Low socio‐economic status is a newly identified independent risk factor for poor vitamin D status in severely obese adults. Issue 2 (15th August 2016)

• Record Type: Journal Article
• Authors: Léger‐Guist'hau, J.; Domingues‐Faria, C.; Miolanne, M.; Peyrol, F.; Gerbaud, L.; Perreira, B.; Minet‐Quinard, R.; Sapin, V.; Walrand, S.; Boirie, Y.
• Is Part Of: Journal of human nutrition and dietetics. Volume 30:Issue 2(2017)
• Page Start: 203
• Page End: 215
• Publication Date: 2016-08-15
• Subjects: deprivation -- obesity -- vitamin D deficiency; Dietetics -- Periodicals; Nutrition -- Periodicals; 613.205
• DOI: 10.1111/jhn.12405
• Languages: English
• ISSNs: 0952-3871

Abstract

Abstract: 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.