Volumetric Dilution, Rather Than Sequestration Best Explains the Low Vitamin D Status of Obesity
Volumetric Dilution, Rather Than Sequestration Best Explains the Low Vitamin D Status of Obesity
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DOI：
10.1038/oby.2011.404
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发表时间：
2012-07-01
期刊：
影响因子：
6.9
通讯作者：
Heaney, Robert P.
中科院分区：
文献类型：
--
作者：
Drincic, Andjela T.;Armas, Laura A. G.;Heaney, Robert P.
众所周知，肥胖者的维生素 D 状况较差；其原因尚未达成共识。对进入我们研究单位的两个研究队列的未补充成年人的基线数据中血清 25-羟基维生素 D (25(OH)D) 浓度与体型之间关系的横断面研究，N = 686。使用线性和双曲线模型对体型变量与血清 25(OH)D 浓度进行回归分析。 25(OH)D 对体重的双曲线模型的拟合完全消除了血清 25(OH)D 浓度个体间变异的肥胖相关成分。使用总体重的双曲线拟合明显优于任何线性模型，特别是优于任何使用 BMI 的模型。肥胖患者的大量脂肪中摄入或皮肤合成的维生素 D 被稀释，这充分解释了他们典型的低维生素 D 状态。没有证据表明补充或内源性胆钙化醇会被隔离。如果要达到所需的血清 25(OH)D 浓度，则需要根据体型调整维生素 D 替代疗法。
Vitamin D status is known to be poor in obese individuals; there is no consensus as to the reason. Cross-sectional study of the relation between serum 25-hydroxyvitamin D (25(OH)D) concentration and body size in the baseline data from unsupplemented adults entering two study cohorts in our research unit, N = 686. Regression analyses of body size variables against serum 25(OH)D concentration, using both linear and hyperbolic models. The fit to a hyperbolic model of 25(OH)D against body weight completely removed the obesity-related component of inter-individual variability in serum 25(OH)D concentration. The hyperbolic fit using total body weight was significantly better than any linear model, and specifically better than any using BMI. Dilution of ingested or cutaneously synthesized vitamin D in the large fat mass of obese patients fully explains their typically low vitamin D status. There is no evidence for sequestration of supplemental or endogenous cholecalciferol. Vitamin D replacement therapy needs to be adjusted for body size if desired serum 25(OH)D concentrations are to be achieved.