Adiposity in the Relationship between Serum Vitamin D Level and Insulin Resistance in Middle-Aged and Elderly Korean Adults: The Korea National Health and Nutrition Examination Survey 2008

다국어 초록 (Multilingual Abstract)

Background: The role of adiposity in the relationship between serum vitamin D levels and insulin resistance has not yet been fully studied. This aim of this study is to clarify the role of adiposity in the relationship between serum vitamin D level and insulin resistance among middle-aged and elderly Korean adults.
Methods: We used data from 2,710 individuals aged ≥50 years based on national data from a representative sample of the fourth Korea National Health and Nutrition Examination Survey IV-2 in 2008.
Results: After adjustment for potential confounders, body mass index (BMI) was significantly associated with 25(OH) vitamin D (P=0.008). However, waist circumference was not significantly associated with 25(OH) vitamin D. In the stratified analyses,25(OH) vitamin D was found to be negatively associated with fasting insulin and homeostasis model assessment estimate of insulin resistance (HOMA-IR) in participants with BMIs ≥25 kg/m2 (P=0.003 for both insulin and HOMR-IR) but was not found to be associated in those with BMIs <23 kg/m2. However, we observed a significant inverse in the association of 25(OH) vitamin D with fasting insulin and HOMA-IR in both the normal (P=0.001 and P<0.001 and the abdominally obese group (P=0.010 and P=0.009) in the stratified analyses according to abdominal obesity.
Conclusion: Our results support that the idea that endogenously-produced vitamin D might be stored in subcutaneous fat deposits.
In addition, the association of vitamin D with insulin resistance in middle-aged and elderly Korean adults was stronger when it was stratified by BMI than when abdominal obesity status.

참고문헌 (Reference)

1 Lee S, "Waist circumference is an independent predictor of insulin resistance in black and white youths" 148 : 188-194, 2006

2 Hypponen E, "Vitamin D status and glucose homeostasis in the 1958 British birth cohort: the role of obesity" 29 : 2244-2246, 2006

3 Haussler MR, "Vitamin D receptor: molecular signaling and actions of nutritional ligands in disease prevention" 66 : 98-112, 2008

4 Choi HS, "Vitamin D insufficiency in Korea: a greater threat to younger generation: the Korea National Health and Nutrition Examination Survey (KNHANES) 2008" 96 : 643-651, 2011

5 Grethen E, "Vitamin D and hyperparathyroidism in obesity" 96 : 1320-1326, 2011

6 Parikh SJ, "The relationship between obesity and serum 1,25-dihydroxy vitamin D concentrations in healthy adults" 89 : 1196-1199, 2004

7 Alberti KG, "The metabolic syndrome: a new worldwide definition" 366 : 1059-1062, 2005

8 Scragg R, "Serum 25-hydroxyvitamin D, diabetes, and ethnicity in the Third National Health and Nutrition Examination Survey" 27 : 2813-2818, 2004

9 Sung CC, "Role of vitamin D in insulin resistance" 2012 : 634195-, 2012

10 McGill AT, "Relationships of low serum vitamin D3 with anthropometry and markers of the metabolic syndrome and diabetes in overweight and obesity" 7 : 4-, 2008

11 Kim TN, "Relationships between sarcopenic obesity and insulin resistance, inflammation, and vitamin D status: the Korean Sarcopenic Obesity Study" 78 : 525-532, 2013

12 "Korea Centers for Disease Control and Prevention, Ministry of Health and Welfare. Korean National Health and Nutrition Examination Surveys: the 4th surveys, 2007" Korea Centers for Disease Control and Prevention, Ministry of Health and Welfare

13 Kabadi SM, "Joint effects of obesity and vitamin D insufficiency on insulin resistance and type 2 diabetes: results from the NHANES 2001-2006" 35 : 2048-2054, 2012

14 Ou HY, "Interaction of BMI with vitamin D and insulin sensitivity" 41 : 1195-1201, 2011

15 Dawson-Hughes B, "IOF position statement: vitamin D recommendations for older adults" 21 : 1151-1154, 2010

16 Chiu KC, "Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction" 79 : 820-825, 2004

17 Matthews DR, "Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man" 28 : 412-419, 1985

18 Boucher BJ, "Glucose intolerance and impairment of insulin secretion in relation to vitamin D deficiency in east London Asians" 38 : 1239-1245, 1995

19 Wortsman J, "Decreased bioavailability of vitamin D in obesity" 72 : 690-693, 2000

20 Ford ES, "Concentrations of serum vitamin D and the metabolic syndrome among U.S. adults" 28 : 1228-1230, 2005

21 Janssen I, "Body mass index and waist circumference independently contribute to the prediction of nonabdominal, abdominal subcutaneous, and visceral fat" 75 : 683-688, 2002

22 Looker AC, "Body fat and vitamin D status in black versus white women" 90 : 635-640, 2005

23 박혜인, "Association of Serum 25-Hydroxyvitamin D Levels with Markers for Metabolic Syndrome in the Elderly: A Repeated Measure Analysis" 대한의학회 27 (27): 653-660, 2012

24 Lee SY, "Appropriate waist circumference cutoff points for central obesity in Korean adults" 75 : 72-80, 2007

25 Yoon YS, "Alcohol consumption and the metabolic syndrome in Korean adults: the 1998 Korean National Health and Nutrition Examination Survey" 80 : 217-224, 2004

26 Snijder MB, "Adiposity in relation to vitamin D status and parathyroid hormone levels: a population- based study in older men and women" 90 : 4119-4123, 2005