bull. 2014;39(4):322–50.
Olmos JM, Hernández JL, García-Velasco P, et al. Serum 25-hydroxyvitamin D, parathyroid hormone, calcium intake, and bone mineral density in Spanish adults. Osteoporos Int. 2016;27(1):105–13.
Samuel L, Borrell LN. The effect of body mass index on optimal vitamin D status in U.S. adults: the National Health and Nutrition Examination Survey 2001-2006. Ann Epidemiol. 2013;23(7):409–14.
Saneei P, Salehi-Abargouei A, Esmaillzadeh A. Serum 25-hydroxy vitamin D levels in relation to body mass index: a systematic review and meta-analysis. Obes Rev. 2013;14(5):393–404.
Pereira-Santos M, Costa PR, Assis AM, et al. Obesity and vitamin D deficiency: a systematic review and meta-analysis. Obes Rev. 2015;16(4):341–9.
Wood RJ. Vitamin D and adipogenesis: new molecular insights. Nutr Rev. 2008;66(1):40–6.
Martini LA, Wood RJ. Vitamin D status and the metabolic syndrome. Nutr Rev. 2006;64(11):479–86.
Bolland MJ, Grey AB, Ames RW, et al. The effects of seasonal variation of 25-hydroxyvitamin D and fat mass on a diagnosis of vitamin D sufficiency. Am J Clin Nutr. 2007;86(4):959–64.
Walsh JS, Evans AL, Bowles S, et al. Free 25-hydroxyvitamin D is low in obesity, but there are no adverse associations with bone health. Am J Clin Nutr. 2016;103(6):1465–71.
Elizondo-Montemayor L, Castillo EC, Rodríguez-López C, et al. Seasonal variation in vitamin D in association with age, inflammatory cytokines, anthropometric parameters, and lifestyle factors in older adults. Mediat Inflamm. 2017;2017:5719461.
Young KA, Engelman CD, Langefeld CD, et al. Association of plasma vitamin D levels with adiposity in Hispanic and African Americans. J Clin Endocrinol Metab. 2009;94(9):3306–13.
Hernández JL, Olmos JM, Pariente E, et al. Metabolic syndrome and bone metabolism. Menopause. 2010;17(5):955–61.
Olmos JM, Hernández JL, Martínez J, et al. Bone turnover markers in Spanish adult men. The Camargo cohort study. Clin Chim Acta. 2010;411(19–20):1511–5.
Earthman CP, Beckman LM, Masodkar K, et al. The link between obesity and low circulating 25-hydroxyvitamin D concentrations: considerations and implications. Int J Obes. 2012;36(3):387–96.
Goldner WS, Stoner JA, Thompson J, et al. Prevalence of vitamin D insufficiency and deficiency in morbidly obese patients: a comparison with non-obese controls. Obes Surg. 2008;18:145–50.
McCarty MF, Thomas CA. PTH excess may promote weight gain by impeding catecholamine-induced lipolysis-implications for the impact of calcium, vitamin D, and alcohol on body weight. Med Hypotheses. 2003;61(5–6):535–42.
Kong J, Li YC. Molecular mechanism of 1,25-dihydroxyvitamin D3 inhibition of adipogenesis in 3T3-L1 cells. Am J Physiol Endocrinol Metab. 2006;290:E916–24.
Hannemann A, Thuesen BH, Friedrich N, Völzke H, Steveling A, Ittermann T, Hegenscheid K, Nauck M, Linneberg A, Wallaschofski H. Adiposity measures and vitamin D concentrations in Northeast Germany and Denmark. Nutr Metab (Lond). 2015 Jun 10; 2:24.
Vimaleswaran KS, Berry DJ, Lu C, et al. Causal relationship between obesity and vitamin D status: bi-directional Mendelian randomization analysis of multiple cohorts. PLoS Med. 2013;10(2):e1001383.
Karonova T, Belyaeva O, Jude EB, et al. Serum 25(OH)D and adipokines levels in people with abdominal obesity. J Steroid Biochem Mol Biol. 2018;175:170–6.
Hyppönen E, Power C. Hypovitaminosis D in British adults at age 45 y: nationwide cohort study of dietary and lifestyle predictors. Am J Clin Nutr. 2007;85(3):860–8.
Cheng S, Massaro JM, Fox CS, et al. Adiposity, cardiometabolic risk, and vitamin D status: the Framingham heart study. Diabetes. 2010;59(1):242–8.
Olmos JM, Vázquez LA, Amado JA, et al. Mineral metabolism in obese patients following vertical banded gastroplasty. Obes Surg. 2008;18(2):197–203.
Scott D, Sanders KM, Ebeling PR. Vitamin D, muscle function, and falls in older adults: does reduced deposition of intramuscular adipose tissue influencetherelationship? J Clin Endocrinol Metab. 2013;98(10):3968–70.
Wortsman J, Matsuoka LY, Chen TC, et al. Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr. 2000;72(3):690–3.
Funding
This study is funded by grants from the Instituto de Salud Carlos III (PI15/00521) that included FEDER funds from the EU, Ministerio de Economía y Competitividad, Spain.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Informed Consent
Informed consent was obtained from all individual participants included in the study. The study was approved by the local Ethics Committee (Comité Ético de Investigación Clínica de Cantabria-IDIVAL, Internal Code 2014.155).
Conflict of Interest
The authors declare that they have no conflicts of interest
Rights and permissions
About this article
Cite this article
Olmos, J.M., Hernández, J.L., Pariente, E. et al. Serum 25-Hydroxyvitamin D in Obese Spanish Adults: the Camargo Cohort Study. OBES SURG 28, 3862–3871 (2018). https://doi.org/10.1007/s11695-018-3430-6
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11695-018-3430-6