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Vitamin D and parathyroid hormone in insulin resistance of abdominal obesity: cause or effect?

Abstract

The objective was to examine whether there were causal links between vitamin D status, parathyroid hormone, insulin resistance (IR)/insulin sensitivity (IS) and the metabolic syndrome (MS). A total of 72 Caucasian men and women, aged 55.7±7.57 years, with body mass index 33.4±4.02 kg/m2 and abdominal obesity, were assessed for IR/IS based on three commonly used indices before and after 12 weeks of supervised weight loss. During weight stability, though both lower intact parathyroid hormone (iPTH) and higher vitamin D were independently associated with greater IS/lower IR, this was consistent for iPTH across the surrogate measures tested. Higher iPTH, but not lower vitamin D, increased the risk of MS after adjustment for IR/IS. Weight loss resulted in significant reductions in percent fat (−2.83±2.20%), waist (−9.26±5.11 cm), improvements in all IS indices, reductions in MS and iPTH (−0.28±1.17 pmol/l), but no increase in vitamin D (+2.19±12.17 nmol/l). Following weight loss, ΔiPTH either predicted change in IR/IS or contributed to their variance by 4.1–8.9%. On adjustment for IR/IS, higher ΔiPTH did not significantly predict MS after weight loss, though the odds ratios for the effect were sizeable. The data are suggestive of an intrinsic inverse relationship between iPTH and IS in abdominally obese individuals, independent of vitamin D. There remains the possibility of a direct relationship between iPTH and MS.

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References

  1. Alberti KGMM, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA et al. (2009). Harmonizing the metabolic syndrome. A joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 120, 1640–1645.

    Article  CAS  Google Scholar 

  2. Buchanan TA, Watanabe RM, Xiang AH (2010). Limitations in surrogate measures of insulin resistance. J Clin Endocrinol Metab 95, 4874–4876.

    Article  CAS  Google Scholar 

  3. Del Gobbo LC, Song Y, Dannenbaum DA, Dewailly E, Egeland GM (2011). Serum 25-hydroxyvitamin D is not associated with insulin resistance or beta cell function in Canadian Cree. J Nutr 141 (Suppl 2), 290–295.

    Article  CAS  Google Scholar 

  4. Chan She Ping-Delfos W (2009). Effects of Dairy Products and Resistance Exercise on Energy Balance PhD Thesis. Curtin University of Technology: Perth, Western Australia.

    Google Scholar 

  5. Cummings NK (2006). The Potential Role of Calcium in Obesity PhD Thesis. Curtin University of Technology: Perth, Western Australia.

    Google Scholar 

  6. Field A (2007). Discovering Statistics using SPSS. SAGE Publications: Los Angeles, USA, pp 173.

    Google Scholar 

  7. Ford ES, Zhao G, Li C, Pearson WS (2009). Serum concentrations of vitamin D and parathyroid hormone and prevalent metabolic syndrome among adults in the United States. J Diabetes 1, 296–303.

    Article  CAS  Google Scholar 

  8. Hjelmesaeth J, Hofso D, Aasheim ET, Jenssen T, Moan J, Hager H et al. (2009). Parathyroid hormone, but not vitamin D, is associated with the metabolic syndrome in morbidly obese women and men: a cross-sectional study. Cardiovasc Diabetol 8, 1–7.

    Article  Google Scholar 

  9. Kim MK, Kang M, Oh KW, Kwon HS, Lee JH, Lee WC et al. (2010). The association of serum vitamin D level with presence of metabolic syndrome and hypertension in middle-aged Korean subjects. Clinic endocrinol 73, 330–338.

    Article  CAS  Google Scholar 

  10. Lee DM, Rutter MK, O’Neill TW, Boonen S, Vanderschueren D, Bouillon R et al. (2009). Vitamin D, parathyroid hormone and the metabolic syndrome in middle-aged and older European men. Eur J Endocrinol 161, 947–954.

    Article  CAS  Google Scholar 

  11. Lerman I, Villa AR, Torres JMR, Tamez LE, Perez FG, del Villar Velasco SC et al. (2003). Correlations between surrogate measures of insulin resistance and cardiovascular risk factors in obese and overweight patients. J Diabetes Complications 17, 66–72.

    Article  Google Scholar 

  12. Lorenzo C, Haffner SM, Stancáková A, Laakso M (2010). Relation of direct and surrogate measures of insulin resistance to cardiovascular risk factors in nondiabetic Finnish offspring of Type 2 diabetic individuals. J Clin Endocrinol Metab 95, 5082–5090.

    Article  CAS  Google Scholar 

  13. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Teacher DF, Turner RC (1985). Homeostasis model assessment: insulin resistance and β cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28, 412–419.

    Article  CAS  Google Scholar 

  14. McAuley KA, Williams SM, Mann JI, Walker RJ, Ledwis-Barned NJ, Temple LA et al. (2001). Diagnosing insulin resistance in the general population. Diabetes Care 24, 460–464.

    Article  CAS  Google Scholar 

  15. Nagpal J, Pande JN, Bhartia A (2008). A double-blind, randomized, placebo-controlled trial of the short-term effect of vitamin D3 supplementation on insulin sensitivity in apparently healthy, middle-aged, centrally obese men. Diabet Med 26, 19–27.

    Article  Google Scholar 

  16. Nowson CA, Margerison C (2002). Vitamin D intake and vitamin D status of Australians. eMJA 177, 149–152.

    PubMed  Google Scholar 

  17. O’Dea K, Rowley KG (2002). Macrovascular disease risk factors and insulin resistance in Aboriginal and Torres Strait Islander people. J Diabetes Complications 16, 9–16.

    Article  Google Scholar 

  18. Pittas AG, Lau J, Hu FB, Dawson-Hughes B (2007). The role of vitamin D and calcium in type 2 diabetes: a systematic review and meta-analysis. Clin Endocrinol Metab 92, 2017–2029.

    Article  CAS  Google Scholar 

  19. Peterlik M, Cross H (2009). Vitamin D and calcium insufficiency-related chronic diseases: molecular and cellular pathophysiology. Eur J Nutr 105, 1–10.

    Google Scholar 

  20. Reis JP, Mühlen DV, Kritz-Silverstein D, Wingard DL, Barret-Connor E (2007). Vitamin D, parathyroid hormone levels, and the prevalence of metabolic syndrome in community-dwelling older adults. Diabetes Care 30 (Suppl 6), 1549–1555.

    Article  CAS  Google Scholar 

  21. Rueda S, Fernández-fernández C, Romero F, de Osaba MJM, Vidal J (2008). Vitamin D, PTH, and the metabolic syndrome in severely obese subjects. Obes Surg 18 (Suppl 2), 151–154.

    Article  Google Scholar 

  22. Soares MJ, Chan She-Ping-Delfos WL (2010). Postprandial energy metabolism in the regulation of body weight: is there a mechanistic role for dietary calcium. Nutrients 2, 586–598.

    Article  CAS  Google Scholar 

  23. Soares MJ, Kuriyan R, Kurpad AV (2010). Calcium and vitamin D modulate postprandial vascular function: a pilot dose–response study. Diab Met Syndr: Clin Res Rev 4, 128–131.

    Article  Google Scholar 

  24. Tai K, Need AG, Horowitz M, Chapman IM (2008). Glucose tolerance and vitamin D: effects of treating vitamin D deficiency. Nutrition 24 (Suppl 10), 950–956.

    Article  CAS  Google Scholar 

  25. Von-Hurst PR, Stonehouse W, Coad J (2010). Vitamin D supplementation reduces insulin resistance in South Asian women living in New Zealand who are insulin resistant and vitamin D deficient—a randomized, placebo-controlled trial. Br J Nutr 103, 549–555.

    Article  CAS  Google Scholar 

  26. Wallace TM, Levy JC, Matthews DR (2004). Use and abuse of HOMA modeling. Diabetes Care 27, 1487–1495.

    Article  Google Scholar 

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Acknowledgements

We thank Dr Leonard S Piers, Tony James, Deepa Sriram and Kyla Smith for their expert assistance with our research. MJS acknowledges financial support from Dairy Australia, the ATN Centre for Metabolic Fitness and Diabetes Australia. No prior permission was required from these organizations for submission of this manuscript.

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Correspondence to M J Soares.

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Soares, M., Ping-Delfos, W., Sherriff, J. et al. Vitamin D and parathyroid hormone in insulin resistance of abdominal obesity: cause or effect?. Eur J Clin Nutr 65, 1348–1352 (2011). https://doi.org/10.1038/ejcn.2011.111

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  • DOI: https://doi.org/10.1038/ejcn.2011.111

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