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Abstract
Metabolic syndrome (MetS) has become a global epidemic. In particular, it is known that there is a dramatic increase in the prevalence of MetS among women during the postmenopausal period. Recently, accumulating studies have suggested that vitamin D deficiency may be inversely associated with the risk factors regarding MetS. However, evidence from postmenopausal women is limited. In this study, we examined the association between the serum 25-hydroxyvitamin D [25(OH)D] and the MetS in Korean adult women aged 20-69 years (n = 2,618) by using the 2007-2008 Korean National Health and Nutrition Examination Survey data. The geometric mean of plasma 25(OH)D were 17.16 ± 6.28 ng/mL and 20.20 ± 7.69 ng/mL for premenopausal and postmenopausal women, respectively. The percentages of vitamin D deficiency [25(OH)D < 12 ng/mL] were 22.5% and 14.4%, respectively. MetS was more prevalent in postmenopausal women (43.0%) compared with premenopausal women (11.2%). When serum concentrations of 25(OH)D were categorized in quintiles, there was no relationship in the prevalence of MetS in both premonopausal and postmenopausal women. However, in premenopausal women, compared with the lowest 25(OH)D quintile, the odds ratio for hypertriglyceridemia in the highest quintile was 0.57 (95% CI 0.34-0.95, Ptrend = 0.041) and for low serum HDL cholesterol 0.60 (95% CI 0.42-0.85, Ptrend = 0.014) after adjusting for all potential confounders. On the other hand, we observed the tendency of an inverse relationship for 25(OH)D regarding low serum HDL cholesterol (OR 0.78, 95% CI 0.50-1.22, Ptrend = 0.029) and a direct relationship with abdominal obesity (OR 1.94, 95% CI 1.01, 3.74, Ptrend = 0.049) in postmenopausal women. Further studies are needed to confirm these findings in other research settings.
Figures and Tables
Fig. 1
Mean serum 25-hydroxyvitamin D concentrations among subjects in premenopausal and postmenopausal period. White bars show subjects without metabolic syndrome and black bars show subjects with metabolic syndrome. *: p < 0.05.
Table 2
Characteristics of subjects included in this study according to quintiles of serum 25-hydroxyvitamin D concentration
Table 3
Adjusted odd ratios (ORs) and 95% confidence intervals (CIs) of having the metabolic syndrome by serum 25-hydroxyvitamin D quintiles among 1,613 premenopausal women
Data are n (%) or adjusted OR (95% CI). For prevalence, Ptrend was from Cochran Mantel Haenzel analysis; for odds ratio, Ptrend was from Wald chi-square test
Model 1: adjusted for age, body mass index, season, Model 2: adjusted for all variables in model 1 plus education (Elementary, Mid-dle, High, College), regular exercise (yes/no), multivitamin supplement use (yes/no), Model 3: adjusted for all variables in model 2 plus total energy, fat, and calcium intake
Table 4
Adjusted odd ratios (ORs) and 95% confidence intervals (CIs) of having the metabolic syndrome by serum 25-hydroxyvitamin D quintiles among 1,005 postmenopausal women
Data are n (%) or adjusted OR (95% CI). For prevalence, Ptrend was from Cochran Mantel Haenzel analysis; for odds ratio, Ptrend was from Wald chi-square test.
Model 1: adjusted for age, body mass index, season, Model 2: adjusted for all variables in model 1 plus education (Elementary, Middle, High, College), monthly drinking (yes/no), regular exercise (yes/no), multivitamin supplement use (yes/no), Model 3: adjusted for all variables in model 2 plus total energy, carbohydrate, and fat intake
References
1. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of The 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). JAMA. 2001. 285(19):2486–2497.
2. Wilson PW, D'Agostino RB, Parise H, Sullivan L, Meigs JB. Metabolic syndrome as a precursor of cardiovascular disease and type 2 diabetes mellitus. Circulation. 2005. 112(20):3066–3072.
3. 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(5):1228–1230.
4. Bong HY, Kim JY, Jeong HI, Moon MS, Kim J, Kwon O. Effects of corn gluten hydrolyzates, branched chain amino acids, and leucine on body weight reduction in obese rats induced by a high fat diet. Nutr Res Pract. 2010. 4(2):106–113.
5. Kannel WB, Hjortland MC, McNamara PM, Gordon T. Menopause and risk of cardiovascular disease: the Framingham study. Ann Intern Med. 1976. 85(4):447–452.
6. Kim HM, Park J, Ryu SY, Kim J. The effect of menopause on the metabolic syndrome among Korean women: the Korean National Health and Nutrition Examination Survey, 2001. Diabetes Care. 2007. 30(3):701–706.
7. Zivkovic TB, Vuksanovic M, Jelic MA, Stojanovic J, Buric B, Jojic B, Milic N, Vujovic S. Obesity and metabolic syndrome during the menopause transition in Serbian women. Climacteric. 2011. 14(6):643–648.
8. Pandey S, Srinivas M, Agashe S, Joshi J, Galvankar P, Prakasam CP, Vaidya R. Menopause and metabolic syndrome: A study of 498 urban women from western India. J Midlife Health. 2010. 1(2):63–69.
9. Holick MF. Vitamin D deficiency. N Engl J Med. 2007. 357(3):266–281.
10. Forouhi NG, Luan J, Cooper A, Boucher BJ, Wareham NJ. 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. 2008. 57(10):2619–2625.
11. Ford ES, Zhao G, Li C, Pearson WS. Serum concentrations of vitamin D and parathyroid hormone and prevalent metabolic syndrome among adults in the United States. J Diabetes. 2009. 1(4):296–303.
12. Lu L, Yu Z, Pan A, Hu FB, Franco OH, Li H, Li X, Yang X, Chen Y, Lin X. Plasma 25-hydroxyvitamin D concentration and metabolic syndrome among middle-aged and elderly Chinese individuals. Diabetes Care. 2009. 32(7):1278–1283.
13. Choi HS, Kim KA, Lim CY, Rhee SY, Hwang YC, Kim KM, Kim KJ, Rhee Y, Lim SK. Low serum vitamin D is associated with high risk of diabetes in Korean adults. J Nutr. 2011. 141(8):1524–1528.
14. Kim MK, Il Kang M, Won Oh K, Kwon HS, Lee JH, Lee WC, Yoon KH, Son HY. The association of serum vitamin D level with presence of metabolic syndrome and hypertension in middle-aged Korean subjects. Clin Endocrinol (Oxf). 2010. 73(3):330–338.
15. Khader YS, Batieha A, Jaddou H, Batieha Z, El-Khateeb M, Ajlouni K. Relationship between 25-hydroxyvitamin D and metabolic syndrome among Jordanian adults. Nutr Res Pract. 2011. 5(2):132–139.
16. Rueda S, Fernández-Fernández C, Romero F, Martínez de, Vidal J. Vitamin D, PTH, and the metabolic syndrome in severely obese subjects. Obes Surg. 2008. 18(2):151–154.
17. Hjelmesaeth J, Hofsø D, Aasheim ET, Jenssen T, Moan J, Hager H, Røislien J, Bollerslev J. Parathyroid hormone, but not vitamin D, is associated with the metabolic syndrome in morbidly obese women and men: a cross-sectional study. Cardiovasc Diabetol. 2009. 8:7.
18. Snijder MB, Lips P, Seidell JC, Visser M, Deeg DJ, Dekker JM, van Dam RM. Vitamin D status and parathyroid hormone levels in relation to blood pressure: a population-based study in older men and women. J Intern Med. 2007. 261(6):558–565.
19. Grundy SM, Brewer HB Jr, Cleeman JI, Smith SC Jr, Lenfant C. American Heart Association. National Heart, Lung, and Blood Institute. Definition of metabolic syndrome: Report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation. 2004. 109(3):433–438.
20. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC Jr, Spertus JA, Costa F. American Heart Association. National Heart, Lung, and Blood Institute. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005. 112(17):2735–2752.
21. Lee SY, Park HS, Kim DJ, Han JH, Kim SM, Cho GJ, Kim DY, Kwon HS, Kim SR, Lee CB, Oh SJ, Park CY, Yoo HJ. Appropriate waist circumference cutoff points for central obesity in Korean adults. Diabetes Res Clin Pract. 2007. 75(1):72–80.
22. Choi HS, Oh HJ, Choi H, Choi WH, Kim JG, Kim KM, Kim KJ, Rhee Y, Lim SK. Vitamin D insufficiency in Korea--a greater threat to younger generation: the Korea National Health and Nutrition Examination Survey (KNHANES) 2008. J Clin Endocrinol Metab. 2011. 96(3):643–651.
23. Kim HW, Kwon MK, Kim NS, Reame NE. Intake of dietary soy isoflavones in relation to perimenstrual symptoms of Korean women living in the USA. Nurs Health Sci. 2006. 8(2):108–113.
24. Devaraj S, Jialal G, Cook T, Siegel D, Jialal I. Low vitamin D levels in Northern American adults with the metabolic syndrome. Horm Metab Res. 2011. 43(1):72–74.
25. Botella-Carretero JI, Alvarez-Blasco F, Villafruela JJ, Balsa JA, Vázquez C, Escobar-Morreale HF. Vitamin D deficiency is associated with the metabolic syndrome in morbid obesity. Clin Nutr. 2007. 26(5):573–580.
26. Hyppönen E, Boucher BJ, Berry DJ, Power C. 25-hydroxyvitamin D, IGF-1, and metabolic syndrome at 45 years of age: a cross-sectional study in the 1958 British Birth Cohort. Diabetes. 2008. 57(2):298–305.
27. Chonchol M, Scragg R. 25-Hydroxyvitamin D, insulin resistance, and kidney function in the Third National Health and Nutrition Examination Survey. Kidney Int. 2007. 71(2):134–139.
28. Pittas AG, Lau J, Hu FB, Dawson-Hughes B. The role of vitamin D and calcium in type 2 diabetes. A systematic review and meta-analysis. J Clin Endocrinol Metab. 2007. 92(6):2017–2029.
29. Oosterwerff MM, Eekhoff EM, Heymans MW, Lips P, van Schoor NM. Serum 25-hydroxyvitamin D levels and the metabolic syndrome in older persons: a population-based study. Clin Endocrinol (Oxf). 2011. 75(5):608–613.
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