Vitamin D and obesity in adults: a pathophysiological and clinical update

Abstract

Vitamin D deficiency has become an increasing focus of clinical interest, especially in understanding its associations with obesity in adults. The pathological associations linking the two appear to demonstrate complex cellular inflammatory, hormonal and genetic pathways. Enhanced understanding at both microcellular and clinical levels will help clarify the role of obesity in the development of vitamin D deficiency.

European guideline on obesity care in patients with gastrointestinal and liver diseases – Joint ESPEN/UEG guideline

“…Low levels of serum vitamin D are characteristics of both obesity and IBD, as well as sarcopenic obesity [72]. The etiopathogenesis of vitamin D deficiency is multifactorial in IBD patients and develops as a result of malabsorption, inflammation, low dietary intake, low sun exposure, and corticosteroid therapy [13,73]. In patients with obesity, vitamin D is being sequestrated in fat tissue, therefore, low serum levels of 25-OH vitamin D are often measured [73].…”

“…The etiopathogenesis of vitamin D deficiency is multifactorial in IBD patients and develops as a result of malabsorption, inflammation, low dietary intake, low sun exposure, and corticosteroid therapy [13,73]. In patients with obesity, vitamin D is being sequestrated in fat tissue, therefore, low serum levels of 25-OH vitamin D are often measured [73]. Furthermore, obesity is characterized by pro-inflammatory pathogenic mechanisms and dysbiosis that are also linked to bone alterations in the IBD population [74].…”

Should patients with obesity be more afraid of COVID‐19?

“…8,9,43 Furthermore, research studies indicate that individuals suffering from obesity present lower vitamin D levels. [45][46][47][48] In fact, vitamin D could also reduce the cytokine storm-there is also a possible inverse association between the vitamin D level and inflammatory biomarkers, such as IL-6, IL-8, and monocyte chemoattractant protein 1 (MCP-1), 46 although this association has not been entirely confirmed. Moreover, vitamin D could also induce cathelicidins and defensins which can lower the viral replication rate.…”

Lifestyle Modification Program on a Metabolically Healthy Elderly Population with Overweight/Obesity, Young-Old vs. Old-Old. CONSEQUENCES of COVID-19 Lockdown in This Program

“…An important parameter that must also be analyzed and controlled in populations with obesity is VD level. Lockdowns led to reduced VD levels in populations worldwide, which influenced and aggravated the health condition of the population with obesity, who normally already have low levels of VD [44]. Furthermore, a normal VD level is extremely important for inducing cathelicidins and defensins to decrease the viral replication rate [45] and to modulate ACE-1 and ACE-2 expression, which leads to a protective effect on lipopolysaccharide-induced lung damage [46].…”