Low socio-econo mic status is a newly identified indepen dent risk factor for poor vitamin D status in severely obese adults

J. Léger Guist’hau (1) , Susana Domingues (2) , M. Miolanne (1) , F. Peyrol (3, 4) , L. Gerbaud (3, 4) , B. Perreira (3, 4) , R. Minet-Quinard (5) , Vincent Sapin (5) , Stephane Walrand (2) , Yves Boirie (1, 2)

1 Service Nutrition Clinique
2 UNH - Unité de Nutrition Humaine
3 Santé Publique
4 UdA - Université d'Auvergne - Clermont-Ferrand I
5 Service de Biochimie

Background: Hypovitaminosis D is very prevalent, especially in the obese population. However, the degree of severity and the parameters involved in vitamin D deficiency in this population are still unclear. The present study aimed to identify, from among the factors known to influence vitamin D status in a healthy population, those impacting the same parameter in obese population. Methods: Serum 25-OH-D concentration was measured in 564 patients with class III obesity [i.e. severe and morbid obesity; mean (SD) body mass index (BMI) 42.04 (6.92) kg m–2] and their demographic, clinical, biologi- cal, anthropometric, dietary and socio-economic data were collected. Results: We observed that 96% of the obese patients had serum 25-OH-D lower than 30 ng mL 1. Severe vitamin D deficiency (serum 25-OH-D con-centration <10 ng mL 1) affected 35% of this population. We found an inverse relationship between 25-OH-D levels and BMI (P = 0.012), fat mass (P = 0.041), metabolic syndrome (P < 0.0001), fasting blood glucose (P = 0.023), homeostasis model assessment for insulin resistance (P = 0.008), waist circumference (P = 0.001), and fasting blood triglycerides (P = 0.002) and C-reactive protein (P = 0.005). Low socio-economic status independently increased the risk of severe vitamin D deficiency [odds ratio (OR) = 1.98;95% confidence interval (CI) 1.25–3.13], especially in the autumn–winter season (OR = 2.94; 95% CI 1.98–4.36), morbid obesity (OR = 3.19; 95% CI 1.49–6.82), metabolic syndrome (OR = 1.6; 95% CI 1.06–2.42) and inflammation (OR = 1.03; 95% CI 1.01–1.06). Conclusions: Vitamin D deficiency is extremely common among obese patients, and the prevalence of severe deficiency is high. The association of adiposity, high body mass index, metabolic syndrome and inflammation with vitamin D status is marked, whereas low socio-economic status appears to be a major risk factor for severe vitamin D deficiency, suggesting that vitamin D deficiency may at least in part be responsible for the greater health vulnerability of populations with low socio-economic status

Mots clés: deprivation; obesity; vitamin D; deficiency; risk factor; deficiency

Mots clés: facteur de risque; vitamine D; obésité; carence; déficience; indice de masse corporelle

Domaines: Alimentation et Nutrition

J. Léger Guist’hau, Susana Domingues, M. Miolanne, F. Peyrol, L. Gerbaud, et al.. Low socio-econo mic status is a newly identified indepen dent risk factor for poor vitamin D status in severely obese adults. Journal of Human Nutrition and Dietetics, 2017, 30 (2), pp.203-215. ⟨10.1111/jhn.12405⟩. ⟨hal-01508871⟩