ارتباط وضعیت ویتامین D با عوامل متابولیکی و التهابی در بزرگسالان مبتلا به چاقی

نوع مقاله : مقاله پژوهشی

نویسندگان

1 استادیار، گروه تغذیه، دانشکده بهداشت، دانشگاه علوم‌پزشکی زابل، زابل، ایران

2 گروه آمار و اپیدمیولوژی، دانشکده بهداشت، دانشگاه علوم پزشکی زابل، زابل، ایران

چکیده

مقدمه
چاقی و کمبود ویتامینD هر دو از معضلات بهداشتی در اغلب مناطق جهان می­باشند که با افزایش خطر بروز بیماری متابولیکی ارتباط دارند. هدف از این مطالعه تعیین ارتباط وضعیت ویتامین D با نشانگرهای متابولیکی و التهابی در افراد مبتلا به چاقی بود.
روش­کار
در این مطالعه مورد-شاهدی، 90 فرد مبتلا به چاقی با کمبود ویتامین D به عنوان گروه مورد و 90 فرد مبتلا به چاقی با وضعیت کافی ویتامین D به عنوان گروه شاهد انتخاب شدند. اطلاعات دموگرافیک، تن­سنجی و غذایی در مورد هر­یک از شرکت­کنندگان جمع­آوری شد. سپس شاخص مقاومت انسولینی (HOMA-IR) و غلظت سرمی گلوکز (FBS)، انسولین، کلسترول تام (TC)، کلسترول LDL (LDL-c)، کلسترول HDL (HDL-c) و تری­گلیسرید (TG) در حالت ناشتا به عنوان نشانگرهای وضعیت متابولیکی و غلظت پروتئین واکنشگر -C با حساسیت بالا (hs-CRP) سرم به عنوان نشانگر وضعیت التهابی مورد بررسی قرار گرفتند.  
نتایج
غلظت سرمی TC (001/0 = p)، LDL-c (003/0 = p)، hs-CRP (004/0 = p)، PTH (001/0 = p)، انسولین ناشتا (020/0 = p) و HOMA-IR (010/0 = p) در گروه دارای کمبود ویتامین D بطور معنی­داری بیشتر از گروه دارای وضعیت کافی ویتامین D بود. غلظت FBS، TG و HDL-c بین دو گروه مطالعه تفاوت آماری معنی­داری نداشت. همچنین، شانس داشتن FBS بالا، هایپرکلسترلمی، LDL-c بالا و hs-CRP بالا در افراد دارای کمبود ویتامین D بیش از 2 برابر افراد با وضعیت کافی این ویتامین بود.
نتیجه ­گیری
کمبود ویتامین D با افزایش خطر بروز اختلالات متابولیکی و التهابی در افراد مبتلا به چاقی ارتباط دارد.

کلیدواژه‌ها

عنوان مقاله [English]

Association of vitamin D status with metabolic and inflammatory factors in adults with obesity

نویسندگان [English]

  • Farshad Amirkhizi 1
  • Soudabeh Hamedi-Shahraki 2
1 Assistant Professor, Department of Nutrition, School of Health, Zabol University of Medical Sciences, Zabol, Iran
2 Department of Epidemiology and Biostatistics, Faculty of Public Health, Zabol University of Medical Sciences, Zabol, Iran
چکیده [English]

Introduction: Obesity and vitamin D deficiency are both have become major public health challenges worldwide which are associated with an increased risk of metabolic diseases. The aim of this study was to investigate the association between vitamin D status with metabolic and inflammatory markers in adults with obesity.
Materials and Methods: In this case-control study, 90 obese subjects with vitamin D deficiency were selected as the case group and 90 obese subjects with adequate vitamin D status were selected as the control group. Demographic, anthropometric, and dietary data were collected for each participant. Then, the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and fasting serum concentrations of glucose (FBS), insulin, total cholesterol (TC), low-density lipoprotein (LDL-c), high-density lipoprotein (HDL-c) and triglyceride (TG) as metabolic factors and serum levels of high-sensitivity C-reactive protein (hs-CRP) as inflammatory marker were measured in the participants.  
Results: The obese subjects with vitamin D deficiency had higher serum concentrations of TC (p=0.001), LDL-C (p=0.003), hs-CRP (p=0.004), parathyroid hormone (p=0.001), and HOMA-IR (p=0.020) compared to the counterparts in the vitamin D sufficiency group. Likewise, vitamin D deficient subjects were at higher risk for having hypercholesrolemia (OR: 2.7, p=0.012), high LDL-c (OR: 2.34, p=0.017), and high hs-CRP (OR: 1.97, p=0.032) than vitamin D sufficient subjects, after controlling for confounders.
Conclusion: vitamin D deficiency in obese subjects was found to be strongly related to higher risk of metabolic and inflammatory disorders.

کلیدواژه‌ها [English]

  • Vitamin D
  • Obesity
  • metabolic disorders
  • inflammation

مراجع

  1. Chooi YC, Ding C, Magkos F. The epidemiology of obesity. Metabolism 2019;92:6–10.
    2. Djalalinia S, Saeedi Moghaddam S, Sheidaei A, Rezaei N, Naghibi Iravani SS, Modirian M, et al. Patterns of Obesity
    and Overweight in the Iranian Population: Findings of STEPs 2016. Front Endocrinol (Lausanne) 2020;11:42.
    3. Pardo F, Villalobos-Labra R, Sobrevia B, Toledo F, Sobrevia L. Extracellular vesicles in obesity and diabetes mellitus.
    Mol Aspects Med 2018;60:81–91.
    4. Haeusler RA. On the Front Line: Obesity and NAFLD. Cell Metab 2020;31.
    5. Adair T, Lopez AD. The role of overweight and obesity in adverse cardiovascular disease mortality trends: an analysis
    of multiple cause of death data from Australia and the USA. BMC Med 2020;18(1):1–11.
    6. Avgerinos KI, Spyrou N, Mantzoros CS, Dalamaga M. Obesity and cancer risk: Emerging biological mechanisms and
    perspectives. Metabolism 2019;92:121–35.
  2. 7. Vekic J, Zeljkovic A, Stefanovic A, Jelic-Ivanovic Z, Spasojevic-Kalimanovska V. Obesity and dyslipidemia.
    Metabolism 2019;92:71–81.
    8. Xia JY, Lloyd-Jones DM, Khan SS. Association of body mass index with mortality in cardiovascular disease: New
    insights into the obesity paradox from multiple perspectives. Trends Cardiovasc Med 2019;29(4):220–225.
    9. Moszak M, Szulińska M, Bogdański P. You are what you eat—The relationship between diet, microbiota, and
    metabolic disorders—A review. Nutrients. 2020;12(4):1096.
    10. Amrein K, Scherkl M, Hoffmann M, Neuwersch-Sommeregger S, Köstenberger M, Berisha AT, et al. Vitamin
    D deficiency 2.0: an update on the current status worldwide. Eur J Clin Nutr 2020;74(11):1498–513.
    11. LeBoff MS, Chou SH, Murata EM, Donlon CM, Cook NR, Mora S, et al. Effects of supplemental vitamin D on
    bone health outcomes in women and men in the VITamin D and OmegA‐3 triaL (VITAL). J Bone Miner Res
    2020;35(5):883–93.
    12. Gouni-Berthold I, Berthold HK. Vitamin D and vascular disease. Curr Vasc Pharmacol. 2020;7(3):414-422.
    13. Gil A, Plaza-Diaz J, Mesa MD. Vitamin D: classic and novel actions. Ann Nutr Metab 2018;72(2):87–95.
    14. Neelankal John A, Jiang F-X. An overview of type 2 diabetes and importance of vitamin D3-vitamin D receptor
    interaction in pancreatic β-cells. J Diabetes Complications 2018;32(4):429–43.
    15. Migliaccio S, Di Nisio A, Mele C, Scappaticcio L, Savastano S, Colao A. Obesity and hypovitaminosis D:
    causality or casualty? Int J Obes Suppl 2019;9(1):20–31.
    16. Hossain MJ, Levinson A, George D, Canas J, Kumar S, Balagopal PB. Vitamin D status and cardiovascular risk
    in obesity: effect of physical activity in nonvitamin D supplemented adolescents. Metab Syndr Relat Disord
    2018;16(4):197–203.
    17. Stokić E, Kupusinac A, Tomić-Naglić D, Zavišić BK, Mitrović M, Smiljenić D, et al. Obesity and vitamin D
    deficiency: trends to promote a more proatherogenic cardiometabolic risk profile. Angiology 2015 Mar;66(3):237–
    43.
    18. Mitri J, Pittas AG. Vitamin D and diabetes. Endocrinol Metab Clin North Am 2014;43(1):205–32.
    19. Alagacone S, Verga E, Verdolini R, Saifullah SM. The association between vitamin D deficiency and the risk
    of resistant hypertension. Clin Exp Hypertens 2020;42(2):177–80.
    20. Sacerdote A, Dave P, Lokshin V, Bahtiyar G. Type 2 Diabetes Mellitus, Insulin Resistance, and Vitamin D. Curr
    Diab Rep 2019;19(10):101.
    21. Faridi KF, Lupton JR, Martin SS, Banach M, Quispe R, Kulkarni K, et al. Vitamin D deficiency and non-lipid
    biomarkers of cardiovascular risk. Arch Med Sci 2017;13(4):732–737.
    22. Jin D, Zhu D-M, Hu H-L, Yao M-N, Yin W-J, Tao R-X, et al. Vitamin D status affects the relationship between
    lipid profile and high-sensitivity C-reactive protein. Nutr Metab (Lond) [Internet]. 2020;17(1):57. Available from:
    https://doi.org/10.1186/s12986-020-00455-x
    23. Rusconi RE, De Cosmi V, Gianluca G, Giavoli C, Agostoni C. Vitamin D insufficiency in obese children and
    relation with lipid profile. Int J Food Sci Nutr 2015;66(2):132–134.
    24. Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical
    activity questionnaire: 12-country reliability and validity. Med Sci Sport Exerc 2003;35(8):1381–1395.
    25. Moghaddam MHB, Aghdam FB, Jafarabadi MA, Allahverdipour H, Nikookheslat SD, Safarpour S. The Iranian
    Version of International Physical Activity Questionnaire (IPAQ) in Iran: content and construct validity, factor
    structure, internal consistency and stability. World Appl Sci 2012;18(8):1073–1080.
    26. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the Concentration of Low-Density Lipoprotein
    Cholesterol in Plasma, Without Use of the Preparative Ultracentrifuge. Clin Chem. 1972;18(6):499 LP – 502.
    27. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment:
    insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia
    1985;28(7):412–419.
    28. Organization WH. The Asia-Pacific perspective: redefining obesity and its treatment. 2000;
    29. Expert Panel on Detection E. Executive summary of the third report of the National Cholesterol Education
    Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult
    Treatment Panel III). JAMA 2001;285(19):2486.
    30. Pearson TA, Mensah GA, Alexander RW, Anderson JL, Cannon RO 3rd, Criqui M, et al. Markers of
    inflammation and cardiovascular disease: application to clinical and public health practice: A statement for healthcare
    professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation
    2003;107(3):499–511.
    31. Aoun A, Maalouf J, Fahed M, El Jabbour F. When and how to diagnose and treat vitamin D deficiency in adults:
    a practical and clinical update. J Diet Suppl 2020;17(3):336–354.
    32. Dawson-Hughes B, Heaney RP, Holick MF, Lips P, Meunier PJ, Vieth R. Estimates of optimal vitamin D status.
    Osteoporos Int 2005;16(7):713–716. 
  3. 33. Bonadonna RC, Leif G, Kraemer N, Ferrannini E, Del Prato S, DeFronzo RA. Obesity and insulin resistance in
    humans: a dose-response study. Metabolism 1990;39(5):452–459.
    34. Kahn SE, Hull RL, Utzschneider KM. Mechanisms linking obesity to insulin resistance and type 2 diabetes.
    Nature 2006;444(7121):840–846.
    35. Dutta D, Maisnam I, Shrivastava A, Sinha A, Ghosh S, Mukhopadhyay P, et al. Serum vitamin-D predicts insulin
    resistance in individuals with prediabetes. Indian J Med Res 2013;138(6):853–860.
    36. Maghbooli Z, Hossein‐nezhad A, Karimi F, Shafaei A, Larijani B. Correlation between vitamin D3 deficiency
    and insulin resistance in pregnancy. Diabetes Metab Res Rev 2008;24(1):27–32.
    37. Delvin EE, Lambert M, Levy E, O’Loughlin J, Mark S, Gray-Donald K, et al. Vitamin D status is modestly
    associated with glycemia and indicators of lipid metabolism in French-Canadian children and adolescents. J Nutr
    2010;140(5):987–991.
    38. De Las Heras J, Rajakumar K, Lee S, Bacha F, Holick MF, Arslanian SA. 25-Hydroxyvitamin D in obese youth
    across the spectrum of glucose tolerance from normal to prediabetes to type 2 diabetes. Diabetes Care
    2013;36(7):2048–2053.
    39. Kamycheva E, Jorde R, Figenschau Y, Haug E. Insulin sensitivity in subjects with secondary
    hyperparathyroidism and the effect of a low serum 25-hydroxyvitamin D level on insulin sensitivity. J Endocrinol
    Invest 2007;30(2):126–132.
    40. CADE C, NORMAN AW. Vitamin D3 improves impaired glucose tolerance and insulin secretion in the vitamin
    D-deficient rat in vivo. Endocrinology 1986;119(1):84–90.
    41. Bourlon PM, Faure-Dussert A, Billaudel B. The de novo synthesis of numerous proteins is decreased during
    vitamin D3 deficiency and is gradually restored by 1, 25-dihydroxyvitamin D3 repletion in the islets of langerhans of
    rats. J Endocrinol 1999;162(1):101–109.
    42. Shiuchi T, Iwai M, Li H-S, Wu L, Min L-J, Li J-M, et al. Angiotensin II type-1 receptor blocker valsartan
    enhances insulin sensitivity in skeletal muscles of diabetic mice. Hypertension 2004;43(5):1003–1010.
    43. Chiu KC, Chu A, Go VLW, Saad MF. Hypovitaminosis D is associated with insulin resistance and β cell
    dysfunction. Am J Clin Nutr 2004;79(5):820–825.
    44. Knekt P, Laaksonen M, Mattila C, Härkänen T, Marniemi J, Heliövaara M, et al. Serum vitamin D and
    subsequent occurrence of type 2 diabetes. Epidemiology 2008;666–671.
    45. Mitri J, Muraru MD, Pittas AG. Vitamin D and type 2 diabetes: a systematic review. Eur J Clin Nutr
    2011;65(9):1005–1015.
    46. Censani M, Hammad HT, Christos PJ, Schumaker T. Vitamin D Deficiency Associated With Markers of
    Cardiovascular Disease in Children With Obesity. Glob Pediatr Heal 2018;5:2333794X17751773.
    47. Kelishadi R, Farajzadegan Z, Bahreynian M. Association between vitamin D status and lipid profile in children
    and adolescents: a systematic review and meta-analysis. Int J Food Sci Nutr 2014;65(4):404–410.
    48. Ashraf AP, Alvarez JA, Gower BA, Saenz KH, McCormick KL. Associations of serum 25‐hydroxyvitamin D
    and components of the metabolic syndrome in obese adolescent females. Obesity 2011;19(11):2214–2221.
    49. Zemel MB, Shi H, Greer B, Dirienzo D, Zemel PC. Regulation of adiposity by dietary calcium. FASEB J
    2000;14(9):1132–1138.
    50. Hintzpeter B, Mensink GBM, Thierfelder W, Müller MJ, Scheidt-Nave C. Vitamin D status and health correlates
    among German adults. Eur J Clin Nutr 2008;62(9):1079–1089.
    51. Jorde R, Figenschau Y, Emaus N, Hutchinson M, Grimnes G. Serum 25-hydroxyvitamin D levels are strongly
    related to systolic blood pressure but do not predict future hypertension Hypertension. 2010;55(3):792–798.
    52. Murr C, Pilz S, Grammer TB, Kleber ME, Meinitzer A, Boehm BO, et al. Vitamin D deficiency parallels
    inflammation and immune activation, the Ludwigshafen Risk and Cardiovascular Health (LURIC) study. Clin Chem
    Lab Med 2012;50(12):2205–2212.
    53. Zupo R, Castellana F, Sardone R, Lampignano L, Di Noia C, Savastano S, et al. Hydroxyvitamin d serum levels are
    negatively associated with platelet number in a cohort of subjects affected by overweight and obesity. Nutrients
    2020;12:474-483.
    54. Silvagno F, De Vivo E., Attanasio A, Gallo V, Mazzucco G, Pescarmona G. Mitochondrial localization of vitamin
    D receptor in human platelets and dierentiated megakaryocytes. PLoS ONE 2010;5: e8670.
  4.  
مجله دانشکده پزشکی دانشگاه علوم پزشکی مشهد
دوره 64، شماره 3
مرداد و شهریور 1400
صفحه 3118-3130

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