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

Yıl 2023, Cilt: 6 Sayı: 5, 968 - 973, 28.09.2023
https://doi.org/10.32322/jhsm.1331970

Öz

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.

Kaynakça

  • 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
Yıl 2023, Cilt: 6 Sayı: 5, 968 - 973, 28.09.2023
https://doi.org/10.32322/jhsm.1331970

Öz

Kaynakça

  • 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
Toplam 32 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular İç Hastalıkları
Bölüm Orijinal Makale
Yazarlar

Nergis Akbaş 0000-0002-7236-1767

Emin Akbaş 0000-0002-3033-0073

Erken Görünüm Tarihi 26 Eylül 2023
Yayımlanma Tarihi 28 Eylül 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 6 Sayı: 5

Kaynak Göster

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

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