Vitamin D and Visceral Obesity in Humans: What Should Clinicians Know?
Abstract
:1. Introduction
2. Methodology and Literature Search
3. Vitamin D Metabolism
4. Association between Vitamin D and Adipose Tissue
5. Vitamin D Action in Human Adipose Tissue
5.1. Role of Vitamin D in Adipocyte Differentiation and Adipogenesis
5.2. Role of Vitamin D in Energy Homeostasis
5.3. Role of Vitamin D in Inflammation
6. Vitamin D and Obesity
6.1. Effect of Medical and Surgical Weight Loss on Vitamin D Status
6.2. Effect of Vitamin D Supplementation on Weight Reduction and Visceral Fat Loss
7. Discussion
8. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Conflicts of Interest
References
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Cell Type | Type of Vitamin D, Dose, Duration | Results |
---|---|---|
hASCs derived from women with normal BMI [30] | 1,25(OH)2D3, 10 nM, 7 and 14 days | - Increased the expression of FABP4, FASN, and PPAR-γ mRNA - Increased ACC, FABP4, and FASN protein levels - Promoted lipid accumulation |
Human subcutaneous preadipocytes derived from obese men and women [24] | 1,25(OH)2D3, 0.1 and 10 nM, 14 days | - Increased the expression of PPAR-γ and LPL mRNA - Increased FABP protein levels - Increased triglyceride accumulation |
Human subcutaneous preadipocytes derived from obese men and women [24] | 25(OH)D3, 1 and 10 nM, 14 days | - Increased the expression of LPL mRNA - Increased FABP4 protein levels - Increased triglyceride accumulation |
Participants | Type of Vitamin D, Dose, Duration | Results |
---|---|---|
96 participants with prediabetes or with newly diagnosed type 2 diabetes [39] | Vitamin D3, 5000 IU/day vs. placebo, 6 months | - Increased M-value (a marker of peripheral insulin sensitivity) in the vitamin D group vs. stable in the placebo group (p = 0.009) - Improved β-cell function (disposition index) in the vitamin D group vs. stable in the placebo group (p = 0.039) |
20 participants with type 2 diabetes [40] | Vitamin D3, 5000 IU/day vs. placebo, 12 weeks | - Increased HOMA-%B in the vitamin D group (p = 0.03) * vs. non-significant increased HOMA-%B in the placebo group (p = 0.08) * |
56 women with gestational diabetes (at 24–28 weeks of gestation) [41] | Vitamin D3 50,000 IU at baseline and day 21 + calcium 1000 mg/day vs. placebo, 3 weeks | - Decreased HOMA-IR in the treatment group vs. stable in the placebo group (p = 0.001) - Increased QUICKI in the treatment group vs. stable in the placebo group (p = 0.003) - A significant increase in GSH in the treatment group when compared with the placebo group (p = 0.03) - A smaller increase in MDA in the treatment when compared with the placebo group (p = 0.03) |
54 participants with obesity and vitamin D deficiency (25(OH)D < 20 ng/mL) [43] | Vitamin D3 100,000 IU bolus, then 4000 IU/day vs. placebo, 16 weeks | - Greater increases in adiponectin (p = 0.002) and leptin (p = 0.002) in the vitamin D group when compared with the placebo group a |
The Association between 25(OH)D Levels and Inflammatory Cytokines | ||
Study Design, n | Results | |
A cross-sectional population-based study, 281 [53] | - A negative association between plasma IL-6 and TNF-α levels and serum 25(OH)D concentration in normal-weight participants - A negative association between plasma adiponectin level and serum 25(OH)D concentration in overweight participants | |
Post hoc analysis from 1-year lifestyle intervention program, 113 men [54] | - An increase in 25(OH)D levels were associated with a decrease in leptin levels after adjustment for changes in adiposity - No association between changes in 25(OH)D levels and changes in adiponectin levels | |
The Effect of Vitamin D Supplementation on Inflammatory Cytokines | ||
Study design, n | Type of vitamin D, dose, duration | Results |
RCT, subcutaneous abdominal adipose tissue from 40 participants with obesity and vitamin D deficiency (25(OH)D < 20 ng/mL) [25] | Vitamin D3 7000 IU/day vs. placebo, 26 weeks | - No differences in the changes in MCP-1, IL-6, IL-8, and adiponectin levels from baseline between the 2 groups - No differences in the expression levels of MCP-1, IL-6, and IL-8 before and after treatment with either placebo or vitamin D |
RCT, 332 participants with overweight and obesity [55] | Vitamin D3 40,000 IU/week vs. 20,000 IU/week vs. placebo, 1 year | - A non-significant decrease in IL-6 (p = 0.08) and a significant increase in CRP (p < 0.05) in the vitamin D group when compared with the placebo group - No effect of vitamin D supplementation on TNF-α levels |
A systematic review and meta-analysis of 13 RCTs, 1955 participants with obesity or overweight [56] | Vitamin D3 700–200,000 IU/day or vitamin D2 150,000 IU at 0 and 12 weeks, duration 4–156 weeks (mean 41 weeks) | - No significant reduction in CRP, TNF- α, and IL-6 levels after receiving vitamin D supplementation |
A systematic review and meta-analysis of 13 RCTs, 875 participants with type 2 diabetes [57] | Vitamin D2 or D3 20–6000 IU/day or 25,000 or 50,000 IU/week, duration 8–52 weeks (median 12 weeks) | - A significant decrease in CRP in the vitamin D group when compared with no vitamin D treatment (p = 0.005) - No effects of vitamin D supplementation on TNF-α and IL-6 |
Study Design, n | Weight Loss Intervention | Results |
---|---|---|
A systematic review and meta-analysis of 15 clinical trials (4 RCTs and 11 non-RCTs), 3471 participants with obesity and overweight [70] | Caloric restriction and/or exercise intervention without weight loss medications ± vitamin D supplementation (median vitamin D intake was 350 IU/day) vs. weight maintenance, first follow-up visit at 6–104 weeks (median 26 weeks) | Weight loss was associated with a small but significant increase in 25(OH)D levels (mean difference 3.76 nmol/L, 95% CI: 2.38, 5.13 nmol/L). |
A systematic review and meta-analysis of 23 clinical trials (14 RCTs and 9 single-arm studies), 2085 participants with obesity and overweight [71] | Caloric restriction and/or exercise intervention without vitamin D supplementation vs. weight maintenance, study duration 2 weeks to 2 years | Weight loss was not significantly associated with increased 25(OH)D levels (6.0 nmol/L, 95% CI: −12.42, 0.47 in the weighted mean difference of 25(OH)D for weight loss of 10 kg (p = 0.06)). |
A systematic review and meta-analysis of 7 studies (2 RCTs and 3 observational studies), 4282 cases/15,630 controls participants with obesity [80] | Bariatric surgery (RYGB or DS with or without BPD) compared to non-surgical controls, 1 year postoperative | 25(OH)D levels did not change significantly compared to controls (weight mean difference 6.79%, 95% CI: −9.01, 22.59). |
A systematic review and meta-analysis of 10 prospective studies, 344 participants with morbid obesity [79] | RYGB, vitamin D, and calcium supplementation after surgery, 6–36 months postoperative | 25(OH)D levels did not increase significantly after RYGB compared to baseline levels despite vitamin D supplementation (mean difference 1.35 ng/mL, 95% CI: −1.12, 3.83). |
A systematic review and meta-analysis of 12 studies (6 RCTs and 6 single-arm studies), 1285 participants with obesity [74] | Bariatric surgery with vitamin D supplementation compared with different types of bariatric surgery or lifestyle intervention, 1 year postoperative | 25(OH)D levels increased significantly after surgery, and the prevalence of vitamin D deficiency decreased only in RCTs with vitamin D supplementation >800 IU/day (prevalence of vitamin D deficiency was 54% before surgery and 31% after surgery). |
A systematic review and meta-analysis of 13 studies (2 RCTs, 9 observational studies), 1503 participants with morbid obesity [81] | Bariatric surgery (RYGB or SG), 1–5 years postoperative | 25(OH)D levels were significantly lowered in patients who underwent RYGB compared to SG at 1 year postoperative (mean difference −1.85 ng/mL, 95% CI: −3.32, −0.39). |
A systematic review and meta-analysis of 5 studies in participants with morbid obesity receiving sufficient vitamin D supplementation according to guidelines [82] | Bariatric surgery (RYGB or SG), 3 months–5 years postoperative | Vitamin D levels significantly increased after RYGB (weighted mean difference 22.71 ng/mL; 95% CI, 15.87, 29.56 at 6–11 month) and SG (weight mean difference 6.03 ng/mL; 95% CI, 4.18, 7.89 at 12–23 months). |
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Shantavasinkul, P.C.; Nimitphong, H. Vitamin D and Visceral Obesity in Humans: What Should Clinicians Know? Nutrients 2022, 14, 3075. https://doi.org/10.3390/nu14153075
Shantavasinkul PC, Nimitphong H. Vitamin D and Visceral Obesity in Humans: What Should Clinicians Know? Nutrients. 2022; 14(15):3075. https://doi.org/10.3390/nu14153075
Chicago/Turabian StyleShantavasinkul, Prapimporn Chattranukulchai, and Hataikarn Nimitphong. 2022. "Vitamin D and Visceral Obesity in Humans: What Should Clinicians Know?" Nutrients 14, no. 15: 3075. https://doi.org/10.3390/nu14153075