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Abstract
Background:
Studies on the relationship between vitamin D and visceral fat area (VFA; intra-abdominal fat area) have been actively conducted. But, there is a few Korean population-based studies about the association between serum vitamin D level and VFA. The aim of our study was to explore the correlation between serum 25-hydroxyvitamin D (25[OH]D) levels and VFA measured using bioelectrical impedance analysis (BIA; electric impedance) in healthy Korean adults.
Methods:
This cross-sectional study involved 1,945 adults aged 20-70 years who visited a health promotion center. All subjects underwent the BIA to estimate the VFA. Serum 25(OH)D level was measured using chemiluminescent immunoassay. Multiple regression analysis was performed to identify independent correlation of VFA and serum 25(OH)D level.
Results:
The prevalence of vitamin D deficiency (25[OH]D: 20-29 ng/mL) and insufficiency (25[OH]D <20 ng/mL) were 54.4% and 38.1%, respectively. After having adjusted age and season, VFA were negatively associated with serum 25(OH)D levels in both men (P<0.001) and women (P<0.001). The obese group with VFA ≥ 100 cm2 had significant lower serum 25(OH)D level in men (P<0.001) and women (P=0.0034).
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Figure 1.
Differential serum 25-hydroxyvitamin D (25[OH]D) concentrations in subjects with or without obesity. (A, B) Comparison of serum 25-hydroxyvitamin D (25[OH]D) levels according to body mass index (BMI) in men and women. Subjects with a BMI ≥25 kg/m2 were classified as obese. (C, D) Comparison of serum 25(OH)D levels according to percentage body fat (PBF) in men and women. Men with a PBF ≥25 % and women with a PBF ≥30 % were classified as obese. (E, F) Comparison of serum 25[OH]D levels according to visceral fat area (VFA) in men and women. Subjects with a VFA ≥100 cm2 were classified as obese. Data are presented as mean±standard deviation. ∗P value from an independent-sample t-test.
Figure 2.
Correlation between 25(OH)D and fatness indices in men and women (A-C); in women aged ≥50 and <50 years (D). Smoothing curve with 95% confidence interval (shaded areas) are fitted by a Loess curve.
Table 1.
Characteristics of study subjects
| Total (n=1,945) | Men (n=1,395) | Women (n=550) | Pa | |
|---|---|---|---|---|
| Age (y) | 46±9.5 | 46.3±9.1 | 47±10.4 | 0.204 |
| BMI (kg/m2) | 24.6±3.2 | 25±3 | 23.3±3.2 | <0.001 |
| Normal (18.5-22.9) | 639 (32.9) | 346 (24.8) | 293 (53.3) | <0.001 |
| Overweight (23-24.9) Obese (≥25) | 517 (26.6) 789 (40.6) | 401 (28.7) 648 (46.5) | 116 (21.1) 141 (25.6) | 0.001 <0.001 |
| Percentage body fat (%) | 27±8 | 24.4±5.4 | 33.1±5.8 | <0.001 |
| Non-obese (<25 in males, <30 in females) | 939 (48.3) | 786 (56.3) | 153 (27.8) | <0.001 |
| Obese (≥25 in males, ≥30 in females) | 1,006 (51.7) | 619 (43.7) | 397 (72.2) | <0.001 |
| VFA (cm2) | 82.5±31.7 | 78±29 | 94.1±10.4 | <0.001 |
| Normal (<100) High-VFA (≥100) | 1,501 (77.2) 444 (22.8) | 1,161 (83.2) 234 (16.8) | 340 (61.8) 210 (38.2) | <0.001 <0.001 |
| Blood pressure (mmHg) | ||||
| Systolic | 118.5±13.9 | 120.4±13.2 | 113.4±14.4 | <0.001 |
| Diastolic | 78.4±11.3 | 80.1±11.1 | 74.3±10.9 | <0.001 |
| 25(OH)D (ng/mL) | 19.5±7.4 | 20.3±7 | 17.3±8 | <0.001 |
| Normal (≥30) | 144 (7.4) | 103 (7.4) | 41 (7.5) | 0.957 |
| Insufficiency (20-29.9) Deficiency (<20) | 742 (38.1) 1,059 (54.4) | 596 (42.7) 696 (49.9) | 146 (26.5) 363 (66) | <0.001 <0.001 |
| Total cholesterol (mg/dL) | 193.4±34.8 | 193.4±35 | 193.6±34.4 | 0.916 |
| Triglyceride (mg/dL) | 138.9±91 | 153.1±98.3 | 102.8±54 | <0.001 |
| HDL cholesterol (mg/dL) | 50.7±11.8 | 48.2±10.3 | 57.1±13.1 | <0.001 |
| LDL cholesterol (mg/dL) | 119.2±25.6 | 120.4±25.7 | 116.2±25.3 | 0.001 |
| Fasting glucose (mg/dL) | 87.2±10.4 | 88.1±10.6 | 84.8±9.8 | <0.001 |
Table 2.
Correlation between serum 25(OH)D and variables
| Men | Women | |||
|---|---|---|---|---|
| ra | Pb | r | P | |
| Age | 0.142 | <0.001 | 0.305 | <0.001 |
| Body mass index | -0.127 | <0.001 | -0.134 | 0.002 |
| Percentage body fat | -0.195 | <0.001 | -0.096 | 0.025 |
| Visceral fat area | -0.185 | <0.001 | -0.153 | <0.001 |
| Systolic blood pressure | -0.079 | 0.003 | -0.038 | 0.379 |
| Diastolic blood pressure Total cholesterol | -0.115 -0.087 | <0.001 0.001 | -0.064 0.060 | 0.133 0.160 |
| Triglyceride | -0.312 | <0.001 | -0.163 | <0.001 |
| High density lipoprotein cholesterol | 0.058 | 0.031 | 0.006 | 0.892 |
| Low density lipoprotein cholesterol | -0.029 | 0.284 | 0.105 | 0.014 |
| Fasting glucose | -0.062 | 0.020 | -0.029 | 0.493 |
Table 3.
Regression analysis of relationship between vitamin D and obesity indices
| Men | Women | |||
|---|---|---|---|---|
| β±SE | Pa | β±SE | P | |
| Model 1b | ||||
| Body mass index | -0.004±0.064 | 0.950 | -0.342±0.111 | 0.002 |
| Percentage body fat | -0.142±0.035 | <0.001 | -0.158±0.059 | 0.008 |
| Visceral fat area | -0.018±0.007 | 0.008 | -0.034±0.010 | -0.149 |
| Model 2c | ||||
| Body mass index Percentage body fat | -0.188±0.060 -0.211±0.033 | 0.002 <0.001 | -0.492±0.100 -0.225±0.056 | <0.001 <0.001 |
| Visceral fat area | -0.032±0.006 | <0.001 | -0.046±0.009 | <0.001 |
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