Endocrinology team, Laboratory of Biology and Physiology, Faculty of Biological Sciences, USTHB, DZ-16111, Algiers, Algeria.
Unit of Clinical Endocrinology, IBN ZIRI Hospital, DZ-16082, Algiers, Algeria.
Ir J Med Sci. 2024 Apr;193(2):615-626. doi: 10.1007/s11845-023-03516-1. Epub 2023 Sep 13.
This first cross-sectional study examined whether vitamin D status and proinflammatory cytokines may be associated with metabolic syndrome (MetS) in Algerian women regarding their menopausal status.
Fasting plasma glucose (FPG), lipids, insulin, 25(OH)D, PTH, adiponectin, resistin, TNFα, and IL-6 levels were assessed in 277 participants aged 18-74 years. MetS was diagnosed according to NCEP-ATPIII criteria. The association of vitamin D deficiency, IL-6, and TNFα with components of MetS was analyzed by the logistic regression.
Among a cohort of 277 participants, the prevalence of MetS in 115 premenopausal vs. 162 postmenopausal women was 54.02 vs. 68.1%. Cut-offs for vitamin D deficiency were 15.7 vs. 13 ng/mL, 51.07 vs. 41 pg/mL for IL-6 and 8.28 vs. 9.33 pg/mL for TNFα, respectively. 25(OH)D levels were positively correlated with adiponectin levels, while negatively with HOMA-IR in postmenopausal-MS + women. Adjustment for age and BMI reveals a significant association between vitamin deficiency and high FPG (OR: 2.92 vs. 2.90), TG (OR:2.79 vs. 3.51), BP (OR:2.20 vs. 1.92), and low HDL-c (OR:2.26 vs. 3.42), respectively. A significant association was also detected in postmenopausal women between IL-6 and high FPG (OR5.11, p = 0.03), BP (OR:3.13, p = 0.04), and low HDL-c (OR5.01, p = 0.02), while TNFα was associated with high BP in postmenopausal women (OR: 3.70, p = 0.01), and inversely with TG in premenopausal women (OR: 0.16, p = 0.04).
This study highlighted that severe vitamin D deficiency increases MetS score and was closely associated with four components of MetS, more potently in postmenopausal women, probably related with estrogens. Abdominal obesity, as influential component of MetS, may be involved in enhancing vitamin D deficiency, and dysregulating some metabolic hormones such as adiponectin, resistin and insulin, that contributes in onset an inflammatory state, through the increase in IL-6 and TNFα levels. These findings need to be improved by expanding investigation to a large cohort of participants.
本研究首次探讨了维生素 D 状态和促炎细胞因子是否与阿尔及利亚女性的代谢综合征(MetS)有关,同时考虑了她们的绝经状态。
对 277 名年龄在 18-74 岁的参与者进行空腹血糖(FPG)、血脂、胰岛素、25(OH)D、甲状旁腺素、脂联素、抵抗素、TNFα和 IL-6 水平的评估。采用 NCEP-ATPIII 标准诊断 MetS。采用逻辑回归分析维生素 D 缺乏、IL-6 和 TNFα与 MetS 各组分的相关性。
在 277 名参与者中,115 名绝经前和 162 名绝经后女性的 MetS 患病率分别为 54.02%和 68.1%。维生素 D 缺乏的截断值分别为 15.7 vs. 13ng/mL、51.07 vs. 41pg/mL 的 IL-6 和 8.28 vs. 9.33pg/mL 的 TNFα。绝经后-MS+女性中 25(OH)D 水平与脂联素水平呈正相关,与 HOMA-IR 呈负相关。调整年龄和 BMI 后,维生素缺乏与高 FPG(OR:2.92 vs. 2.90)、TG(OR:2.79 vs. 3.51)、BP(OR:2.20 vs. 1.92)和低 HDL-c(OR:2.26 vs. 3.42)显著相关。绝经后妇女中 IL-6 与高 FPG(OR5.11,p=0.03)、BP(OR:3.13,p=0.04)和低 HDL-c(OR5.01,p=0.02)显著相关,而 TNFα与绝经后妇女的高 BP(OR:3.70,p=0.01)相关,与绝经前妇女的 TG 呈负相关(OR:0.16,p=0.04)。
本研究表明,严重的维生素 D 缺乏会增加 MetS 评分,并与 MetS 的四个组成部分密切相关,在绝经后妇女中更为明显,可能与雌激素有关。腹部肥胖作为 MetS 的一个重要组成部分,可能通过增加 IL-6 和 TNFα 水平,影响维生素 D 的缺乏,并调节脂联素、抵抗素和胰岛素等一些代谢激素,导致炎症状态的发生。这些发现需要通过扩大对大量参与者的研究来进一步证实。