Adiposity, Cardiometabolic Risk, and Vitamin D Status: The Framingham Heart Study
- Susan Cheng1,2,3,4,
- Joseph M. Massaro1,5,
- Caroline S. Fox1,6,7,
- Martin G. Larson1,5,
- Michelle J. Keyes1,5,
- Elizabeth L. McCabe1,2,
- Sander J. Robins1,8,
- Christopher J. O'Donnell1,2,6,
- Udo Hoffmann9,
- Paul F. Jacques10,
- Sarah L. Booth10,
- Ramachandran S. Vasan1,8,11,
- Myles Wolf12 and
- Thomas J. Wang1,2
- 1Framingham Heart Study, Framingham, Massachusetts;
- 2Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts;
- 3Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts;
- 4Clinical Investigator Training Program, Beth Israel Deaconness Medical Center, Harvard Medical School, Boston, Massachusetts;
- 5Department of Mathematics and Statistics, Boston University, Boston, Massachusetts;
- 6Center for Population Studies, National Heart, Lung, and Blood Institute, Bethesda, Maryland;
- 7Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts;
- 8Department of Medicine, Boston University School of Medicine, Boston, Massachusetts;
- 9Radiology Department, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts;
- 10Nutritional Epidemiology Program, Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts;
- 11Epidemiology Department, Boston University School of Public Health, Boston, Massachusetts;
- 12Division of Nephrology and Hypertension, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida.
- Corresponding author: Thomas J. Wang, tjwang{at}partners.org.
Abstract
OBJECTIVE Because vitamin D deficiency is associated with a variety of chronic diseases, understanding the characteristics that promote vitamin D deficiency in otherwise healthy adults could have important clinical implications. Few studies relating vitamin D deficiency to obesity have included direct measures of adiposity. Furthermore, the degree to which vitamin D is associated with metabolic traits after adjusting for adiposity measures is unclear.
RESEARCH DESIGN AND METHODS We investigated the relations of serum 25-hydroxyvitamin D (25[OH]D) concentrations with indexes of cardiometabolic risk in 3,890 nondiabetic individuals; 1,882 had subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) volumes measured by multidetector computed tomography (CT).
RESULTS In multivariable-adjusted regression models, 25(OH)D was inversely associated with winter season, waist circumference, and serum insulin (P < 0.005 for all). In models further adjusted for CT measures, 25(OH)D was inversely related to SAT (−1.1 ng/ml per SD increment in SAT, P = 0.016) and VAT (−2.3 ng/ml per SD, P < 0.0001). The association of 25(OH)D with insulin resistance measures became nonsignificant after adjustment for VAT. Higher adiposity volumes were correlated with lower 25(OH)D across different categories of BMI, including in lean individuals (BMI <25 kg/m2). The prevalence of vitamin D deficiency (25[OH]D <20 ng/ml) was threefold higher in those with high SAT and high VAT than in those with low SAT and low VAT (P < 0.0001).
CONCLUSIONS Vitamin D status is strongly associated with variation in subcutaneous and especially visceral adiposity. The mechanisms by which adiposity promotes vitamin D deficiency warrant further study.
Footnotes
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The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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- Received July 10, 2009.
- Accepted September 22, 2009.
- © 2010 American Diabetes Association
