The Cooper Institute, Dallas, Texas, USA.
Department of Medicine, Stanford University, Palo Alto, California, USA.
J Womens Health (Larchmt). 2022 Jul;31(7):957-964. doi: 10.1089/jwh.2021.0402. Epub 2022 Mar 23.
Although physical inactivity, obesity, and low serum vitamin D [25-hydroxyvitamin D, 25(OH)D] are common among women, joint associations among these biomarkers are not well-described. A total of 7553 healthy women received a comprehensive examination (2006-2018), including self-reported physical activity (PA), body mass index (BMI), waist circumference (WC), waist:height ratio (W:HT), percent body fat (%Fat), and 25(OH)D. Participants were divided into four categories of PA based on current guidelines: <500 (not meeting guidelines), 500-1000 (meeting guidelines), 1001-2500 (>1-2.5 times guidelines), and >2500 (>2.5 times guidelines) metabolic equivalent-minutes/week (MET-Min/wk), and were also classified by clinical cut points for adiposity measures and 25(OH)D. We examined trends of 25(OH)D and adiposity exposures across PA categories and calculated odds ratios (ORs) of vitamin D deficiency across categories of each adiposity exposure. We examined joint associations among PA and adiposity with 25(OH)D. A positive trend was observed for 25(OH)D across PA categories ( < 0.001). Compared with normal weight status, the odds for 25(OH)D deficiency were significantly higher for overweight women within adiposity exposures ( for all <0.001). When examining joint associations, 25(OH)D was higher across PA categories within each stratum of BMI, WC, W:HT, and %Fat ( trend <0.007 for all). When examining PA and BMI as continuous variables, OR for vitamin D deficiency were 0.95 (95% confidence interval [CI]: 0.93-0.96) per 250 MET-minutes/week increment in PA, and 1.20 (95% CI: 1.17-1.23) per 2 kg/m increment in BMI. 25(OH)D levels are positively associated with PA and negatively associated with different measures of adiposity. Higher levels of PA attenuate the association between adiposity and 25(OH)D.
尽管身体活动不足、肥胖和血清维生素 D 水平低（25-羟维生素 D，25[OH]D）在女性中很常见，但这些生物标志物之间的综合关联尚未得到很好的描述。共有 7553 名健康女性接受了全面检查（2006-2018 年），包括自我报告的身体活动（PA）、体重指数（BMI）、腰围（WC）、腰高比（W:HT）、体脂百分比（%Fat）和 25（OH）D。参与者根据当前指南分为四个 PA 类别：<500（不符合指南）、500-1000（符合指南）、1001-2500（>1-2.5 倍指南）和>2500（>2.5 倍指南）代谢当量-分钟/周（MET-Min/wk），并根据肥胖测量和 25（OH）D 的临床切点进行分类。我们检查了 25（OH）D 和 PA 类别中肥胖暴露的趋势，并计算了每个肥胖暴露类别的维生素 D 缺乏的比值比（OR）。我们检查了 PA 和肥胖与 25（OH）D 之间的联合关联。在 PA 类别中观察到 25（OH）D 呈正趋势（<0.001）。与正常体重状态相比，超重女性的 25（OH）D 缺乏症的几率明显更高，肥胖暴露（均<0.001）。当检查联合关联时，在 BMI、WC、W:HT 和%Fat 的每个分层中，25（OH）D 在 PA 类别中更高（所有趋势<0.007）。当以连续变量检查 PA 和 BMI 时，PA 每增加 250 MET-minutes/周，维生素 D 缺乏症的 OR 为 0.95（95%置信区间[CI]：0.93-0.96），BMI 每增加 2 kg/m，OR 为 1.20（95% CI：1.17-1.23）。25（OH）D 水平与 PA 呈正相关，与不同的肥胖指标呈负相关。较高水平的 PA 减轻了肥胖与 25（OH）D 之间的关联。
