Vitamin D Levels Decline with Rising Number of Cardiometabolic Risk Factors in Healthy Adults: Association with Adipokines, Inflammation, Oxidative Stress and Advanced Glycation Markers.

Zora Krivošíková,Katarína Šebeková,Martin Gajdoš,Alan Stitt

doi:10.1371/journal.pone.0131753

Zora Krivošíková, Katarína Šebeková + Show 2 more

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https://doi.org/10.1371/journal.pone.0131753

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Abstract

IntroductionHypovitaminosis D associates with obesity, insulin resistance, hypertension, and dyslipoproteinemia. We asked whether the presence of multiple cardiometabolic risk factors, and which particular combination, exerts additive negative effects on 25(OH)D3 levels; and whether 25(OH)D3 levels associate with markers of inflammation and oxidative stress.Subjects and MethodsIn non-diabetic medication-free adults central obesity (waist-to-height ratio > 0.5); elevated blood pressure (systolic BP≥130 mm Hg and/or diastolic BP ≥85 mm Hg); increased atherogenic risk (log(TAG/HDL) ≥ 0.11); and insulin resistance (QUICKI < 0.322) were considered as cardiometabolic risk factors. 25(OH)D3 status was classified as deficiency (25(OH)D3 ≤20 ng/ml); insufficiency (levels between 20-to-30 ng/ml), or as satisfactory (>30 ng/ml). Plasma adipokines, inflammatory and oxidative stress markers, advanced glycation end-products, and their soluble receptor were determined.Results162 subjects were cardiometabolic risk factors-free, 162 presented increased (i.e. 1 or 2), and 87 high number (i.e. 3 or 4) of cardiometabolic risk factors. Mean 25(OH)D3 decreased with rising number of manifested risk factors (36 ± 14 ng/ml, 33 ± 14 ng/ml, and 31 ± 15 ng/ml, respectively; pANOVA: 0.010), while prevalence of hypovitaminosis D did not differ significantly. Elevated blood pressure and insulin resistance appeared as significant determinants of hypovitaminosis D. Subjects presenting these risk factors concurrently displayed the lowest 25(OH)D3 levels (29 ± 15 ng/ml). Plasma adipokines, inflammatory and oxidative stress markers, advanced glycation end-products, and their soluble receptor generally differed significantly between the groups, but only advanced oxidation protein products and advanced glycation end-products associated fluorescence of plasma showed significant independent association with 25(OH)D3 levels.ConclusionIn apparently healthy adults increasing number of cardiometabolic risk factors associates with poorer 25(OH)D3 status, while the association between 25(OH)D3 status and inflammatory or oxidative stress markers remains equivocal.

Highlights

MethodsIn non-diabetic medication-free adults central obesity (waist-to-height ratio > 0.5); elevated blood pressure (systolic BP130 mm Hg and/or diastolic BP 85 mm Hg); increased atherogenic risk (log(TAG/HDL) 0.11); and insulin resistance (QUICKI < 0.322) were considered as cardiometabolic risk factors. 25(OH)D3 status was classified as deficiency (25(OH) D3 20 ng/ml); insufficiency (levels between 20-to-30 ng/ml), or as satisfactory (>30 ng/ml)
Hypovitaminosis D associates with obesity, insulin resistance, hypertension, and dyslipoproteinemia
In non-diabetic medication-free adults central obesity; elevated blood pressure; increased atherogenic risk (log(TAG/HDL) 0.11); and insulin resistance (QUICKI < 0.322) were considered as cardiometabolic risk factors. 25(OH)D3 status was classified as deficiency (25(OH) D3 20 ng/ml); insufficiency, or as satisfactory (>30 ng/ml)

Summary

Methods

In non-diabetic medication-free adults central obesity (waist-to-height ratio > 0.5); elevated blood pressure (systolic BP130 mm Hg and/or diastolic BP 85 mm Hg); increased atherogenic risk (log(TAG/HDL) 0.11); and insulin resistance (QUICKI < 0.322) were considered as cardiometabolic risk factors. 25(OH)D3 status was classified as deficiency (25(OH) D3 20 ng/ml); insufficiency (levels between 20-to-30 ng/ml), or as satisfactory (>30 ng/ml). Inflammatory and oxidative stress markers, advanced glycation endproducts, and their soluble receptor were determined. This cross-sectional study was conducted in accordance to the principles of the Declaration of Helsinki. The study protocol was approved by the Ethics Committee of the Slovak Medical University in Bratislava. Elevated fasting plasma glucose (FPG 7 mmol/l), decreased renal function (eGFR 0.6 ml/s/1.73m2), pregnancy and lactation were exclusion criteria. From among 452 recruited subjects aged 18-to-81 years who underwent blood sampling during winter period 41 were excluded: 11 in whom 25(OH)D3 levels were not determined for technical reasons, 17 presenting FPG 7 mmol/l, 2 with eGFR 0.6 ml/s/1.73m2, and 11 with incomplete data for unequivocal classification of cardiometabolic risk factors.

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