Abstract

Vitamin D deficiency or insufficiency is common in obese people, with some studies suggesting that low vitamin D level might be an independent predictor of obesity. Thus, the purpose of the present randomized, double-blind, placebo-controlled study was to investigate the effect of oral spray vitamin D3 3000 IU supplementation along with personalized weight-loss diet on obesity markers in overweight and obese Caucasians with vitamin d deficiency or insufficiency. The impact of vitamin D receptor (VDR) and adrenergic receptors (ADRs) genetic variants on vitamin D levels and weight loss diet outcomes was also investigated. After signing informed consent, a total of 125 eligible volunteers were randomly assigned into vitamin D (vitamin D3 3000 IU/d oral spray supplementation, n = 76) or placebo (xylitol, water, mint, n = 49) group following a weight loss program (600 calories less than the total energy expenditure of each volunteer) for 3 months. Fat mass, BMI, REE and 25(OH)D serum level were monitored on baseline and each month. DNA samples were extracted from buccal swabs and genotyped for the rs2228570 (VDR), rs1544410 (VDR), rs731236 (VDR), rs1800544 (ADRA2A), rs1801252 (ADRB1), rs1042713 (ADRB2), and rs4994 (ADRB3) polymorphisms. Statistical analysis was performed using SPSS package (v.23). Between group comparisons revealed significant improvement in serum 25(OH)D level and greater reduction in weight, BMI and fat percentage in the vitamin D group compared to placebo group (p < 0.05). In the vitamin D group, carriers of the rs2228570 T allele tended to have greater vitamin D level improvement compared with the homozygous C allele (p = 0.067). Furthermore, heterozygous (CT) for the rs731236 tended to have lesser weight loss (p = 0.068) and for the rs1042713, a lower decline in fat percentage was observed for homozygous AA carriers compared to the heterozygous (p = 0.051). In the control group, differences in weight loss (p = 0.055) and BMI (p = 0.045) were observed between rs1544410 AA and GG homozygous. In conclusion, vitamin D oral spray supplementation seems to improve vitamin D status and decrease obesity markers during a weight-loss intervention in overweight/obese Caucasians with vitamin D deficiency or insufficiency. Also, the results of the present study indicate that VDR and ADRs genetic polymorphisms seem to influence vitamin D supplementation response and obesity markers.

Highlights

  • Vitamin D is a fat-soluble vitamin synthesized from 7dehydrocholesterol in the skin after exposure to sunlight or obtained from diet and dietary supplements

  • The results of the current double-blind placebo-controlled study in overweight and obese (BMI>25 kg/m2) Southeastern European Caucasians with vitamin D deficiency (serum 25(OH)D3

  • No significant impact of the vitamin D oral spray supplementation was observed on Resting Energy Expenditure (REE)

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Summary

Introduction

Vitamin D is a fat-soluble vitamin synthesized from 7dehydrocholesterol in the skin after exposure to sunlight or obtained from diet and dietary supplements. Two sequential hydroxylations convert vitamin D into its biologically active form; 25-hydroxylation in the liver, which produces 25-hydroxyvitamin D3 (25 (OH)D3, calcidiol), the major vitamin D3 circulating form in the body used as a valid vitamin D status biomarker, followed by the second 1α-hydroxylation in the kidney, which converts 25(OH)D3 to 1,25 dihydroxyvitamin D (1,25 (OH)2D3, calcitriol) [3–6]. 1,25(OH)2D3 is the most active vitamin D metabolite and a steroid hormone with multiple skeletal and extraskeletal biological roles, mediated by the vitamin D receptor (VDR), that controls over several hundreds of genes [7, 8]. Worldwide data indicate that the prevalence of hypovitaminosis D is a serious global health problem in all ages, even in countries with sun exposure throughout the year [9]. BMI and fat mass are factors inversely related with 25(OH)D level [11–15]

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