Research Article
BibTex RIS Cite

Assessment of vitamin D deficiency and hyperparathyroidism in metabolically healthy and unhealthy obese patients

Year 2023, Volume: 6 Issue: 5, 968 - 973, 28.09.2023
https://doi.org/10.32322/jhsm.1331970

Abstract

Aims: This study aimed to compare the levels of vitamin D in metabolically healthy (MHO) and metabolically unhealthy obese (MUO) individuals and determine if there are differences between these two groups concerning vitamin D deficiency and hyperparathyroidism.
Methods: A total of 263 obese female patients were included in the study and divided into two groups based on metabolic syndrome diagnostic criteria. Biochemical and anthropometric data obtained after a 12-hour fasting period were analyzed.
Results: Among the patients, the average 25-OH vitamin D level was 10.9±6.5 ng/ml. A total of 242 patients (92%) had vitamin D deficiency, and 132 patients (50.2%) were diagnosed with hyperparathyroidism. Significant differences were found in vitamin D (p=0.003) and uric acid (p<0.001) levels between the MHO and MUO groups. Additionally, the groups with vitamin D deficiency showed significantly different glucose (p=0.026) and homeostatic model assessment for insulin resistance (p=0.042) values. Patients with hyperparathyroidism had higher waist circumference (p<0.001), waist-to-hip ratio (p=0.018), BMI (p=0.006), and systolic (p=0.001) and diastolic (p<0.001) blood pressure values compared to those with normal parathyroid hormone levels.
Conclusion: The study emphasizes the importance of monitoring vitamin D deficiency and hyperparathyroidism in obese patients, as these conditions are more prevalent in this population and might be associated with metabolic syndrome parameters, increasing cardiometabolic risk.

References

  • The GBD 2015 Obesity Collaborators. Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med . 2017;377(1):13-27.
  • Stival C, Lugo A, Odone A, et al. Prevalence and correlates of overweight and obesity in 12 European Countries in 2017–2018. Obes Facts. 2022;15(5):655-665.
  • Magkos F. Metabolically healthy obesity: what–s in a name? Am J Clin Nutr. 2019;110(3):533-539. doi:https://doi.org/10.1093/ajcn/nqz133
  • Smith GI, Mittendorfer B, Klein S. Metabolically healthy obesity: facts and fantasies. J Clin Invest. 2019;129(10):3978-3989.
  • Szymczak-Pajor I, Śliwińska A. Analysis of association between vitamin D deficiency and insulin resistance. Nutrients. 2019;11(4):794.
  • Doğan M, Doğan AG, Hastanesi A, et al. Vitamin D yetersizliği ve eksikliğine güncel yaklaşım. J Health Sci Med. 2019;2(2):58-61. doi:10.32322/JHSM.496326
  • Vranić L, Mikolašević I, Milić S. Vitamin D deficiency: consequence or cause of obesity? Medicina (B Aires). 2019;55(9):541.
  • Karampela I, Sakelliou A, Vallianou N, Christodoulatos GS, Magkos F, Dalamaga M. Vitamin D and obesity: current evidence and controversies. Curr Obes Rep. 2021;10(2):162-180. doi:10.1007/S13679-021-00433-1/FIGURES/1
  • Trimarco V, Manzi MV, Mancusi C, et al. Insulin resistance and vitamin D deficiency: a link beyond the appearances. Front Cardiovasc Med. 2022;9:859793.
  • Şabanoğlu C, İnanç İH. The relationship between vitamin D deficiency and hypertensive organ damage. J Health Sci Med. 2022;5(6):1704-1712. doi:10.32322/jhsm.1173794
  • Ford ES, Zhao G, Li C, Pearson WS. Serum concentrations of vitamin D and parathyroid hormone and prevalent metabolic syndrome among adults in the United States. J Diabetes. 2009;1(4):296-303. doi:10.1111/J.1753-0407.2009.00046.X
  • Grethen E, McClintock R, Gupta CE, et al. Vitamin D and hyperparathyroidism in obesity. J Clin Endocrinol Metab. 2011;96(5):1320-1326.
  • Andersen T, McNair P, Hyldstrup L, et al. Secondary hyperparathyroidism of morbid obesity regresses during weight reduction. Metabolism. 1988;37(5):425-428.
  • Grundy SM, Cleeman JI, Merz CNB, et al. Implications of recent clinical trials for the national cholesterol education program adult treatment panel III guidelines. Circulation. 2004;110(2):227-239.
  • Türkiye Endokrinoloji ve Metabolizma Derneği Obezite Lipid Metabolizmasi Hipertansiyon Çalişma Grubu. TEMD Obezite Tanı ve Tedavi Kılavuzu 2019. TEMD; 2019.
  • Cigerli O, Parildar H, Unal AD, Tarcin O, Erdal R, Guvener Demirag N. Vitamin D deficiency is a problem for adult out-patients? A university hospital sample in Istanbul, Turkey. Public Health Nutr. 2013;16(7):1306-1313. doi:10.1017/S1368980012003588
  • Cinar N, Harmanci A, Yildiz BO, Bayraktar M. Vitamin D status and seasonal changes in plasma concentrations of 25-hydroxyvitamin D in office workers in Ankara, Turkey. Eur J Intern Med. 2014;25(2):197-201. doi:10.1016/J.EJIM.2013.11.004
  • Göktaş O, Ersoy C, Ercan I, Can FE. Vitamin D status in the adult population of Bursa-Turkey. Eur J Gen Pract. 2020;26(1):156-162. doi:10.1080/13814788.2020.1846712
  • Walsh JS, Bowles S, Evans AL. Vitamin D in obesity. Curr Opin Endocrinol Diabetes Obes. 2017;24(6):389-394. doi:10.1097/MED.0000000000000371
  • Pourshahidi LK. Vitamin D and obesity: current perspectives and future directions. Proc Nutr Soc. 2015;74(2):115-124. doi:10.1017/S0029665114001578
  • Osmancevic A, Gillstedt M, Landin-Wilhelmsen K, et al. Size of the exposed body surface area, skin erythema and body mass index predict skin production of vitamin D. J Photochem Photobiol B . 2015;149:224-229.
  • Bell N, Epstein S, Greene A, Shary J, Oexmann MJ, Shaw S. Evidence for alteration of the vitamin D-endocrine system in obese subjects. Am Soc Clin Investig. 1985:370-373.
  • Schmitt EB, Nahas-Neto J, Bueloni-Dias F, Poloni PF, Orsatti CL, Petri Nahas EA. Vitamin D deficiency is associated with metabolic syndrome in postmenopausal women. Maturitas. 2018;107:97-102. doi:10.1016/j.maturitas.2017.10.011
  • Botella-Carretero JI, Alvarez-Blasco F, Villafruela JJ, Balsa JA, Vázquez C, Escobar-Morreale HF. Vitamin D deficiency is associated with the metabolic syndrome in morbid obesity. Clin Nutr. 2007;26(5):573-580. doi:10.1016/J.CLNU.2007.05.009
  • Lee SJ, Lee EY, Lee JH, et al. Associations of serum 25-hydroxyvitamin D with metabolic syndrome and its components in elderly men and women: The Korean Urban Rural Elderly cohort study. BMC Geriatr. 2019;19(1):1-8. doi:10.1186/S12877-019-1118-Y/TABLES/5
  • Zhu W, Heil DP. Associations of vitamin D status with markers of metabolic health: a community-based study in Shanghai, China. Diabetes Metab Syndr. 2018;12(5):727-732. doi:10.1016/J.DSX.2018.04.010
  • Kamycheva E, Sundsfjord J, Jorde R. Serum parathyroid hormone level is associated with body mass index. The 5th Tromso study. Eur J Endocrinol. 2004;151(2):167-172. doi:10.1530/eje.0.1510167
  • Bolland MJ, Grey AB, Ames RW, Horne AM, Gamble GD, Reid IR. Fat mass is an important predictor of parathyroid hormone levels in postmenopausal women. Bone. 2006;38(3):317-321. doi:10.1016/j.bone.2005.08.018
  • Pitroda AP, Harris SS, Dawson-Hughes B. The association of adiposity with parathyroid hormone in healthy older adults. Endocrine. 2009;36(2):218-223. doi:10.1007/S12020-009-9231-X/TABLES/4
  • Stein EM, Strain G, Sinha N, et al. Vitamin D insufficiency prior to bariatric surgery: risk factors and a pilot treatment study. Clin Endocrinol (Oxf). 2009;71(2):176-183. doi:10.1111/J.1365-2265.2008.03470.X
  • Fish E, Beverstein G, Olson D, Reinhardt S, Garren M, Gould J. Vitamin D status of morbidly obese bariatric surgery patients. J Surg Res. 2010;164(2):198-202. doi:10.1016/J.JSS.2010.06.029
  • Salazar DA, Ferreira MJS, Neves JS, et al. Variable Thresholds of Vitamin D Plasma Levels to Suppress PTH: the Effect of Weight and Bariatric Surgery. Obes Surg. 2020;30(4):1551-1559. doi:10.1007/S11695-019-04351-Z/TABLES/7
Year 2023, Volume: 6 Issue: 5, 968 - 973, 28.09.2023
https://doi.org/10.32322/jhsm.1331970

Abstract

References

  • The GBD 2015 Obesity Collaborators. Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med . 2017;377(1):13-27.
  • Stival C, Lugo A, Odone A, et al. Prevalence and correlates of overweight and obesity in 12 European Countries in 2017–2018. Obes Facts. 2022;15(5):655-665.
  • Magkos F. Metabolically healthy obesity: what–s in a name? Am J Clin Nutr. 2019;110(3):533-539. doi:https://doi.org/10.1093/ajcn/nqz133
  • Smith GI, Mittendorfer B, Klein S. Metabolically healthy obesity: facts and fantasies. J Clin Invest. 2019;129(10):3978-3989.
  • Szymczak-Pajor I, Śliwińska A. Analysis of association between vitamin D deficiency and insulin resistance. Nutrients. 2019;11(4):794.
  • Doğan M, Doğan AG, Hastanesi A, et al. Vitamin D yetersizliği ve eksikliğine güncel yaklaşım. J Health Sci Med. 2019;2(2):58-61. doi:10.32322/JHSM.496326
  • Vranić L, Mikolašević I, Milić S. Vitamin D deficiency: consequence or cause of obesity? Medicina (B Aires). 2019;55(9):541.
  • Karampela I, Sakelliou A, Vallianou N, Christodoulatos GS, Magkos F, Dalamaga M. Vitamin D and obesity: current evidence and controversies. Curr Obes Rep. 2021;10(2):162-180. doi:10.1007/S13679-021-00433-1/FIGURES/1
  • Trimarco V, Manzi MV, Mancusi C, et al. Insulin resistance and vitamin D deficiency: a link beyond the appearances. Front Cardiovasc Med. 2022;9:859793.
  • Şabanoğlu C, İnanç İH. The relationship between vitamin D deficiency and hypertensive organ damage. J Health Sci Med. 2022;5(6):1704-1712. doi:10.32322/jhsm.1173794
  • Ford ES, Zhao G, Li C, Pearson WS. Serum concentrations of vitamin D and parathyroid hormone and prevalent metabolic syndrome among adults in the United States. J Diabetes. 2009;1(4):296-303. doi:10.1111/J.1753-0407.2009.00046.X
  • Grethen E, McClintock R, Gupta CE, et al. Vitamin D and hyperparathyroidism in obesity. J Clin Endocrinol Metab. 2011;96(5):1320-1326.
  • Andersen T, McNair P, Hyldstrup L, et al. Secondary hyperparathyroidism of morbid obesity regresses during weight reduction. Metabolism. 1988;37(5):425-428.
  • Grundy SM, Cleeman JI, Merz CNB, et al. Implications of recent clinical trials for the national cholesterol education program adult treatment panel III guidelines. Circulation. 2004;110(2):227-239.
  • Türkiye Endokrinoloji ve Metabolizma Derneği Obezite Lipid Metabolizmasi Hipertansiyon Çalişma Grubu. TEMD Obezite Tanı ve Tedavi Kılavuzu 2019. TEMD; 2019.
  • Cigerli O, Parildar H, Unal AD, Tarcin O, Erdal R, Guvener Demirag N. Vitamin D deficiency is a problem for adult out-patients? A university hospital sample in Istanbul, Turkey. Public Health Nutr. 2013;16(7):1306-1313. doi:10.1017/S1368980012003588
  • Cinar N, Harmanci A, Yildiz BO, Bayraktar M. Vitamin D status and seasonal changes in plasma concentrations of 25-hydroxyvitamin D in office workers in Ankara, Turkey. Eur J Intern Med. 2014;25(2):197-201. doi:10.1016/J.EJIM.2013.11.004
  • Göktaş O, Ersoy C, Ercan I, Can FE. Vitamin D status in the adult population of Bursa-Turkey. Eur J Gen Pract. 2020;26(1):156-162. doi:10.1080/13814788.2020.1846712
  • Walsh JS, Bowles S, Evans AL. Vitamin D in obesity. Curr Opin Endocrinol Diabetes Obes. 2017;24(6):389-394. doi:10.1097/MED.0000000000000371
  • Pourshahidi LK. Vitamin D and obesity: current perspectives and future directions. Proc Nutr Soc. 2015;74(2):115-124. doi:10.1017/S0029665114001578
  • Osmancevic A, Gillstedt M, Landin-Wilhelmsen K, et al. Size of the exposed body surface area, skin erythema and body mass index predict skin production of vitamin D. J Photochem Photobiol B . 2015;149:224-229.
  • Bell N, Epstein S, Greene A, Shary J, Oexmann MJ, Shaw S. Evidence for alteration of the vitamin D-endocrine system in obese subjects. Am Soc Clin Investig. 1985:370-373.
  • Schmitt EB, Nahas-Neto J, Bueloni-Dias F, Poloni PF, Orsatti CL, Petri Nahas EA. Vitamin D deficiency is associated with metabolic syndrome in postmenopausal women. Maturitas. 2018;107:97-102. doi:10.1016/j.maturitas.2017.10.011
  • Botella-Carretero JI, Alvarez-Blasco F, Villafruela JJ, Balsa JA, Vázquez C, Escobar-Morreale HF. Vitamin D deficiency is associated with the metabolic syndrome in morbid obesity. Clin Nutr. 2007;26(5):573-580. doi:10.1016/J.CLNU.2007.05.009
  • Lee SJ, Lee EY, Lee JH, et al. Associations of serum 25-hydroxyvitamin D with metabolic syndrome and its components in elderly men and women: The Korean Urban Rural Elderly cohort study. BMC Geriatr. 2019;19(1):1-8. doi:10.1186/S12877-019-1118-Y/TABLES/5
  • Zhu W, Heil DP. Associations of vitamin D status with markers of metabolic health: a community-based study in Shanghai, China. Diabetes Metab Syndr. 2018;12(5):727-732. doi:10.1016/J.DSX.2018.04.010
  • Kamycheva E, Sundsfjord J, Jorde R. Serum parathyroid hormone level is associated with body mass index. The 5th Tromso study. Eur J Endocrinol. 2004;151(2):167-172. doi:10.1530/eje.0.1510167
  • Bolland MJ, Grey AB, Ames RW, Horne AM, Gamble GD, Reid IR. Fat mass is an important predictor of parathyroid hormone levels in postmenopausal women. Bone. 2006;38(3):317-321. doi:10.1016/j.bone.2005.08.018
  • Pitroda AP, Harris SS, Dawson-Hughes B. The association of adiposity with parathyroid hormone in healthy older adults. Endocrine. 2009;36(2):218-223. doi:10.1007/S12020-009-9231-X/TABLES/4
  • Stein EM, Strain G, Sinha N, et al. Vitamin D insufficiency prior to bariatric surgery: risk factors and a pilot treatment study. Clin Endocrinol (Oxf). 2009;71(2):176-183. doi:10.1111/J.1365-2265.2008.03470.X
  • Fish E, Beverstein G, Olson D, Reinhardt S, Garren M, Gould J. Vitamin D status of morbidly obese bariatric surgery patients. J Surg Res. 2010;164(2):198-202. doi:10.1016/J.JSS.2010.06.029
  • Salazar DA, Ferreira MJS, Neves JS, et al. Variable Thresholds of Vitamin D Plasma Levels to Suppress PTH: the Effect of Weight and Bariatric Surgery. Obes Surg. 2020;30(4):1551-1559. doi:10.1007/S11695-019-04351-Z/TABLES/7
There are 32 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases
Journal Section Original Article
Authors

Nergis Akbaş 0000-0002-7236-1767

Emin Akbaş 0000-0002-3033-0073

Early Pub Date September 26, 2023
Publication Date September 28, 2023
Published in Issue Year 2023 Volume: 6 Issue: 5

Cite

AMA Akbaş N, Akbaş E. Assessment of vitamin D deficiency and hyperparathyroidism in metabolically healthy and unhealthy obese patients. J Health Sci Med / JHSM. September 2023;6(5):968-973. doi:10.32322/jhsm.1331970

Interuniversity Board (UAK) Equivalency: Article published in Ulakbim TR Index journal [10 POINTS], and Article published in other (excuding 1a, b, c) international indexed journal (1d) [5 POINTS].

The Directories (indexes) and Platforms we are included in are at the bottom of the page.

Note: Our journal is not WOS indexed and therefore is not classified as Q.

You can download Council of Higher Education (CoHG) [Yüksek Öğretim Kurumu (YÖK)] Criteria) decisions about predatory/questionable journals and the author's clarification text and journal charge policy from your browser. https://dergipark.org.tr/tr/journal/2316/file/4905/show







The indexes of the journal are ULAKBİM TR Dizin, Index Copernicus, ICI World of Journals, DOAJ, Directory of Research Journals Indexing (DRJI), General Impact Factor, ASOS Index, WorldCat (OCLC), MIAR, EuroPub, OpenAIRE, Türkiye Citation Index, Türk Medline Index, InfoBase Index, Scilit, etc.

       images?q=tbn:ANd9GcRB9r6zRLDl0Pz7om2DQkiTQXqDtuq64Eb1Qg&usqp=CAU

500px-WorldCat_logo.svg.png

atifdizini.png

logo_world_of_journals_no_margin.png

images?q=tbn%3AANd9GcTNpvUjQ4Ffc6uQBqMQrqYMR53c7bRqD9rohCINkko0Y1a_hPSn&usqp=CAU

doaj.png  

images?q=tbn:ANd9GcSpOQFsFv3RdX0lIQJC3SwkFIA-CceHin_ujli_JrqBy3A32A_Tx_oMoIZn96EcrpLwTQg&usqp=CAU

ici2.png

asos-index.png

drji.png





The platforms of the journal are Google Scholar, CrossRef (DOI), ResearchBib, Open Access, COPE, ICMJE, NCBI, ORCID, Creative Commons, etc.

COPE-logo-300x199.jpgimages?q=tbn:ANd9GcQR6_qdgvxMP9owgnYzJ1M6CS_XzR_d7orTjA&usqp=CAU

icmje_1_orig.png

cc.logo.large.png

ncbi.pngimages?q=tbn:ANd9GcRBcJw8ia8S9TI4Fun5vj3HPzEcEKIvF_jtnw&usqp=CAU

ORCID_logo.png

1*mvsP194Golg0Dmo2rjJ-oQ.jpeg


Our Journal using the DergiPark system indexed are;

Ulakbim TR Dizin,  Index Copernicus, ICI World of JournalsDirectory of Research Journals Indexing (DRJI), General Impact FactorASOS Index, OpenAIRE, MIAR,  EuroPub, WorldCat (OCLC)DOAJ,  Türkiye Citation Index, Türk Medline Index, InfoBase Index


Our Journal using the DergiPark system platforms are;

Google, Google Scholar, CrossRef (DOI), ResearchBib, ICJME, COPE, NCBI, ORCID, Creative Commons, Open Access, and etc.


Journal articles are evaluated as "Double-Blind Peer Review". 

Our journal has adopted the Open Access Policy and articles in JHSM are Open Access and fully comply with Open Access instructions. All articles in the system can be accessed and read without a journal user.  https//dergipark.org.tr/tr/pub/jhsm/page/9535

Journal charge policy   https://dergipark.org.tr/tr/pub/jhsm/page/10912


Editor List for 2022

Assoc. Prof. Alpaslan TANOĞLU (MD)  

Prof. Aydın ÇİFCİ (MD)

Prof. İbrahim Celalaettin HAZNEDAROĞLU (MD)

Prof. Murat KEKİLLİ (MD)

Prof. Yavuz BEYAZIT (MD) 

Prof. Ekrem ÜNAL (MD)

Prof. Ahmet EKEN (MD)

Assoc. Prof. Ercan YUVANÇ (MD)

Assoc. Prof. Bekir UÇAN (MD) 

Assoc. Prof. Mehmet Sinan DAL (MD)


Our journal has been indexed in DOAJ as of May 18, 2020.

Our journal has been indexed in TR-Dizin as of March 12, 2021.


17873

Articles published in the Journal of Health Sciences and Medicine have open access and are licensed under the Creative Commons CC BY-NC-ND 4.0 International License.