Abstract
To evaluate the association between MetS, its components and insulin resistance (IR) with 25(OH)D and hsCRP. The moderator role of 25(OH)D in the association of MetS, its diagnostic components and IR with hsCRP were also explored. A cross-sectional study (2014/2015) with a population-based cohort in Southern Brazil (n = 605). Metabolic syndrome (MetS) diagnosis was defined based on the Joint Interim Statement, while the Homeostasis Model Assessment of insulin resistance (IR) (HOMA-IR) was used for determining IR. Serum concentrations of 25-hydroxy vitamin D [25(OH)D] (ng/mL) and high sensitivity C-reactive protein (hsCRP) (mg/L) were evaluated following standard protocols. 25(OH)D was categorized as sufficiency (>30 ng/mL), insufficiency (20-30 ng/mL) or deficiency (<20 ng/mL) to test its moderator role. Multiple linear regression was used to test the associations. The results were adjusted for possible confounders. Hypertriglyceridemia and IR were associated with lower 25(OH)D concentrations. However, except for systolic blood pressure, other MetS components and IR were associated with higher hsCRP. The association between elevated waist circumference (WC) and hsCRP was moderated by the 25(OH)D concentrations. The hsCRP median concentrations were more than two times higher among those with elevated WC and 25(OH)D insufficiency or deficiency. In this study, inadequate concentrations of 25(OH)D increased the adverse relationship between elevated WC and inflammation. 25(OH)D concentrations could be incorporated into the clinical protocols for monitoring individuals with abdominal obesity to identify those at a higher risk of complications.
Highlights
Metabolic syndrome (MetS) is a condition that combines several cardiometabolic risk factors, including abdominal obesity, hypertension, dyslipidemia, hyperglycemia and insulin resistance (IR)
Among individuals with MetS, there was a higher proportion of males, older individuals, with a lower education level or elevated waist circumference (WC) that their peers, but no difference was observed according to physical activity level or smoking status
P-value of the median difference in high sensitivity C-reactive protein (hsCRP) between those with normal or elevated waist circumference (WC). This population-based study conducted in Southern Brazil verified that only hypertriglyceridemia and IR were associated with lower 25(OH)D concentrations
Summary
Metabolic syndrome (MetS) is a condition that combines several cardiometabolic risk factors, including abdominal obesity, hypertension, dyslipidemia, hyperglycemia and insulin resistance (IR). MetS is associated with the development of diabetes mellitus, cardiovascular disease (CVD) and their complications, including hospitalizations and deaths [1]. MetS is characterized by the release of free fatty acids, which promote chain reactions in different tissues, modifying glycemic markers, lipoproteins, blood pressure concentrations and IR [1]. These metabolic abnormalities are associated with chronic inflammation of low intensity, including increased synthesis of C-reactive protein (CRP), which is a marker of cardiovascular risk [2]. The Framingham Offspring Study conducted a study between 1997-2001 to corroborate data provided by in vitro studies suggesting a protective effect of vitamin D
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