Adiposity, cardiometabolic risk, and vitamin D status: the Framingham Heart Study.
Adiposity, cardiometabolic risk, and vitamin D status: the Framingham Heart Study.
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作者：
Cheng S;Massaro JM;Fox CS;Larson MG;Keyes MJ;McCabe EL;Robins SJ;O'Donnell CJ;Hoffmann U;Jacques PF;Booth SL;Vasan RS;Wolf M;Wang TJ
由于维生素D缺乏症与各种慢性疾病有关，因此了解促进健康成人维生素D缺乏症的特征可能具有重要的临床意义。很少有关于维生素D缺乏与肥胖的研究包括肥胖的直接测量。此外，维生素D在调整肥胖指标后与代谢性状的相关程度尚不清楚。我们调查了3，890名非糖尿病个体血清25-羟基维生素D（25[OH]D）浓度与心脏代谢风险指数的关系;其中1，882人通过多探测器计算机断层扫描（CT）测量了皮下脂肪组织（SAT）和内脏脂肪组织（VAT）体积。在多变量校正回归模型中，25（OH）D与冬季、腰围和血清胰岛素呈负相关（均P < 0.005）。在进一步校正CT测量的模型中，25（OH）D与SAT（SAT中每SD增量为-1.1 ng/ml，P = 0.016）和VAT（每SD为-2.3 ng/ml，P < 0.0001）呈负相关。调整VAT后，25（OH）D与胰岛素抵抗指标的相关性变得不显著。在不同的BMI类别中，较高的肥胖体积与较低的25（OH）D相关，包括瘦个体（BMI <25 kg/m2）。高SAT和高VAT组维生素D缺乏（25[OH]D <20 ng/ml）的患病率是低SAT和低VAT组的3倍（P < 0.0001）。维生素D状况与皮下脂肪，特别是内脏脂肪的变化密切相关。肥胖促进维生素D缺乏的机制值得进一步研究。
Because vitamin D deficiency is associated with a variety of chronic diseases, understanding the characteristics that promote vitamin D deficiency in otherwise healthy adults could have important clinical implications. Few studies relating vitamin D deficiency to obesity have included direct measures of adiposity. Furthermore, the degree to which vitamin D is associated with metabolic traits after adjusting for adiposity measures is unclear. We investigated the relations of serum 25-hydroxyvitamin D (25[OH]D) concentrations with indexes of cardiometabolic risk in 3,890 nondiabetic individuals; 1,882 had subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) volumes measured by multidetector computed tomography (CT). In multivariable-adjusted regression models, 25(OH)D was inversely associated with winter season, waist circumference, and serum insulin (P < 0.005 for all). In models further adjusted for CT measures, 25(OH)D was inversely related to SAT (−1.1 ng/ml per SD increment in SAT, P = 0.016) and VAT (−2.3 ng/ml per SD, P < 0.0001). The association of 25(OH)D with insulin resistance measures became nonsignificant after adjustment for VAT. Higher adiposity volumes were correlated with lower 25(OH)D across different categories of BMI, including in lean individuals (BMI <25 kg/m2). The prevalence of vitamin D deficiency (25[OH]D <20 ng/ml) was threefold higher in those with high SAT and high VAT than in those with low SAT and low VAT (P < 0.0001). Vitamin D status is strongly associated with variation in subcutaneous and especially visceral adiposity. The mechanisms by which adiposity promotes vitamin D deficiency warrant further study.