Association of low vitamin D levels with metabolic syndrome in hemodialysis patients

Abstract

Low vitamin D levels have been linked to metabolic syndrome in the general population. In the present study, the relationship between inadequate serum concentrations of vitamin D and metabolic syndrome in patients with end-stage renal disease undergoing hemodialysis was explored. In a cross-sectional setting, 145 patients undergoing maintenance hemodialysis were enrolled. Metabolic syndrome was defined using the International Diabetes Federation criteria. Serum concentration of 25(OH) vitamin D was determined by a commercially available enzyme immunosorbent assay method. The prevalence of metabolic syndrome was 53.1%. The prevalence rate of severe vitamin D deficiency (<5 ng/mL) was 3.4%, mild vitamin D deficiency (5-15 ng/mL) 31.0%, vitamin D insufficiency (16-30 ng/mL) 36.6%, and vitamin D sufficiency (>30 ng/mL) 29.0%. With the increasing number of metabolic abnormalities, vitamin D levels significantly decreased (P for trend = 0.028). Among the components of metabolic syndrome, vitamin D deficiency was significantly associated with central obesity (odds ratio [OR], 95% confident interval [CI] = 2.80, 1.11-7.04, P = 0.028). A positive, but nonsignificant association between vitamin D deficiency and raised fasting plasma glucose was noted (OR, 95% CI = 2.40, 0.94-6.11, P = 0.067). Both vitamin D deficiency and insufficiency were significantly associated with an increased likelihood of having metabolic syndrome (P < 0.05). In a final model controlling for age, sex, and parathyroid hormone levels, vitamin D deficiency increased the odds of having metabolic syndrome by more than threefold (OR, 95% CI = 3.26, 1.30-8.20, P = 0.012). Low levels of vitamin D are frequent among hemodialysis patients and are associated with the metabolic syndrome.

Serum vitamin D levels in relation to abdominal obesity: A systematic review and dose–response meta‐analysis of epidemiologic studies

“…Twenty‐three other articles used other cut‐off points that most of them were less than WC >102 cm for male and WC >88 cm for female. Although subjects of 34 investigations were healthy, the subjects of seven others were patients with colorectal neoplasia, 10 obstructive sleep apnea, 57 hemodialysis, 50 systemic lupus erythematous (SLE) 22,53 and type 2 diabetes 65 or high‐risk individuals for diabetes 47 . Potential confounders that were mostly considered in the analysis of the included studies were age ( n = 36), smoking status ( n = 23), physical activity ( n = 21), season or sun exposure ( n = 16), education ( n = 14), alcohol consumption ( n = 14), serum triglyceride (TG) levels ( n = 14), high‐density lipoprotein (HDL) cholesterol ( n = 13), body mass index (BMI) ( n = 13), fasting blood sugar (FBS) ( n = 12), blood pressure (BP) ( n = 12), dietary or supplemental vitamin D intake ( n = 7), low‐density lipoprotein (LDL) ( n = 7), race or ethnicity ( n = 5) and parathyroid hormone (PTH) ( n = 4).…”

“…14,16 The included cross-sectional and cohort studies have included a total of 269,258 and 6,278 participants, respectively. Nine of cross-sectional studies were carried out in South Korea, 9,12,17,[40][41][42][43][44][45] four in United States, 10,[46][47][48] four in Iran, 19,[49][50][51] three in China, 8,52,53 two studies in the Netherlands, 11,54 Russia, 13,55 Spain 56,57 and the remaining in Iceland, 56 Ireland, 56 Australia 58 Brazil, 21 California, 59 India, 20 Japan, 60 Portugal, 61 Jordan, 62 Malaysia, 63 Mexico, 22 Norway, 14 Romania, 64 Thailand, 15 Saudi Arabia 18 and United Arab Emirates. 65 Two cohort studies were also done in Australia 16 and Norway.…”

Vitamin D in Chronic Kidney Disease and Dialysis Patients

“…Boudville et al reported that 25(OH)D deficiency is associated with muscular weakness and falls in dialysis patients, but with a J curve and maximal benefit in the range between 24 and 44 ng/mL of serum 25(OH)D levels [36]. Vitamin D deficiency has been associated with metabolic syndrome and obesity [37] in HD patients. In PD patients, low vitamin D levels have been associated with cognitive impairment [42].…”

Bone Metabolism Parameters in Hemodialysis Patients With Chronic Kidney Disease and in Patients After Kidney Transplantation

“…Patients with CKD are affected by vitamin D deficiency, which has even been reported after successful kidney transplantation (Ewers et al 2008). Low levels of vitamin D in hemodialyzed patients were reported to be associated with obesity and metabolic syndrome (Ahmadi et al 2016). Also, Klotho and FGF23 proteins closely related to calcium-phosphate metabolism may be associated with insulin resistance (Kanbay et al 2017).…”