Hypovitaminosis D and "Metabolic" Inflammatory Status in Patients With Obesity: a Retrospective Cohort Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 208
- 试验地点
- 1
- 主要终点
- Vitamine D plasma level in patients with obesity
研究概览
简要总结
Since obesity is related to systemic chronic inflammatory status and hypovitaminosis D, the study aimed to assess the incidence of hypovitaminosis D in obese patients and the correlations between vitamin D levels, inflammation indices, and bioimpedance measures.
A retrospective study was conducted on a cohort of obese patients. The inflammation-based prognostic scores, diagnosis of liver fibrosis, systemic inflammatory indices, and bioimpedance measures were analyzed. The linear relationship between vitamin D levels and continuous variables was assessed through the Spearman correlation coefficient, and to determine significant predictors of vitamin D levels a stepwise multiple linear regression was used.
详细描述
Introduction Obesity is a major health problem related to a cluster of chronic metabolic disorders and is associated with increased overall morbidity and mortality. Several studies proved that obesity is linked to a low grade of systemic chronic inflammatory status, considering the adipose tissue the largest metabolically active organ with endocrine, inflammatory, and immunological functions.
The "metabolic" inflammatory process leads to the release of inflammatory cytokines with subsequent systemic effects on insulin-sensitive organs, such as the liver which markedly suffers from the systemic proinflammatory environment. Vitamin D (25(OH)D) plays a key role in the regulation of mineral homeostasis by binding the vitamin D receptors, leading to an adequate calcium level to promote skeletal health. Furthermore, vitamin D has anti-inflammatory and immunoregulatory functions. It is an indispensable nutritive component that regulates the inflammatory microenvironment through several mechanisms such as the up-regulation of Mitogen-activated protein kinases (MAPKs) and inhibition of Nuclear Factor-Kappa B (NF-Kb) signaling pathways.
A low level of vitamin D in the visceral adipose tissue (VAT) induces more lipogenesis and less lipolysis promoting fat storage and obesity. The prevalence of vitamin D deficiency is 24% and 35% higher in overweight and obese people, respectively, compared to the general population. Many hypotheses have been proposed to explain the inverse correlation between Vitamin D and obesity:1) the storage of this fatsoluble nutrient in the exceeded VAT; 2) the higher plasma dilution of the Vitamin D in the obese patient compared to the normal-weight population; 3) the reduced sun exposure due to the stigma of obesity; 4) the presence of metabolic syndrome or type 2 diabetes that often co-exist with obesity; 5) molecular interactions between Vitamin D and pro-inflammatory cytokines.
Thus, hypovitaminosis D, inflammation, and obesity are three pathological conditions closely linked. In the literature, data explaining this relationship are still inconsistent, but crosstalk based on molecular signals exists.
On this basis, patients with obesity could be a high-achieving biological model helping to clarify the noncalcemic effects of vitamin D in regulating inflammation.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Cross Sectional
入排标准
- 年龄范围
- 18 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •BMI> 35 Eligible for bariatric surgery according to the current international guidelines (IFSO guidelines)
排除标准
- •Patients affected by active liver viral infection
- •Patient alcohol or drug addicted
- •Incompetent patients
结局指标
主要结局
Vitamine D plasma level in patients with obesity
时间窗: enrollment time
To assess the incidence of hypovitaminosis D in a cohort of patients with obesity
次要结局
- Vitamin D plasma level and systemic inflammation(enrollment time)
- Vitamin D plasma level and liver fibrosis/inflammation(enrollment time)
- Vitamine D plasma level and bioimpedance parameters(enrollment time)
研究者
Silvia Palmisano
Associate professor
University of Trieste