To assess the association of vitamin D deficiency with general and abdominal obesity among high educated Iranian adults.
Current cross-sectional study was done on 500 Iranian professors aged 35 years or more. Complete data on general and abdominal obesity as well as serum 25(OH)D concentrations were available for 352 persons. Obesity was considered as body mass index ≥ 30, and abdominal obesity as waist circumference ≥ 80 cm for women and ≥ 94 cm for men. Furthermore, vitamin D deficiency was defined as serum 25(OH)D < 30 ng/ml.
Mean age of study population was 53.03 ± 7.15 years. Compared with those in the first quartile of serum 25(OH)D, participants in the fourth quartile were less likely to be generally obese (OR 0.46, 65% CI 0.22–0.99). Such finding was also seen even after taking potential confounders into account. Furthermore, we found an inverse association between serum 25(OH)D and abdominal obesity in fully adjusted model (OR 0.44, 95% CI 0.22–0.86). In addition, a significant positive association was found between vitamin D deficiency and obesity; such that after controlling for potential confounders, participants with vitamin D deficiency had 2.16 and 2.04 times greater odds for having general (OR 2.16, 95% CI 1.05–4.45) and abdominal obesity (OR 2.04, 95% CI 1.16–3.60), respectively, than those with normal levels of vitamin D.
Serum 25(OH)D concentrations were inversely associated with general and abdominal obesity. In addition, vitamin D deficiency was positively associated with both general and abdominal obesity.
Level of evidence
Level V, cross-sectional descriptive study.
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World Health Organization. WHO Media center. Obesity and overweight. World Health Organization, Geneva
Brooks B, Rajeshwari R, Nicklas TA, Yang S-J, Berenson GS (2006) Association of calcium intake, dairy product consumption with overweight status in young adults (1995–1996): the Bogalusa Heart Study. J Am Coll Nutr 25:523–532
Janghorbani M, Amini M, Willett WC, Gouya MM, Delavari A, Alikhani S et al (2007) First nationwide survey of prevalence of overweight, underweight, and abdominal obesity in Iranian adults. Obesity 15:2797–2808. https://doi.org/10.1038/oby.2007.332
Silverwood V, Blagojevic-Bucknall M, Jinks C, Jordan J, Protheroe J, Jordan K (2015) Current evidence on risk factors for knee osteoarthritis in older adults: a systematic review and meta-analysis. Osteoarthr Cartil 23:507–515. https://doi.org/10.1016/j.joca.2014.11.019
Deng T, Lyon CJ, Bergin S, Caligiuri MA, Hsueh WA (2016) Obesity, inflammation, and cancer. Annu Rev Pathol 11:421–449. https://doi.org/10.1016/j.yexmp.2017.01.003
Ekelund U, Ward HA, Norat T, Luan JA, May AM, Weiderpass E et al (2015) Physical activity and all-cause mortality across levels of overall and abdominal adiposity in European men and women: the European Prospective Investigation into Cancer and Nutrition Study (EPIC)–. Am J Clin Nutr 101:613–621. https://doi.org/10.3945/ajcn.114.100065
Azadbakht L, Esmaillzadeh A (2008) Dietary and non-dietary determinants of central adiposity among Tehrani women. Public Health Nutr 11:528–534. https://doi.org/10.1017/S1368980007000882
Bank SS, Ghanjali N, Ghalaeh RS, Azadbakht L (2013) Association between dairy and calcium intake and general and central obesity among female students. J Educ Health Promot 31:16. https://doi.org/10.4103/2277-9531.112685
Krzizek EC, Brix JM, Herz CT, Kopp HP, Schernthaner GH, Schernthaner G et al (2018) Prevalence of micronutrient deficiency in patients with morbid obesity before bariatric surgery. Obes Surg 28:550–551. https://doi.org/10.1007/s11695-017-3027-5
Poli VFS, Sanches RB, Moraes ADS, Fidalgo JPN, Nascimento MA, Bresciani P et al (2017) The excessive caloric intake and micronutrient deficiencies related to obesity after a long-term interdisciplinary therapy. Nutrition 38:113–119. https://doi.org/10.1016/j.nut.2017.01.012
Ribaldone DG, Saracco GM, Pellicano R (2018) Prevalence of micronutrient deficiency in patients with morbid obesity before bariatric surgery: what about celiac disease? Obes Surg 28:550–551. https://doi.org/10.1007/s11695-017-3027-5
Censani M, Hammad HT, Christos PJ, Schumaker T (2018) Vitamin D deficiency associated with markers of cardiovascular disease in children with obesity. Glob Pediatr Health 5:2333794X17751773. https://doi.org/10.1177/2333794x17751773
Ha J, Jo K, Lim DJ, Lee JM, Chang SA, Kang MI et al (2017) 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 12:e0175132. https://doi.org/10.1371/journal.pone.0175132
Mansouri M, Abasi R, Nasiri M, Sharifi F, Vesaly S, Sadeghi O et al (2018) Association of vitamin D status with metabolic syndrome and its components: a cross-sectional study in a population of high educated Iranian adults. Diabetes Metab Syndr 17:30480–30480. https://doi.org/10.1016/j.dsx.2018.01.007
Forouhi NG, Luan JA, Cooper A, Boucher BJ, Wareham NJ (2008) Baseline serum 25-hydroxy vitamin D is predictive of future glycemic status and insulin resistance: the Medical Research Council Ely Prospective Study 1990–2000. Diabetes 57:2619–2625. https://doi.org/10.2337/db08-0593
Kayaniyil S, Vieth R, Retnakaran R, Knight JA, Qi Y, Gerstein HC et al (2010) Association of vitamin D with insulin resistance and β-cell dysfunction in subjects at risk for type 2 diabetes. Diabetes Care 33:1379–1381. https://doi.org/10.2337/dc09-2321
Sergeev IN, Song Q (2014) High vitamin D and calcium intakes reduce diet-induced obesity in mice by increasing adipose tissue apoptosis. Mol Nutr Food Res 58:1342–1348. https://doi.org/10.1002/mnfr.201300503
Marcotorchino J, Tourniaire F, Astier J, Karkeni E, Canault M, Amiot M-J et al (2014) Vitamin D protects against diet-induced obesity by enhancing fatty acid oxidation. J Nutr Biochem 25:1077–1083. https://doi.org/10.1016/j.jnutbio.2014.05.010
Lips P (2007) Vitamin D status and nutrition in Europe and Asia. J Steroid Biochem Mol Biol 103:620–625. https://doi.org/10.1016/j.jsbmb.2006.12.076
Sadeghi O, Saneei P, Nasiri M, Larijani B, Esmaillzadeh A (2017) Abdominal obesity and risk of hip fracture: a systematic review and meta-analysis of prospective studies. Adv Nutr 8:728–738. https://doi.org/10.3945/an.117.015545
Zhang Y, Zhang X, Wang F, Zhang W, Wang C, Yu C et al (2016) The relationship between obesity indices and serum vitamin D levels in Chinese adults from urban settings. Asia Pac J Clin Nutr 25:333–339. https://doi.org/10.6133/apjcn.2016.25.2.15
Afzal S, Brondum-Jacobsen P, Bojesen SE, Nordestgaard BG (2014) Vitamin D concentration, obesity, and risk of diabetes: a mendelian randomisation study. Lancet Diabetes Endocrinol 2:298–306. https://doi.org/10.1016/s2213-8587(13)70200-6
Khan AH, Iqbal R, Naureen G, Dar FJ, Ahmed FN (2012) Prevalence of vitamin D deficiency and its correlates: results of a community-based study conducted in Karachi, Pakistan. Arch Osteoporos 7:275–282. https://doi.org/10.1007/s11657-012-0108-x
Goswami R, Mishra SK, Kochupillai N (2008) Prevalence and potential significance of vitamin D deficiency in Asian Indians. Indian J Med Res 127:229–238
van der Meer IM, Middelkoop BJ, Boeke AJ, Lips P (2011) Prevalence of vitamin D deficiency among Turkish, Moroccan, Indian and sub-Sahara African populations in Europe and their countries of origin: an overview. Osteoporos Int 22:1009–1021. https://doi.org/10.1007/s00198-010-1279-1
Esmaillzadeh A, Azadbakht L (2008) Major dietary patterns in relation to general obesity and central adiposity among Iranian women. J Nutr 138:358–363. https://doi.org/10.1093/jn/138.2.358
Kimiagar M (1995) National food consumption survey. National Nutrition and Food Technology Research Institute, Tehran
Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP et al (2011) Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 96:1911–1930. https://doi.org/10.1210/jc.2011-0385
Lean ME, Han TS, Morrison CE (1995) Waist circumference as a measure for indicating need for weight management. BMJ 311:158–161
Third report of the National Cholesterol Education Program (NCEP) Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III) final report. Circulation 2002;106:3143–3421
Wahl S, Drong A, Lehne B, Loh M, Scott WR, Kunze S et al (2017) Epigenome-wide association study of body mass index, and the adverse outcomes of adiposity. Nature 541:81–86. https://doi.org/10.1038/nature20784
Manousopoulou A, Al-Daghri NM, Garbis SD, Chrousos GP (2015) Vitamin D and cardiovascular risk among adults with obesity: a systematic review and meta-analysis. Eur J Clin Invest 45:1113–1126. https://doi.org/10.1111/eci.12510
Holick MF (2006) Resurrection of vitamin D deficiency and rickets. J Clin Invest 116:2062–2072. https://doi.org/10.1172/JCI29449
McGrath J (2001) Does ‘imprinting’with low prenatal vitamin D contribute to the risk of various adult disorders? Med Hypotheses 56:367–371. https://doi.org/10.1054/mehy.2000.1226
Palomer X, González-Clemente J, Blanco-Vaca F, Mauricio D (2008) Role of vitamin D in the pathogenesis of type 2 diabetes mellitus. Diabetes Obes Metab 10:185–197. https://doi.org/10.1111/j.1463-1326.2007.00710.x
Cheng S, Massaro JM, Fox CS, Larson MG, Keyes MJ, McCabe EL et al (2010) Adiposity, cardiometabolic risk, and vitamin D status: the Framingham Heart Study. Diabetes 59:242–248. https://doi.org/10.2337/db09-1011
Parker J, Hashmi O, Dutton D, Mavrodaris A, Stranges S, Kandala N-B et al (2010) Levels of vitamin D and cardiometabolic disorders: systematic review and meta-analysis. Maturitas 65:225–236. https://doi.org/10.1016/j.maturitas.2009.12.013
Al-khalidi B, Kimball SM, Kuk JL, Ardern CI (2018) Metabolically healthy obesity, vitamin D, and all-cause and cardiometabolic mortality risk in NHANES III. Clin Nutr. https://doi.org/10.1016/j.clnu.2018.02.025
Cefalo CM, Conte C, Sorice GP, Moffa S, Sun VA, Cinti F et al (2018) Effect of Vitamin D supplementation on obesity-induced insulin resistance: a double-blind, randomized, placebo-controlled trial. Obesity (Silver Spring) 26:651–657. https://doi.org/10.1002/oby.22132
Wimalawansa SJ (2016) Associations of vitamin D with insulin resistance, obesity, type 2 diabetes, and metabolic syndrome. J Steroid Biochem Mol Biol 175:177–189. https://doi.org/10.1016/j.jsbmb.2016.09.017
Caprio M, Infante M, Calanchini M, Mammi C, Fabbri A (2017) Vitamin D: not just the bone. Evidence for beneficial pleiotropic extraskeletal effects. Eat Weight Disord 22:27–41. https://doi.org/10.1007/s40519-016-0312-6
Stokić E, Kupusinac A, Tomic-Naglic D, Smiljenic D, Kovacev-Zavisic B, Srdic-Galic B et al (2015) Vitamin D and dysfunctional adipose tissue in obesity. Angiology 66:613–618. https://doi.org/10.1177/0003319714543512
Zipitis CS, Akobeng AK (2008) Vitamin D supplementation in early childhood and risk of type 1 diabetes: a systematic review and meta-analysis. Arch Dis Child 93:512–517. https://doi.org/10.1136/adc.2007.128579
Wood RJ (2008) Vitamin D and adipogenesis: new molecular insights. Nutr Rev 66. https://doi.org/10.1111/j.1753-4887.2007.00004.x
Martini LA, Wood RJ (2006) Vitamin D status and the metabolic syndrome. Nutr Rev 64:479–486
Mammi C, Calanchini M, Antelmi A, Feraco A, Gnessi L, Falcone S et al (2013) Bisphosphonates and adipogenesis: evidence for alendronate inhibition of adipocyte differentiation in 3T3-L1 preadipocytes through a vitamin D receptor mediated effect. Nat Sci 5:955
Armani A, Mammi C, Marzolla V, Calanchini M, Antelmi A, Rosano G et al (2010) Cellular models for understanding adipogenesis, adipose dysfunction, and obesity. J Cell Biochem 110:564–572. https://doi.org/10.1002/jcb.22598
Pereira-Santos M, Costa PR, Assis AM, Santos CA, Santos DB (2015) Obesity and vitamin D deficiency: a systematic review and meta-analysis. Obes Rev 16:341–349. https://doi.org/10.1111/obr.12239
Zubiaga Toro L, Ruiz-Tovar Polo J, Díez-Tabernilla M, Giner Bernal L, Arroyo Sebastián A, Calpena Rico R (2014) Fórmula CUN-BAE y factores bioquímicos como marcadores predictivos de obesidad y enfermedad cardiovascular en pacientes pre y post gastrectomía vertical. Nutr Hosp 30:281–286. https://doi.org/10.3305/nh.2014.30.2.7581
Ruiz-Tovar J, Oller I, Tomas A, Llavero C, Arroyo A, Calero A et al (2012) Mid-term effects of sleeve gastrectomy on calcium metabolism parameters, vitamin D and parathormone (PTH) in morbid obese women. Obes Surg 22:797–801. https://doi.org/10.1007/s11695-011-0582-z
Ruiz-Tovar J, Oller I, Priego P, Arroyo A, Calero A, Diez M et al (2013) Short-and mid-term changes in bone mineral density after laparoscopic sleeve gastrectomy. Obes Surg 23:861–866. https://doi.org/10.1007/s11695-013-0866-6
Søvik TT, Aasheim ET, Taha O, Fagerland MW, Björkman S, Kristinsson J et al (2011) Weight loss, cardiovascular risk factors, and quality of life after gastric bypass and duodenal switch: a randomized trial. Ann Intern Med 155:281–291. https://doi.org/10.7326/0003-4819-155-5-201109060-00005
Authors appreciate the valuable assistance of all subjects. We also would like to thank the authorities of Health Center of Tarbiat Modares University, Tehran, Iran, for their cooperation.
This study was supported by Health Center of Tarbiat Modares University, Tehran, Iran.
Conflict of interest
Authors declared no personal or financial conflicts of interest.
All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all subjects included in the study.
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Mansouri, M., Miri, A., Varmaghani, M. et al. Vitamin D deficiency in relation to general and abdominal obesity among high educated adults. Eat Weight Disord 24, 83–90 (2019). https://doi.org/10.1007/s40519-018-0511-4
- Vitamin D
- Abdominal obesity