Department of Internal Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy.
Intern Emerg Med. 2013 Feb;8(1):33-40. doi: 10.1007/s11739-011-0559-x. Epub 2011 Mar 25.
Obesity is frequently characterized by a reduced vitamin D bioavailability, as well as insulin-resistance and a chronic inflammatory response. We tested the hypothesis of an independent relationship between serum concentrations of 25-hydroxyvitamin D (25[OH]D) and several circulating inflammatory markers in a cohort of severely obese individuals. Cross-sectional study was carried out among obese patients undergoing a clinical evaluation before bariatric surgery in our University Hospital. Serum 25(OH)D, fasting and post load glucose and insulin, high-sensitive C-reactive protein (hs CRP), fibrinogen, interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), leptin, adiponectin and lipid profile were collected. Insulin-resistance was assessed by insulin sensitivity index (ISI). Total body fat (FAT kg), total percent body fat (FAT%) and truncal fat mass (TrFAT) were assessed with dual-energy X-ray absorptiometry. A total of 147 obese subjects (89 women, 37.8 ± 7.1 years) with mean body mass index (BMI) of 43.6 ± 4.3 kg/m(2) were enrolled. Patients in the lowest tertile of 25(OH)D were significantly more obese with a higher amount of TrFAT, more insulin-resistant, and had higher levels of fasting and post-challenge glucose (p < 0.05 for all). In a multivariate regression analysis, serum 25(OH)D was inversely related to significant levels of hs CRP, IL-6 and TNF-α after accounting for age, gender, season of recruitment, BMI, FAT kg and TrFAT (p < 0.01 for all). In extremely obese subjects, 25(OH)D serum concentrations are inversely associated with several biomarkers of systemic inflammation, regardless of the total quantity of fat mass.
肥胖常伴有维生素 D 生物利用度降低、胰岛素抵抗和慢性炎症反应。我们检验了肥胖个体血清 25-羟维生素 D（25[OH]D）浓度与几种循环炎症标志物之间存在独立关系的假说。这是一项在我们大学医院接受减重手术临床评估的肥胖患者中进行的横断面研究。采集了血清 25（OH）D、空腹和负荷后血糖及胰岛素、高敏 C 反应蛋白（hs CRP）、纤维蛋白原、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、瘦素、脂联素和血脂谱。胰岛素敏感性指数（ISI）评估胰岛素抵抗。双能 X 射线吸收法评估总体脂肪量（FAT kg）、总体体脂百分比（FAT%）和躯干脂肪量（TrFAT）。共纳入 147 名肥胖患者（89 名女性，37.8±7.1 岁），平均体重指数（BMI）为 43.6±4.3 kg/m2。25（OH）D 最低三分位组的患者明显更肥胖，TrFAT 更多，胰岛素抵抗更严重，空腹和负荷后血糖水平更高（所有 p 值均<0.05）。在多元回归分析中，在校正年龄、性别、招募季节、BMI、FAT kg 和 TrFAT 后，血清 25（OH）D 与 hs CRP、IL-6 和 TNF-α的显著水平呈负相关（所有 p 值均<0.01）。在极度肥胖的患者中，血清 25（OH）D 浓度与全身炎症的多种生物标志物呈负相关，而与脂肪总量无关。
