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Severely Obese had low vitamin D (less than 30 nanograms) – Aug 2016

Low socio-economic status is a newly identified independent risk factor for poor vitamin D status in severely obese adults

Journal of Human Nutrition and Diatetics, 15 August 2016. DOI: 10.1111/jhn.12405
J. Léger-Guist'hau, C. Domingues-Faria, M. Miolanne, F. Peyrol,
L. Gerbaud, B. Perreira, R. Minet-Quinard, V. Sapin, S. Walrand, Y. Boirie

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Background: Hypovitaminosis D is very prevalent, especially in the obese population. However, the degree of severity and the parameters involved in vitamin D deficiency in this population are still unclear. The present study aimed to identify, from among the factors known to influence vitamin D status in a healthy population, those impacting the same parameter in obese population.

Methods: Serum 25-OH-D concentration was measured in 564 patients with class III obesity [i.e. severe and morbid obesity; mean (SD) body mass index (BMI) 42.04 (6.92) kg m–2] and their demographic, clinical, biological, anthropometric, dietary and socio-economic data were collected.

Results: We observed that 96% of the obese patients had serum 25-OH-D lower than 30 ng mL-1. Severe vitamin D deficiency (serum 25-OH-D concentration <10 ng mL-1) affected 35% of this population.
We found an inverse relationship between 25-OH-D levels and

  • BMI (P = 0.012), fat mass (P = 0.041),
  • metabolic syndrome (P < 0.0001),
  • fasting blood glucose (P = 0.023),
  • homeostasis model assessment for insulin resistance (P = 0.008),
  • waist circumference (P = 0.001), and
  • fasting blood triglycerides (P = 0.002) and
  • C-reactive protein (P = 0.005).

Low socio-economic status independently increased the risk of severe vitamin D deficiency [odds ratio (OR) = 1.98; 95% confidence interval (CI) 1.25–3.13], especially in the autumn–winter season (OR = 2.94; 95% CI 1.98–4.36), morbid obesity (OR = 3.19; 95% CI 1.49–6.82), metabolic syndrome (OR = 1.6; 95% CI 1.06–2.42) and inflammation (OR = 1.03; 95% CI 1.01–1.06).
Conclusions: Vitamin D deficiency is extremely common among obese patients, and the prevalence of severe deficiency is high. The association of adiposity, high body mass index, metabolic syndrome and inflammation with vitamin D status is marked, whereas low socio-economic status appears to be a major risk factor for severe vitamin D deficiency, suggesting that vitamin D deficiency may at least in part be responsible for the greater health vulnerability of populations with low socio-economic status.

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