Inverse Relationship between Metabolic Syndrome and 25-Hydroxyvitamin D Concentration in Elderly People without Vitamin D deficiency

Chun-Min Wang,Chuan-Yu Chen,Chin-Sung Chang,Meng-Tzu Hou,Chih-Hsing Wu,Yin-Fan Chang,Shin-Jiuan Wu,Ping-Yen Liu,Ching-Ju Chiu

doi:10.1038/s41598-018-35229-2

Abstract

Vitamin D status is inversely associated with the prevalence of metabolic syndrome (MetS). Whether this is true in the elderly without vitamin D deficiency is rarely investigated. Our data source is a cross-sectional survey of 1,966 community-dwelling elderly Taiwanese in 2012. An overnight fasting blood were obtained for biochemistry variables. Vitamin D deficiency was defined as serum 25-hydroxyvitamin D3 [25(OH)D] concentration <20 ng/mL. MetS is defined using modified ATP-III criteria. Of 523 participants without vitamin D deficiency (Men/Women = 269/254, age = 76.0 ± 6.2 years old [65–102 years old]), mean 25(OH)D was 44.0 ± 11.1 ng/mL, and the MetS prevalence of MS was 46.5%. Serum 25(OH)D was negatively associated with osteocalcin, the homeostatic model assessment insulin resistance (HOMA-IR) index, body mass index (BMI), and glycated hemoglobin A1c. Participants with more MetS features have lower serum 25(OH)D and osteocalcin. Binary logistic regression models showed that 25(OH)D, physical activity, and osteocalcin were negatively independent MetS factors, but that the HOMA-IR index, BMI, and being female were positively independent factors. The risk of MetS was progressively lower along with the increased 25(OH)D concentration, even above 60 ng/mL. In conclusion, a low 25(OH)D concentration is an independent risk factor for MetS in elderly people without vitamin D deficiency.

Highlights

One study[8] of elderly Chinese found no association between IR and vitamin D status in patient with type 2 DM
After excluding participants with vitamin D deficiency, we reviewed and analyzed 523 medical records (269 men, 254 women; mean age: 76.0 ± 6.2 years old; age range: 65–102 years) with complete data
Vitamin D concentrations were more often relatively lower (20 ng/mL ≤ 25(OH) D < 30 ng/mL) in women, those living with a partner, with greater cognitive impairment, who smoked less, and who had a higher fasting glucose level, homeostasis model assessment insulin resistance (HOMA-IR) index, and osteocalcin level (Appendix 2)

Summary

Introduction

One study[8] of elderly Chinese found no association between IR and vitamin D status in patient with type 2 DM. High sensitivity C-reactive protein (hsCRP) is a commonly used biomarker for systemic inflammation, and several studies[9] found an inverse relationship between vitamin D status and inflammation markers. The interrelationships among vitamin D, osteocalcin, the HOMA-IR index, hsCRP, and MetS are complicated and inadequately evaluated. We investigated these associations in the elderly without vitamin D deficiency, defined as 25-hydroxyvitamin D [25(OH)D]

Methods

Results

Conclusion