Document Type : Original Articles

Authors

1 School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, IR Iran

2 Epidemiology Department, School of Health, Shiraz University of Medical Sciences, Shiraz, IR Iran

Abstract

Background:Serum vitamin D (VIT D) concentration has been inversely associated with the prevalence of metabolic syndrome (MS), but the relationship has remained unclear. We evaluated the prevalence of VIT D deficiency, and its association with MS, and its components in the adult population in a sunny tropical region (Lamerd: a city in the south of Iran)Patients and Methods: Totally, 210 patients referring to different medical centers across the Lamerd city participated in this cross-sectional study through January and February of 2016. To select medical service center, we used a one-stage cluster sampling method. Anthropometric indices and dietary intake were measured using modified food frequency questionnaire (FFQ) and blood samples collected. Data were analyzed using SPPS version 16, Pearson’s correlation was used to investigate the bivariate relationships between the variables, and unpaired t-test was used to determine the differences between genders for all variables. A P-value < 0.05 was considered statistically sig­nificant.Results:Overall, 62 menand 144 womenwith a mean age of 35.84± 10.84 years old completed this study; the prevalence of VIT D deficiency among the participants equaled 64.1% (women=66.7% and men=58.1%). A significant positive relationship between sun exposure time on the serum VIT (p= <0.0015), and a negative relationship between the serum VIT D on triglyceride (p= 0.035), TC (p= 0.025, age (p= 0.001), and fasting blood sugar (p= <0.001) were found.Conclusions: This study showed that lower VIT D concentrations were associated with increased MS risk factors. 

Keywords

  1. Moy F-M, Bulgiba A. High prevalence of vitamin D insufficiency and its association with obesity and metabolic syndrome among Malay adults in Kuala Lumpur, Malaysia. BMC public health. 2011;11(1):1.
  2. Holick MF. Vitamin D deficiency. New England Journal of Medicine. 2007;357(3):266-81.
  3. Wang TJ, Pencina MJ, Booth SL, Jacques PF, Ingelsson E, Lanier K, et al. Vitamin D deficiency and risk of cardiovascular disease. Circulation. 2008;117(4):503-11.
  4. Misra M, Pacaud D, Petryk A, Collett-Solberg PF, Kappy M. Vitamin D deficiency in children and its management: review of current knowledge and recommendations. Pediatrics. 2008;122(2):398-417.
  5. Ford ES, Ajani UA, McGuire LC, Liu S. Concentrations of serum vitamin D and the metabolic syndrome among US adults. Diabetes care. 2005;28(5):1228-30.
  6. Liu S, Song Y, Ford ES, Manson JE, Buring JE, Ridker PM. Dietary calcium, vitamin D, and the prevalence of metabolic syndrome in middle-aged and older US women. Diabetes care. 2005;28(12):2926-32.
  7. Heshmat R, Mohammad K, Majdzadeh S, Forouzanfar M, Bahrami A, Ranjbar Omrani G. Vitamin D deficiency in Iran: A multi-center study among different urban areas. Iran J Public Health. 2008;37(suppl).
  8. Seida JC, Mitri J, Colmers IN, Majumdar SR, Davidson MB, Edwards AL, et al. Effect of vitamin D3 supplementation on improving glucose homeostasis and preventing diabetes: a systematic review and meta-analysis. The Journal of Clinical Endocrinology & Metabolism. 2014;99(10):3551-60.
  9. Hjelmesæth J, Hofsø D, Aasheim ET, Jenssen T, Moan J, Hager H, et al. Parathyroid hormone, but not vitamin D, is associated with the metabolic syndrome in morbidly obese women and men: a cross-sectional study. Cardiovascular diabetology. 2009;8(1):1.
  10. Gordon CM, DePeter KC, Feldman HA, Grace E, Emans SJ. Prevalence of vitamin D deficiency among healthy adolescents. Archives of pediatrics & adolescent medicine. 2004;158(6):531-7.
  11. Parker J, Hashmi O, Dutton D, Mavrodaris A, Stranges S, Kandala N-B, et al. Levels of vitamin D and cardiometabolic disorders: systematic review and meta-analysis. Maturitas. 2010;65(3):225-36.
  12. Talaei A, Mohamadi M, Adgi Z. The effect of vitamin D on insulin resistance in patients with type 2 diabetes. Diabetology & metabolic syndrome. 2013;5(1):1.
  13. Matsuoka LY, Wortsman J, Dannenberg MJ, Hollis BW, Lu Z, Holick MF. Clothing prevents ultraviolet-B radiation-dependent photosynthesis of vitamin D3. The Journal of Clinical Endocrinology & Metabolism. 1992;75(4):1099-103.
  14. Lehmann B. The vitamin D3 pathway in human skin and its role for regulation of biological processes. Photochemistry and photobiology. 2005;81(6):1246-51.
  15. Martini LA, Wood RJ. Vitamin D status and the metabolic syndrome. Nutrition reviews. 2006;64(11):479-86.
  16. Forrest KY, Stuhldreher WL. Prevalence and correlates of vitamin D deficiency in US adults. Nutrition research. 2011;31(1):48-54.
  17. Azizi F, Salehi P, Etemadi A, Zahedi-Asl S. Prevalence of metabolic syndrome in an urban population: Tehran Lipid and Glucose Study. Diabetes research and clinical practice. 2003;61(1):29-37.
  18. Hanwell H, Vieth R, Cole D, Scillitani A, Modoni S, Frusciante V, et al. Sun exposure questionnaire predicts circulating 25-hydroxyvitamin D concentrations in Caucasian hospital workers in southern Italy. The Journal of steroid biochemistry and molecular biology. 2010;121(1):334-7.
  19. Booth M. Assessment of physical activity: an international perspective. Research quarterly for exercise and sport. 2000;71(sup2):114-20.
  20. Hosseini-Esfahani F, Jessri M, Mirmiran P, Bastan S, Azizi F. Adherence to dietary recommendations and risk of metabolic syndrome: Tehran Lipid and Glucose Study. Metabolism. 2010;59(12):1833-42.
  21. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism. 2011;96(7):1911-30.
  22. Bea JW, Jurutka PW, Hibler EA, Lance P, Martinez ME, Roe DJ, et al. Concentrations of the vitamin D metabolite 1, 25 (OH) 2 D and odds of metabolic syndrome and its components. Metabolism. 2015;64(3):447-59.
  23. Mathieu C, Gysemans C, Giulietti A, Bouillon R. Vitamin D and diabetes. Diabetologia. 2005;48(7):1247-57.
  24. Pannu PK, Zhao Y, Soares MJ, Piers LS, Ansari Z. The associations of vitamin D status and dietary calcium with the metabolic syndrome: an analysis of the Victorian Health Monitor survey. Public health nutrition. 2016:1-12.
  25. Kim J. Association between serum vitamin D, parathyroid hormone and metabolic syndrome in middle-aged and older Korean adults. European journal of clinical nutrition. 2015;69(4):425-30.
  26. Huang C-Y, Chang H-H, Lu C-W, Tseng F-Y, Lee L-T, Huang K-C. Vitamin D status and risk of metabolic syndrome among non-diabetic young adults. Clinical Nutrition. 2015;34(3):484-9.
  27. Sugden J, Davies J, Witham M, Morris A, Struthers A. Vitamin D improves endothelial function in patients with Type 2 diabetes mellitus and low vitamin D levels. Diabetic medicine. 2008;25(3):320-5.
  28. Pittas AG, Harris SS, Stark PC, Dawson-Hughes B. The effects of calcium and vitamin D supplementation on blood glucose and markers of inflammation in nondiabetic adults. Diabetes care. 2007;30(4):980-6.
  29. Ju SY, Jeong HS, Kim DH. Blood vitamin D status and metabolic syndrome in the general adult population: a dose-response meta-analysis. The Journal of Clinical Endocrinology & Metabolism. 2013;99(3):1053-63.
  30. Soerensen KV, Thorning TK, Astrup A, Kristensen M, Lorenzen JK. Effect of dairy calcium from cheese and milk on fecal fat excretion, blood lipids, and appetite in young men. The American journal of clinical nutrition. 2014;99(5):984-91.
  31. Perez-Lopez FR. Vitamin D metabolism and cardiovascular risk factors in postmenopausal women. Maturitas. 2009;62(3):248-62.
  32. Schmitt EB, Nahas-Neto J, Bueloni-Dias F, Poloni PF, Orsatti CL, Nahas EAP. Vitamin D deficiency is associated with metabolic syndrome in postmenopausal women. Maturitas. 2018;107:97-102.
  33. Hossein-Nezhad A, Khoshniat N, Maghbooli M, Karimi Z, Mirzaei F, Hosseini A, et al. Relationship between serum vitamin D concentration and metabolic syndrome among Iranian adults population. DARU Journal of Pharmaceutical Sciences. 2015 (1):1-5.
  34. Lips P. Vitamin D status and nutrition in Europe and Asia. The Journal of steroid biochemistry and molecular biology. 2007;103(3):620-5.
  35. Hollis BW. Circulating 25-hydroxyvitamin D levels indicative of vitamin D sufficiency: implications for establishing a new effective dietary intake recommendation for vitamin D. The Journal of nutrition. 2005;135(2):317-22.
  36. Pittas AG, Dawson-Hughes B, Li T, Van Dam RM, Willett WC, Manson JE, et al. Vitamin D and calcium intake in relation to type 2 diabetes in women. Diabetes care. 2006;29(3):650-6.
  37. McGill A-T, Stewart JM, Lithander FE, Strik CM, Poppitt SD. Relationships of low serum vitamin D 3 with anthropometry and markers of the metabolic syndrome and diabetes in overweight and obesity. Nutrition journal. 2008;7(1):1.
  38. Botella-Carretero JI, Alvarez-Blasco F, Villafruela JJ, Balsa JA, Vazquez C, Escobar-Morreale HF. Vitamin D deficiency is associated with the metabolic syndrome in morbid obesity. Clinical Nutrition. 2007;26(5):573-80.
  39. Du X, Greenfield H, Fraser DR, Ge K, Trube A, Wang Y. Vitamin D deficiency and associated factors in adolescent girls in Beijing. The American journal of clinical nutrition. 2001;74(4):494-500.
  40. Hashemipour S, Larijani B, Adibi H, Javadi E, Sedaghat M, Pajouhi M, et al. Vitamin D deficiency and causative factors in the population of Tehran. BMC public health. 2004;4(1):1.
  41. Gagnon C, Lu ZX, Magliano DJ, Dunstan DW, Shaw JE, Zimmet PZ, et al. Low serum 25-hydroxyvitamin D is associated with increased risk of the development of the metabolic syndrome at five years: results from a national, population-based prospective study (The Australian Diabetes, Obesity and Lifestyle Study: AusDiab). The Journal of Clinical Endocrinology & Metabolism. 2012;97(6):1953-61.
  42. Hatun S, Islam Ö, Cizmecioglu F, Kara B, Babaoglu K, Berk F, et al. Subclinical vitamin D deficiency is increased in adolescent girls who wear concealing clothing. The Journal of nutrition. 2005;135(2):218-22.
  43. Holick MF. Environmental factors that influence the cutaneous production of vitamin D. The American journal of clinical nutrition. 1995;61(3):638S-45S.
  44. Ross AC, Manson JE, Abrams SA, Aloia JF, Brannon PM, Clinton SK, et al. The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. The Journal of Clinical Endocrinology & Metabolism. 2011;96(1):53-8.
  45. Moore C, Murphy MM, Keast DR, Holick MF. Vitamin D intake in the United States. Journal of the American Dietetic Association. 2004;104(6):980-3.