Skip to main content
SpringerLink
Log in

Association of vitamin D deficiency and insulin resistance in nondiabetic obese women: role of parathyroid hormone

  • Original Article
  • Published:
International Journal of Diabetes in Developing Countries Aims and scope Submit manuscript

Abstract

Objective

Serum vitamin D (25-hydroxyvitamin-D; 25(OH) D) is associated with glucose metabolism in obese subjects. However, results are conflicting as other related metabolites like a parathyroid hormone (PTH) were not accounted for. We examined the joint association of 25(OH) D and PTH with the prevalence of insulin resistance (IR) in non-diabetic obese women.

Method

This study included 220 obese women (mean BMI 33.7 ± 5.8) of the age range 20–50 years. Blood sample in fasting was analyzed for glucose, insulin, 25(OH) D, PTH, and calcium levels. Vitamin D levels less than 12 ng/ml and more than 30 ng/ml were considered deficiency and sufficiency, respectively.

Results

Most women (96.8%) were either vitamin D deficient or insufficient. Fasting glucose was positively and insulin and HOMA-IR index were negatively correlated (r = 0.047, –0.032, –0.024, respectively) with vitamin D. All these correlations were positive with PTH levels (r = 0.193, 0.108, and 0.136, respectively). IR was detected in 96 (43.6%) women. Vitamin D and calcium were comparable, but PTH was significantly (p < 0.05) higher in IR than in non-IR obese women. The obese women with a PTH level more than median value (17.0 pg/ml; n = 111) had a significantly higher percentage of women with IR than those below (n = 109) this threshold (57.4% versus 30.4%; p = 0.0003). The highest prevalence of IR (64.1%) was detected in vitamin D-deficient women having more than median PTH levels.

Conclusion

The prevalence of insulin resistance in obese women could be better explained by serum vitamin D and PTH levels jointly rather than vitamin D levels alone.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Data Availability

Data supporting the findings of this study are available from the corresponding author on request.

References

  1. Wiebe N, Ye F, Crumley ET, Bello A, Stenvinkel P, Tonelli M. Temporal associations among body mass index, fasting insulin, and systemic inflammation: a systematic review and meta-analysis. JAMA Netw Open 2021;4:e211263-e.

  2. Petersen MC, Shulman GI. Mechanisms of insulin action and insulin resistance. Physiol Rev. 2018;98:2133–223.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Miao Z, Wang S, Wang Y, Guo L, Zhang J, Liu Y, et al. A potential linking between vitamin D and adipose metabolic disorders. Can J Gastroenterol Hepatol 2020; 2020.

  4. Ashraf A, Alvarez J, Saenz K, Gower B, McCormick K, Franklin F. Threshold for effects of vitamin D deficiency on glucose metabolism in obese female African-American adolescents. J Clin Endocrinol Metab. 2009;94:3200–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Kamycheva E, Jorde R, Figenschau Y, Haug E. Insulin sensitivity in subjects with secondary hyperparathyroidism and the effect of a low serum 25-hydroxyvitamin D level on insulin sensitivity. J Endocrinol Invest. 2007;30:126–32.

    Article  CAS  PubMed  Google Scholar 

  6. Kumar S, Olukoga A, Gordon C, Mawer E, France M, Hosker J, et al. Impaired glucose tolerance and insulin insensitivity in primary hyperparathyroidism. Clin Endocrinol. 1994;40:47–53.

    Article  CAS  Google Scholar 

  7. Graf H, Prager R, Kovarik J, Luger A, Schernthaner G, Pinggera W. Glucose metabolism and insulin sensitivity in patients on chronic hemodialysis. Metabolism. 1985;34:974–7.

    Article  CAS  PubMed  Google Scholar 

  8. Prager R, Kovarik J, Schernthaner G, Woloszczuk W, Willvonseder R. Peripheral insulin resistance in primary hyperparathyroidism. Metabolism. 1983;32:800–5.

    Article  CAS  PubMed  Google Scholar 

  9. Akmal M, Massry SG, Goldstein D, Fanti P, Weisz A, DeFronzo RA. Role of parathyroid hormone in the glucose intolerance of chronic renal failure. J Clin Invest. 1985;75:1037–44.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Holvik K, Meyer HE, Sogaard AJ, Haug E, Falch JA. Pakistanis living in Oslo have lower serum 1,25-dihydroxyvitamin D levels but higher serum ionized calcium levels compared with ethnic Norwegians. The Oslo Health Study. BMC Endocr Disord 2007;7(9):1–6.

  11. Mustafa G, Khalid M, Ahmed I, Talib MA. Correlation of serum levels of vitamin D3 with serum parathormone in nursing mothers and infants 1–6 months’ age from South Punjab Pakistan. Pak J Med Sci. 2020;36(5):1015–9.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Giustina A, Bouillon R, Binkley N, Sempos C, Adler RA, Bollerslev J, Bess Dawson-Hughes B, et al. Controversies in vitamin D: a statement from the third international conference. JBMR Plus. 2020;4: e10417.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Matthews DR, Hosker J, Rudenski A, Naylor B, Treacher D, Turner R. Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412–9.

    Article  CAS  PubMed  Google Scholar 

  14. Mansoor S, Habib A, Ghani F, Fatmi Z, Badruddin S, Mansoor S, et al. Prevalence and significance of vitamin D deficiency and insufficiency among apparently healthy adults. Clin Biochem. 2010;43:1431–5.

    Article  CAS  PubMed  Google Scholar 

  15. Junaid K, Rehman A, Jolliffe DA, Wood K, Martineau AR. High prevalence of vitamin D deficiency among women of child-bearing age in Lahore Pakistan, associating with lack of sun exposure and illiteracy. BMC Womens Health. 2015;15:1–8.

    Article  CAS  Google Scholar 

  16. Shaikh SY, Jaffar SR, Ijaz A. Frequency of insulin resistance in patients with hypovitaminosis D. Pak J Pathol. 2016;27(2):78–84.

    Google Scholar 

  17. Ilincic B, Stokic E, Stosic Z, Kojic NE, Katsiki N, Mikhailidis DP, et al. Vitamin D status and circulating biomarkers of endothelial dysfunction and inflammation in non-diabetic obese individuals: a pilot study. Arch Med Sci. 2017;13(1):53–60.

    Article  CAS  PubMed  Google Scholar 

  18. Kramer CK, Swaminathan B, Hanley AJ, Connelly PW, Sermer M, Zinman B, et al. Prospective associations of vitamin D status with β-cell function, insulin sensitivity and glycemia: the impact of parathyroid hormone status. Diabetes. 2014;63:3868–79.

    Article  CAS  PubMed  Google Scholar 

  19. Chang E, Donkin SS, Teegarden D. Parathyroid hormone suppresses insulin signaling in adipocytes. Mol Cell Endocrinol. 2009;307:77–82.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Chiu KC, Chuang L-M, Lee NP, Ryu JM, McGullam JL, Tsai GP, et al. Insulin sensitivity is inversely correlated with plasma intact parathyroid hormone level. Metab Clin Exp. 2000;49:1501–5.

    Article  CAS  PubMed  Google Scholar 

  21. Karras SN, Anagnostis P, Antonopoulou V, Tsekmekidou X, Koufakis T, Goulis DG, et al. The combined effect of vitamin D and parathyroid hormone concentrations on glucose homeostasis in older patients with prediabetes: a cross-sectional study. Diab Vasc Dis Res. 2018;15:150–3.

    Article  CAS  PubMed  Google Scholar 

  22. Ha J, Jo K, Lim D-J, Lee J-M, Chang S-A, Kang MI, et al. Parathyroid hormone and vitamin D are associated with the risk of metabolic obesity in a middle-aged and older Korean population with preserved renal function: a cross-sectional study. PLoS ONE. 2017;12: e0175132.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Al-Sultan AI, Amin TT, Abou-Seif MA, Al Naboli MR. Vitamin D, parathyroid hormone levels and insulin sensitivity among obese young adult Saudis. Eur Rev Med Pharmacol Sci. 2011;15:135–47.

    CAS  PubMed  Google Scholar 

  24. Bellia A, Marinoni G, D’Adamo M, Guglielmi V, Lombardo M, Donadel G, Gentileschi P, Lauro D, Federici M, Lauro R, Sbraccia P. Parathyroid hormone and insulin resistance in distinct phenotypes of severe obesity: a cross-sectional analysis in middle-aged men and premenopausal women. J Clin Endocrinol Metab. 2012;97:4724–32.

    Article  CAS  PubMed  Google Scholar 

  25. Rahimi Z. Parathyroid hormone, glucose metabolism and diabetes mellitus. Mol Cell Endocrinol. 2009;307:77–82.

    Google Scholar 

  26. Hultin H, Edfeldt K, Sundbom M, Hellman P. Left-shifted relation between calcium and parathyroid hormone in obesity. J Clin Endocrinol Metab. 2010;95:3973–81.

    Article  CAS  PubMed  Google Scholar 

  27. Soares MJ, Ping-Delfos WCS, Sherriff JL, Nezhad DH, Cummings NK. Zhao Y Vitamin D and parathyroid hormone in insulin resistance of abdominal obesity: cause or effect? Eur J Clin Nutr. 2011;65:1348–52.

    Article  CAS  PubMed  Google Scholar 

  28. Reusch JE, Sussman KE, Draznin B. Inverse relationship between GLUT-4 phosphorylation and its intrinsic activity. J Biol Chem. 1993;268:3348–51.

    Article  CAS  PubMed  Google Scholar 

  29. Lowe NM, Ellahi B, Bano Q, Bangash SA, Mitra SR. Zaman M Dietary calcium intake, vitamin D status, and bone health in postmenopausal women in rural Pakistan. J Health Popul Nutr. 2011;29(5):465–70.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Lotito A, Teramoto M, Cheung M, Becker K, Sukumar D. Serum parathyroid hormone responses to vitamin D supplementation in overweight/obese adults: a systematic review and meta-analysis of randomized clinical trials. Nutrients. 2017;9:241.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Chemistry, Lahore College for Women University, Lahore, Pakistan

    Nazish Saleem

  2. Centre for Nuclear Medicine (CENUM), Mayo Hospital, PO Box No.53, Lahore, Pakistan

    Shan Elahi

  3. School of Chemistry, New Campus, University of the Punjab, Lahore, Pakistan

    Nayab Batool Rizvi

Authors
  1. Nazish Saleem
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shan Elahi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nayab Batool Rizvi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nazish Saleem.

Ethics declarations

The institutional ethics committee (Bio-Ethical Committee, Institute of Chemistry, Punjab University, Lahore) approved the study.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Saleem, N., Elahi, S. & Rizvi, N.B. Association of vitamin D deficiency and insulin resistance in nondiabetic obese women: role of parathyroid hormone. Int J Diabetes Dev Ctries 43, 923–928 (2023). https://doi.org/10.1007/s13410-022-01164-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13410-022-01164-2

Keywords

Search

Navigation