IM - ORIGINAL

Internal and Emergency Medicine

, Volume 8, Issue 1, pp 33-40

First online:

Serum 25-hydroxyvitamin D levels are inversely associated with systemic inflammation in severe obese subjects

  • Alfonso BelliaAffiliated withDepartment of Internal Medicine, University of Rome “Tor Vergata”
  • , Caterina GarcovichAffiliated withDepartment of Internal Medicine, University of Rome “Tor Vergata”
  • , Monica D’AdamoAffiliated withDepartment of Internal Medicine, University of Rome “Tor Vergata”
  • , Mauro LombardoAffiliated withDepartment of Internal Medicine, University of Rome “Tor Vergata”
  • , Manfredi TesauroAffiliated withDepartment of Internal Medicine, University of Rome “Tor Vergata”
  • , Giulia DonadelAffiliated withDepartment of Internal Medicine, University of Rome “Tor Vergata”
  • , Paolo GentileschiAffiliated withDepartment of Surgery, University of Rome “Tor Vergata”
  • , Davide LauroAffiliated withDepartment of Internal Medicine, University of Rome “Tor Vergata”
  • , Massimo FedericiAffiliated withDepartment of Internal Medicine, University of Rome “Tor Vergata”
    • , Renato LauroAffiliated withDepartment of Internal Medicine, University of Rome “Tor Vergata”
    • , Paolo SbracciaAffiliated withDepartment of Internal Medicine, University of Rome “Tor Vergata” Email author 

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Abstract

Obesity is frequently characterized by a reduced vitamin D bioavailability, as well as insulin-resistance and a chronic inflammatory response. We tested the hypothesis of an independent relationship between serum concentrations of 25-hydroxyvitamin D (25[OH]D) and several circulating inflammatory markers in a cohort of severely obese individuals. Cross-sectional study was carried out among obese patients undergoing a clinical evaluation before bariatric surgery in our University Hospital. Serum 25(OH)D, fasting and post load glucose and insulin, high-sensitive C-reactive protein (hs CRP), fibrinogen, interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), leptin, adiponectin and lipid profile were collected. Insulin-resistance was assessed by insulin sensitivity index (ISI). Total body fat (FAT kg), total percent body fat (FAT%) and truncal fat mass (TrFAT) were assessed with dual-energy X-ray absorptiometry. A total of 147 obese subjects (89 women, 37.8 ± 7.1 years) with mean body mass index (BMI) of 43.6 ± 4.3 kg/m2 were enrolled. Patients in the lowest tertile of 25(OH)D were significantly more obese with a higher amount of TrFAT, more insulin-resistant, and had higher levels of fasting and post-challenge glucose (p < 0.05 for all). In a multivariate regression analysis, serum 25(OH)D was inversely related to significant levels of hs CRP, IL-6 and TNF-α after accounting for age, gender, season of recruitment, BMI, FAT kg and TrFAT (p < 0.01 for all). In extremely obese subjects, 25(OH)D serum concentrations are inversely associated with several biomarkers of systemic inflammation, regardless of the total quantity of fat mass.

Keywords

Vitamin D Inflammation Insulin-resistance Obesity