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      Serum Vitamin D is Llow and Inversely Associated with LDL Cholesterol in the Kazak Ethnic Population: A Cross-Sectional Study

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          Abstract

          Background

          Accumulating evidence suggests that low concentrations of serum 25(OH)D is coupled with increased risks of hypertension, obesity, and cardiovascular disease. However, this relationship has not been established in populations with very low levels of 25(OH)D. Therefore, the aim of our study was to clarify the associations between 25(OH)D and blood pressure, obesity, sex, and lipid profiles in the Kazak ethnic population, who have an extremely low level of 25(OH)D.

          Material/Methods

          A multistage-cluster sampling survey was carried out for residents with Kazak ethnicity in Xinjiang, China. Anthropometric measurements of each participant were taken and the concentrations of 25(OH)D, calcium, alkaline phosphatase, and lipid profiles were measured. Individuals were classified into different groups in terms of vitamin D status, degree of adiposity, presence of hypertension, and other comorbidities.

          Results

          The madian concentration of 25(OH)D was 16.2 (11.8–20.5) ng/mL and the prevalence of vitamin D deficiency was 72.4% in this Kazak population (n=928, 59.0% women). Females had a lower 25(OH)D concentration than males – 14.6 (10.5–19.4) ng/mL vs. 17.7 (14.8–22.5) ng/mL, P<0.001. The subjects were classified into 3 groups according to their vitamin D status. There were significant differences in BMI ( P=0.046), waist circumference ( P=0.037), hip circumference ( P=0.003), systolic BP ( P=0.035), and LDL cholesterol ( P=0.008) among the groups after adjustment for sex and age. On the other hand, there was no significant difference in vitamin D levels between groups with or without hypertension ( P=0.586), and groups with or without obesity ( P=0.639). A multifactor-regression analysis revealed that every increment of 1mg/dL in LDL cholesterol was associated with a 1.0 ng/mL decline in serum 25(OH)D.

          Conclusions

          The insufficiency of vitamin D is highly prevalent in Kazaks. Sex, LDL cholesterol, and hip circumference are 3 variables strongly associated with serum 25(OH)D concentration. In a population with low levels of 25(OH)D, the negative relationship between obesity and serum 25(OH)D, a common finding from most previous studies, could not be established.

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          The role of vitamin D and calcium in type 2 diabetes. A systematic review and meta-analysis.

          Anastassios G Pittas, Joseph Lau, Frank Hu … (2007)
          Altered vitamin D and calcium homeostasis may play a role in the development of type 2 diabetes mellitus (type 2 DM). EVIDENCE ACQUISITION AND ANALYSES: MEDLINE review was conducted through January 2007 for observational studies and clinical trials in adults with outcomes related to glucose homeostasis. When data were available to combine, meta-analyses were performed, and summary odds ratios (OR) are presented. Observational studies show a relatively consistent association between low vitamin D status, calcium or dairy intake, and prevalent type 2 DM or metabolic syndrome [OR (95% confidence interval): type 2 DM prevalence, 0.36 (0.16-0.80) among nonblacks for highest vs. lowest 25-hydroxyvitamin D; metabolic syndrome prevalence, 0.71 (0.57-0.89) for highest vs. lowest dairy intake]. There are also inverse associations with incident type 2 DM or metabolic syndrome [OR (95% confidence interval): type 2 DM incidence, 0.82 (0.72-0.93) for highest vs. lowest combined vitamin D and calcium intake; 0.86 (0.79-0.93) for highest vs. lowest dairy intake]. Evidence from trials with vitamin D and/or calcium supplementation suggests that combined vitamin D and calcium supplementation may have a role in the prevention of type 2 DM only in populations at high risk (i.e. glucose intolerance). The available evidence is limited because most observational studies are cross-sectional and did not adjust for important confounders, whereas intervention studies were short in duration, included few subjects, used a variety of formulations of vitamin D and calcium, or did post hoc analyses. Vitamin D and calcium insufficiency may negatively influence glycemia, whereas combined supplementation with both nutrients may be beneficial in optimizing glucose metabolism.
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            The relationship between obesity and serum 1,25-dihydroxy vitamin D concentrations in healthy adults.

            Shamik Parikh, Marni Edelman, Gabriel Uwaifo … (2004)
            Several previous reports of small cohorts have found significantly higher serum 1,25-dihydroxy vitamin D (1,25-vit D) in obese compared with nonobese whites. Based on these reports and on recent in vitro studies of adipocytes which suggest that administration of 1,25-vit D can stimulate lipogenesis and inhibit lipolysis, some investigators have proposed that high 1,25-vit D may play a role in promoting or maintaining adipocyte triglyceride stores in obese adults. To test the hypothesis that obesity is commonly associated with increased 1,25-vit D, we examined the relationships between calciotropic hormones and body adiposity in a large cohort of healthy adults. Serum intact PTH, 25-hydroxy vitamin D, and 1,25-vit D were measured in the postabsorptive state in 302 healthy adults who were Caucasian (n = 190; 71% female), African-American (n = 84; 89% female), and of other race/ethnicity (n = 28; 61% female). Results from the 154 obese subjects [body mass index (BMI) 37.3 +/- 5.8 kg/m(2); range, 30.1-58.2 kg/m(2)] were compared with those from 148 nonobese (BMI 25.6 +/- 2.9 kg/m(2); range, 18.0-29.9 kg/m(2)) age-, race-, and sex-matched participants. Body composition was measured by dual energy x-ray absorptiometry. Serum intact PTH was positively correlated with both BMI (r = 0.42; P < 0.0001) and body fat mass (r = 0.37; P < 0.0001). Serum 25-hydroxy vitamin D was negatively correlated with BMI (r = -0.4; P < 0.0001) and body fat mass (r = -0.41; P < 0.0001). Serum 1,25-vit D was also negatively correlated with BMI (r = -0.26; P < 0.0001) and body fat mass (r = -0.25; P = 0.0001). Serum 1,25-vit D was significantly lower in obese than nonobese subjects (105.7 +/- 41.1 vs. 124.8 +/- 36.7 pmol/liter; P < 0.0001) in both Caucasian and African-American adults. We conclude that, because 1,25-vit D concentrations fall with increasing adiposity, it appears unlikely that elevation in 1,25-vit D is an important hormonal mechanism causing or maintaining obesity in adults.
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              Perceived racial discrimination and hypertension: a comprehensive systematic review.

              Cynthia Dolezsar, Jennifer McGrath, Alyssa Herzig … (2014)
              Discrimination is posited to underlie racial disparities in hypertension. Extant literature suggests a possible association between racial discrimination and blood pressure, although inconsistent findings have been reported. The aim of this comprehensive systematic review was to quantitatively evaluate the association between perceived racial discrimination with hypertensive status and systolic, diastolic, and ambulatory blood pressure.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Med Sci Monit
                Journal ID (iso-abbrev): Med. Sci. Monit
                Journal ID (publisher-id): Medical Science Monitor
                Title: Medical Science Monitor : International Medical Journal of Experimental and Clinical Research
                Publisher: International Scientific Literature, Inc.
                ISSN (Print): 1234-1010
                ISSN (Electronic): 1643-3750
                Publication date Collection: 2014
                Publication date (Electronic): 23 July 2014
                Volume: 20
                Pages: 1274-1283
                Affiliations
                [1 ]Department of Hypertension, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
                [2 ]Department of Cardiology, Xinjiang Armed Police Hospital, Urumqi, China
                [3 ]Department of Endocrinology, Peking Union Medical College Hospital, Key Laboratory of Endocrinology, Ministry of Health, Beijing, China
                Author notes
                Corresponding Author: Xinjuan Xu, e-mail: zcxu2002@ 123456medmial.com.cn
                [A]

                Study Design

                [B]

                Data Collection

                [C]

                Statistical Analysis

                [D]

                Data Interpretation

                [E]

                Manuscript Preparation

                [F]

                Literature Search

                [G]

                Funds Collection

                [*]

                These authors contributed equally to this work

                Article
                Publisher ID: 890930
                DOI: 10.12659/MSM.890930
                PMC ID: 4114700
                PubMed ID: 25064492
                SO-VID: b55ece4c-eef7-4d7e-baf5-f4131a64841a
                Copyright © © Med Sci Monit, 2014
                License:

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License

                History
                Date received : 26 April 2014
                Date accepted : 11 June 2014
                Categories
                Subject: Clinical Research

                Keywords: blood pressure,calcifediol,gender identity,obesity
                Data availability:
                Keywords: blood pressure, calcifediol, gender identity, obesity

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