Obesity Surgery

, Volume 18, Issue 2, pp 151–154 | Cite as

Vitamin D, PTH, and the Metabolic Syndrome in Severely Obese Subjects

  • Sergio Rueda
  • Cristian Fernández-Fernández
  • Fabiola Romero
  • Ma. Jesús Martínez de Osaba
  • Josep Vidal
Research Article



The objective of this study was to evaluate the association between the metabolic syndrome (MS) and vitamin D [25(OH)D] or parathyroid hormone (PTH) levels in severely obese subjects.

Research Design and Methods

Cross-sectional study in 298 severely obese patients [body mass index (BMI) 46.7 ± 5.3 kg/m2; women/men, 70.4/29.6%; age 42.9 ± 10.6 years]. Logistic and stepwise regression models were fit to estimate the odds for the MS (revised ATPIII criteria) and each of its individual components across quartiles of 25(OH)D and PTH after adjusting for age (years), gender, BMI, %FM, and season of blood sample collection.


Insufficient 25(OH)D and elevated PTH plasma levels were encountered, respectively, in 64.3 and 47.4% of the studied subjects. The prevalence of MS was 79.5%. In the unadjusted analysis, those in the highest quartile of 25(OH)D were less likely to present the MS [0.42 (95% CI 0.19–0.96)], hyperglycemia [0.47, (0.24–0.92)], high triglycerides [0.48 (0.25–0.95)], low HDL-cholesterol [1.51 (0.76–2.98)], and high blood pressure [0.35 (0.16–0.77)]. Nonetheless, these odds ratios lost significance after adjustment for age, gender, BMI, fat mass, and season. Backward stepwise regression analysis showed that only male gender [2.66 (1.16–6.10)] and age [1.07 (1.03–1.10)] were predictive variables for the MS. We did not find an association between the PTH quartiles and the MS or its individual components.


Our data are consistent with previous reports on the high prevalence of alterations in calcium metabolism in severely obese subjects. However, our data do not support an independent contribution of 25(OH)D or PTH in the pathogenesis of the MS in severely obese subjects.


Obesity Metabolic syndrome Parathyroid hormone Vitamin D 


  1. 1.
    Ford ES, Ajani UA, McGuire LC, Liu S. Concentrations of serum vitamin D and the metabolic syndrome among U.S. adults. Diabetes Care 2005;28:1228–30.PubMedCrossRefGoogle Scholar
  2. 2.
    Martini LA, Wood RJ. Vitamin D status and the metabolic syndrome. Nutr Rev 2006;64:479–86.PubMedCrossRefGoogle Scholar
  3. 3.
    Reis JP, von Muhlen D, Kritz-Silverstein D, Wingard DL, Barrett-Connor E. Vitamin D, parathyroid hormone levels, and the prevalence of metabolic syndrome in community-dwelling older adults. Diabetes Care 2007;30:1549–55.PubMedCrossRefGoogle Scholar
  4. 4.
    Buffington C, Walker B, Cowan GS Jr, Scruggs D. Vitamin D deficiency in the morbidly obese. Obes Surg 1993;3:421–4.PubMedCrossRefGoogle Scholar
  5. 5.
    Hamoui N, Anthone G, Crookes PF. Calcium metabolism in the morbidly obese. Obes Surg 2004;14:9–12.PubMedCrossRefGoogle Scholar
  6. 6.
    Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357:266–81.PubMedCrossRefGoogle Scholar
  7. 7.
    Chiu KC, Chu A, Go VL, Saad MF. Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction. Am J Clin Nutr 2004;79:820–5.PubMedGoogle Scholar
  8. 8.
    Resnick LM, Muller FB, Laragh JH. Calcium-regulating hormones in essential hypertension. Relation to plasma renin activity and sodium metabolism. Ann Intern Med 1986;105:649–54.PubMedGoogle Scholar
  9. 9.
    Scragg R, Sowers M, Bell C. Serum 25-hydroxyvitamin D, diabetes, and ethnicity in the Third National Health and Nutrition Examination Survey. Diabetes Care 2004;27:2813–8.PubMedCrossRefGoogle Scholar
  10. 10.
    Mathieu C, Gysemans C, Giulietti A, Bouillon R. Vitamin D and diabetes. Diabetologia 2005;48:1247–57.PubMedCrossRefGoogle Scholar
  11. 11.
    Parikh SJ, Edelman M, Uwaifo GI, et al. The relationship between obesity and serum 1,25-dihydroxy vitamin D concentrations in healthy adults. J Clin Endocrinol Metab 2004;89:1196–9.PubMedCrossRefGoogle Scholar
  12. 12.
    Jorde R, Svartberg J, Sundsfjord J. Serum parathyroid hormone as a predictor of increase in systolic blood pressure in men. J Hypertens 2005;23:1639–44.PubMedCrossRefGoogle Scholar
  13. 13.
    Chiu KC, Chuang LM, Lee NP, et al. Insulin sensitivity is inversely correlated with plasma intact parathyroid hormone level. Metabolism 2000;49:1501–5.PubMedCrossRefGoogle Scholar
  14. 14.
    Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron 1976;16:31–41.PubMedCrossRefGoogle Scholar
  15. 15.
    Vidal J, Morinigo R, Codoceo VH, et al. The importance of diagnostic criteria in the association between the metabolic syndrome and cardiovascular disease in obese subjects. Int J Obes (Lond) 2005;29:668–74.CrossRefGoogle Scholar
  16. 16.
    McKenna MJ, Freaney R. Secondary hyperparathyroidism in the elderly: means to defining hypovitaminosis D. Osteoporos Int 1998;8 Suppl 2:S3–6.PubMedGoogle Scholar
  17. 17.
    Pietrobelli A, Rubiano F, St Onge MP, Heymsfield SB. New bioimpedance analysis system: improved phenotyping with whole-body analysis. Eur J Clin Nutr 2004;58:1479–84.PubMedCrossRefGoogle Scholar
  18. 18.
    Botella-Carretero JI, Alvarez-Blasco F, Villafruela JJ, et al. Vitamin D deficiency is associated with the metabolic syndrome in morbid obesity. Clin Nutr 2007;26:573–80.PubMedCrossRefGoogle Scholar
  19. 19.
    Lips P, Chapuy MC, Dawson-Hughes B, Pols HA, Holick MF. An international comparison of serum 25-hydroxyvitamin D measurements. Osteoporos Int 1999;9:394–7.PubMedCrossRefGoogle Scholar
  20. 20.
    Martinez-Larrad MT, Fernandez-Perez C, Gonzalez-Sanchez JL, et al. Prevalence of the metabolic syndrome (ATP-III criteria). Population-based study of rural and urban areas in the Spanish province of Segovia. Med Clin (Barc) 2005;125:481–6.CrossRefGoogle Scholar

Copyright information

© Springer Science + Business Media B.V. 2007

Authors and Affiliations

  • Sergio Rueda
    • 1
  • Cristian Fernández-Fernández
    • 1
  • Fabiola Romero
    • 1
  • Ma. Jesús Martínez de Osaba
    • 2
  • Josep Vidal
    • 1
  1. 1.Obesity UnitHospital Clínic UniversitariBarcelonaSpain
  2. 2.Center for Biological DiagnosticsHospital Clínic UniversitariBarcelonaSpain

Personalised recommendations