Botella-Carretero José I, Alvarez-Blasco Francisco, Villafruela Juan J, Balsa José A, Vázquez Clotilde, Escobar-Morreale Héctor F
Department of Clinical Nutrition, Hospital Ramón y Cajal, 28034 Madrid, Spain.
Clin Nutr. 2007 Oct;26(5):573-80. doi: 10.1016/j.clnu.2007.05.009. Epub 2007 Jul 10.
BACKGROUND & AIMS: Vitamin D deficiency has been recently associated with the metabolic syndrome. However, it is not known whether this possible association of vitamin D deficiency with the metabolic syndrome is still present at very high degrees of obesity, as in morbidly obese patients.
Transversal, observational study that included 73 consecutive morbidly obese patients (body mass index 40 kg/m(2)). In every patient, anthropometric variables were recorded, fasting blood was assayed for 25-hydroxyvitamin D concentrations, lipid profiles, glucose and insulin levels, and insulin resistance was estimated by homeostasis model assessment.
Vitamin D deficiency was present in 37 of the 73 patients (50.7%). As defined by revised Adult Treatment Panel III criteria, 46 of the 73 obese patients (63%) had the metabolic syndrome. Vitamin D deficiency was more prevalent in morbidly obese patients presenting with the metabolic syndrome, compared with those who did not achieve the criteria for this syndrome (60.9% vs. 33.3% respectively, P = 0.023). When serum concentrations of 25-hydroxyvitamin D were categorized in tertiles, there was an association of the prevalence of the metabolic syndrome with the former (P = 0.038). Serum high-density lipoprotein cholesterol concentrations were lower (37.0+/-7.8 mg/dl vs. 44.9+/-8.7 mg/dl, P = 0.003), and triglycerides levels were higher (163.3+/-81.5 mg/dl vs. 95.1+/-24.2 mg/dl, P = 0.001) in the vitamin D-deficient group.
Vitamin D deficiency is associated with the metabolic syndrome in morbidly obese patients.
维生素D缺乏症近来被认为与代谢综合征有关。然而，在极度肥胖的患者（如病态肥胖患者）中，维生素D缺乏与代谢综合征之间这种可能的关联是否依然存在尚不清楚。
这是一项横向观察性研究，纳入了73例连续的病态肥胖患者（体重指数≥40kg/m²）。记录每位患者的人体测量学变量，检测空腹血中的25-羟基维生素D浓度、血脂谱、血糖和胰岛素水平，并通过稳态模型评估来估算胰岛素抵抗。
73例患者中有37例（50.7%）存在维生素D缺乏。根据修订的成人治疗小组III标准，73例肥胖患者中有46例（63%）患有代谢综合征。与未达到该综合征标准的患者相比，患有代谢综合征的病态肥胖患者中维生素D缺乏更为普遍（分别为60.9%和33.3%，P = 0.023）。当将血清25-羟基维生素D浓度分为三个三分位数时，代谢综合征的患病率与前者有关联（P = 0.038）。维生素D缺乏组的血清高密度脂蛋白胆固醇浓度较低（37.0±7.8mg/dl对44.9±8.7mg/dl，P = 0.003），甘油三酯水平较高（163.3±81.5mg/dl对95.1±24.2mg/dl，P = 0.001）。
病态肥胖患者中维生素D缺乏与代谢综合征有关。
