European Journal of Nutrition

, Volume 56, Issue 1, pp 161–170 | Cite as

Association between body weight and composition and plasma 25-hydroxyvitamin D level in the Diabetes Prevention Program

  • Lisa CegliaEmail author
  • Jason Nelson
  • James Ware
  • Konstantinos-Dionysios Alysandratos
  • George A. Bray
  • Cheryl Garganta
  • David M. Nathan
  • Frank B. Hu
  • Bess Dawson-Hughes
  • Anastassios G. Pittas
  • Diabetes Prevention Program Research Group
Original Contribution



We examined associations between body weight and plasma 25-hydroxyvitamin D concentration (25OHD) in prediabetes and sought to estimate the impact of adiposity on these associations.


The study was conducted in the placebo (n = 1082) and intensive lifestyle (n = 1079) groups of the Diabetes Prevention Program (DPP), a multicenter trial to prevent type 2 diabetes in adults with prediabetes. Weight and 25OHD were measured at baseline, month 6, years 1 and 2. In a subset (n = 584), visceral (VAT) and subcutaneous (SAT) adiposity were assessed by computed tomography at baseline and year 1.


In cross-sectional analyses, baseline body weight, total fat, VAT, and SAT were inversely associated with plasma 25OHD concentration after multivariable adjustment. VAT accounted for 40 % [95 % CI 11, 69] of the association of body weight with plasma 25OHD concentration. There was no significant contribution by total fat or SAT. Two-year changes in plasma 25OHD concentration varied inversely with changes in body weight (p < 0.0001). One-year changes in total fat, VAT, or SAT were not significant mediators of the association between change in plasma 25OHD concentration and body weight.


Our study found an inverse association between body weight and plasma 25OHD concentration at baseline and over a 2-year period in adults with prediabetes. These findings in the DPP, a weight loss intervention study, raise the possibility that weight loss increases plasma 25OHD concentration. Whether adiposity mediates this association remains inconclusive.


Body composition Diabetes Prevention Program Body weight Obesity Vitamin D Adipose tissue 



We acknowledge the commitment and dedication of the DPP participants.

Author contributions

L.C, J.W, K.D.A, G.A.B, A.G.P were responsible for the study design. CG conducted the 25OHD assay analysis. J.N was responsible for the statistical analysis. All authors were involved in the interpretation of the data. All authors and the DPP Publications and Ancillary Studies Committees were involved in the critical revision of the manuscript for intellectual content.

Compliance with ethical standards

Conflict of interest

None disclosed.


The present ancillary study was supported by research Grant R01DK79003 (to AGP) from the National Institute of Diabetes and Digestive and Kidney Disease; UL1RR025752 (to Tufts University) from the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health; a research grant by the Gerald J. and Dorothy R. Friedman Foundation (to LC); the US Department of Agriculture Agreement 58-1950-9001 (to BDH). The parent DPP study was supported by research Grant UO1DK48489 from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health to the DPP clinical centers and the Coordinating Center for the design and conduct of the DPP study. The Southwestern American Indian Centers were supported directly by the NIDDK, including its Intramural Research Program, and the Indian Health Service. The General Clinical Research Center Program, National Center for Research Resources, supported data collection at many of the clinical centers. Funding was also provided by the National Institute of Child Health and Human Development, the National Institute on Aging, the National Eye Institute, the National Heart Lung and Blood Institute, the Office of Research on Women’s Health, the National Center for Minority Health and Human Disease, the Centers for Disease Control and Prevention, the Indian Health Service, and the American Diabetes Association. Lipha (Merck-Sante) provided medication. LifeScan Inc., Merck-Medco Managed Care, Inc., and Merck and Co. donated materials, equipment, or medicines for concomitant conditions.

Supplementary material

394_2015_1066_MOESM1_ESM.pptx (92 kb)
Supplementary material 1 (PPTX 91 kb)
394_2015_1066_MOESM2_ESM.docx (14 kb)
Supplementary material 2 (DOCX 13 kb)


  1. 1.
    Looker AC et al (2008) Serum 25-hydroxyvitamin D status of the US population: 1988–1994 compared with 2000–2004. Am J Clin Nutr 88(6):1519–1527CrossRefGoogle Scholar
  2. 2.
    Snijder MB et al (2005) Adiposity in relation to vitamin D status and parathyroid hormone levels: a population-based study in older men and women. J Clin Endocrinol Metab 90(7):4119–4123CrossRefGoogle Scholar
  3. 3.
    Bell NH et al (1985) Evidence for alteration of the vitamin D-endocrine system in obese subjects. J Clin Invest 76(1):370–373CrossRefGoogle Scholar
  4. 4.
    Liel Y et al (1988) Low circulating vitamin D in obesity. Calcif Tissue Int 43(4):199–201CrossRefGoogle Scholar
  5. 5.
    Parikh SJ et al (2004) The relationship between obesity and serum 1,25-dihydroxy vitamin D concentrations in healthy adults. J Clin Endocrinol Metab 89(3):1196–1199CrossRefGoogle Scholar
  6. 6.
    Arunabh S et al (2003) Body fat content and 25-hydroxyvitamin D levels in healthy women. J Clin Endocrinol Metab 88(1):157–161CrossRefGoogle Scholar
  7. 7.
    Mason C et al (2011) Effects of weight loss on serum vitamin D in postmenopausal women. Am J Clin Nutr 94(1):95–103CrossRefGoogle Scholar
  8. 8.
    Jorde R et al (2010) Cross-sectional and longitudinal relation between serum 25-hydroxyvitamin D and body mass index: the Tromso study. Eur J Nutr 49(7):401–407CrossRefGoogle Scholar
  9. 9.
    Tzotzas T et al (2010) Rising serum 25-hydroxy-vitamin D levels after weight loss in obese women correlate with improvement in insulin resistance. J Clin Endocrinol Metab 95(9):4251–4257CrossRefGoogle Scholar
  10. 10.
    Newbury L et al (2003) Calcium and vitamin D depletion and elevated parathyroid hormone following biliopancreatic diversion. Obes Surg 13(6):893–895CrossRefGoogle Scholar
  11. 11.
    Rickers H et al (1984) Impairment of vitamin D metabolism and bone mineral content after intestinal bypass for obesity. A longitudinal study. Scand J Gastroenterol 19(2):184–189Google Scholar
  12. 12.
    Pramyothin P et al (2011) Vitamin D in adipose tissue and serum 25-hydroxyvitamin D after roux-en-Y gastric bypass. Obesity (Silver Spring) 19(11):2228–2234CrossRefGoogle Scholar
  13. 13.
    Reinehr T et al (2007) Vitamin D status and parathyroid hormone in obese children before and after weight loss. Eur J Endocrinol 157(2):225–232CrossRefGoogle Scholar
  14. 14.
    Vimaleswaran KS et al (2013) Causal relationship between obesity and vitamin D status: bi-directional Mendelian randomization analysis of multiple cohorts. PLoS Med 10(2):e1001383CrossRefGoogle Scholar
  15. 15.
    Carlin AM et al (2006) Effect of gastric bypass surgery on vitamin D nutritional status. Surg Obes Relat Dis 2(6):638–642CrossRefGoogle Scholar
  16. 16.
    Wortsman J et al (2000) Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr 72(3):690–693Google Scholar
  17. 17.
    Alemzadeh R et al (2008) Hypovitaminosis D in obese children and adolescents: relationship with adiposity, insulin sensitivity, ethnicity, and season. Metabolism 57(2):183–191CrossRefGoogle Scholar
  18. 18.
    van der Wielen RP et al (1995) Serum vitamin D concentrations among elderly people in Europe. Lancet 346(8969):207–210CrossRefGoogle Scholar
  19. 19.
    Drincic AT et al (2012) Volumetric dilution, rather than sequestration best explains the low vitamin D status of obesity. Obesity (Silver Spring)Google Scholar
  20. 20.
    Li J et al (2008) 1alpha,25-Dihydroxyvitamin D hydroxylase in adipocytes. J Steroid Biochem Mol Biol 112(1–3):122–126CrossRefGoogle Scholar
  21. 21.
    Knowler WC et al (2002) Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 346(6):393–403CrossRefGoogle Scholar
  22. 22.
    Bray GA et al (2008) Relation of central adiposity and body mass index to the development of diabetes in the Diabetes Prevention Program. Am J Clin Nutr 87(5):1212–1218Google Scholar
  23. 23.
    Lissner D, Mason RS, Posen S (1981) Stability of vitamin D metabolites in human blood serum and plasma. Clin Chem 27(5):773–774Google Scholar
  24. 24.
    Hankinson SE et al (1989) Effect of transport conditions on the stability of biochemical markers in blood. Clin Chem 35(12):2313–2316Google Scholar
  25. 25.
    National Institute of Standards and Technology, Standard Reference Materials. 11/3/2010;
  26. 26.
    Mayer-Davis EJ et al (2004) Dietary intake in the Diabetes Prevention Program cohort: baseline and 1-year post randomization. Ann Epidemiol 14(10):763–772CrossRefGoogle Scholar
  27. 27.
    Poggio ED et al (2005) Performance of the modification of diet in renal disease and Cockcroft-Gault equations in the estimation of GFR in health and in chronic kidney disease. J Am Soc Nephrol: JASN 16(2):459–466CrossRefGoogle Scholar
  28. 28.
    Diabetes Prevention Program Research G (2012) Long-term safety, tolerability, and weight loss associated with metformin in the diabetes prevention program outcomes study. Diab Care 35(4):731–737CrossRefGoogle Scholar
  29. 29.
    MacKinnon DP, Fairchild AJ, Fritz MS (2007) Mediation analysis. Annu Rev Psychol 58:593–614CrossRefGoogle Scholar
  30. 30.
    Mackinnon DP, Warsi G, Dwyer JH (1995) A simulation study of mediated effect measures. Multivar Behav Res 30(1):41CrossRefGoogle Scholar
  31. 31.
    Baron RM, Kenny DA (1986) The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Personal Soc Psychol 51(6):1173–1182CrossRefGoogle Scholar
  32. 32.
    Harris SS (2006) Vitamin D and African Americans. J Nutr 136(4):1126–1129Google Scholar
  33. 33.
    Young KA et al (2009) Association of plasma vitamin D levels with adiposity in hispanic and African Americans. J Clin Endocrinol Metab 94(9):3306–3313CrossRefGoogle Scholar
  34. 34.
    Holick MF (2007) Vitamin D deficiency. N Engl J Med 357(3):266–281CrossRefGoogle Scholar
  35. 35.
    Cheng S et al (2010) Adiposity, cardiometabolic risk, and vitamin D status: the Framingham heart study. Diabetes 59(1):242–248CrossRefGoogle Scholar
  36. 36.
    Goodpaster BH et al (2003) Association between regional adipose tissue distribution and both type 2 diabetes and impaired glucose tolerance in elderly men and women. Diabetes Care 26(2):372–379CrossRefGoogle Scholar
  37. 37.
    Hayashi T et al (2003) Visceral adiposity and the risk of impaired glucose tolerance: a prospective study among Japanese Americans. Diabetes Care 26(3):650–655CrossRefGoogle Scholar
  38. 38.
    Kanaya AM et al (2004) Adipocytokines attenuate the association between visceral adiposity and diabetes in older adults. Diabetes Care 27(6):1375–1380CrossRefGoogle Scholar
  39. 39.
    Boyko EJ et al (2000) Visceral adiposity and risk of type 2 diabetes: a prospective study among Japanese Americans. Diabetes Care 23(4):465–471CrossRefGoogle Scholar
  40. 40.
    Thurnham DI (2011) Plasma 25-Hydroxy-Cholecalciferol (Vitamin D) is depressed by inflammation: implications and parallels with other micronutrients. Sight Life 25(2):38–47Google Scholar
  41. 41.
    Duncan A et al (2012) Quantitative data on the magnitude of the systemic inflammatory response and its effect on micronutrient status based on plasma measurements. Am J Clin Nutr 95(1):64–71CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Lisa Ceglia
    • 1
    • 9
    Email author
  • Jason Nelson
    • 2
  • James Ware
    • 3
  • Konstantinos-Dionysios Alysandratos
    • 10
  • George A. Bray
    • 4
  • Cheryl Garganta
    • 5
  • David M. Nathan
    • 6
  • Frank B. Hu
    • 7
    • 8
  • Bess Dawson-Hughes
    • 1
    • 9
  • Anastassios G. Pittas
    • 1
  • Diabetes Prevention Program Research Group
  1. 1.Division of EndocrinologyDiabetes and Metabolism, Tufts Medical CenterBostonUSA
  2. 2.Institute for Clinical Research and Health Policy StudiesTufts Medical CenterBostonUSA
  3. 3.Department of BiostatisticsHarvard School of Public HealthBostonUSA
  4. 4.Pennington Biomedical Research CenterLouisiana State UniversityBaton RougeUSA
  5. 5.Department of Pathology, Immunology and Laboratory MedicineUniversity of FloridaGainsvilleUSA
  6. 6.Diabetes CenterMassachusetts General Hospital and Harvard Medical SchoolBostonUSA
  7. 7.Departments of Nutrition and EpidemiologyHarvard School of Public HealthBostonUSA
  8. 8.Channing LaboratoryBrigham and Women’s HospitalBostonUSA
  9. 9.Bone Metabolism Laboratory, Jean Mayer US Department of Agriculture Human Nutrition Research Center on AgingTufts UniversityBostonUSA
  10. 10.Division of NeurologyBoston University Medical CenterBostonUSA

Personalised recommendations