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      Body Mass Index, Vitamin D, and Type 2 Diabetes: A Systematic Review and Meta-Analysis

      review-article
      , *
      Nutrients
      MDPI
      hypovitaminosis D, type 2 diabetes, body mass index, Vitamin D, BMI

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          Abstract

          The deficiency of vitamin D is prevalent all over the world. Studies have shown that vitamin D may play an important role in the development of obesity. The current study was conducted to quantitatively evaluate the association between serum 25-(OH) vitamin D levels and the risk of obesity in both diabetic and non-diabetic subjects. A systematic review and meta-analysis of observational studies was carried out for that purpose. We searched the Medline, PubMed, and Embase databases throughout all of March 2018. A total of fifty five observational studies for both diabetic and non-diabetic subjects were finally included in the meta-analysis. The data were analyzed by comprehensive meta-analysis software version 3 and the random effects model was used to analyze the data. The meta-analysis showed an overall inverse relationship between serum vitamin D status and body mass index (BMI) in studies of both diabetic ( r = −0.173, 95% = −0.241 to −0.103, p = 0.000) and non-diabetic ( r = −0.152, 95% = −0.187 to −0.116, p = 0.000) subjects. The evidence of publication bias was not found in this meta-analysis. In conclusion, the deficiency of vitamin D is associated with an increased level of BMI in the studies of both diabetic and non-diabetic subjects. Reliable evidence from well-designed future randomized controlled trials is required to confirm the findings from observational studies and to find out the potential regulatory effects of vitamin D supplementation to lower BMI.

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          Most cited references102

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          The obesity epidemic in the United States--gender, age, socioeconomic, racial/ethnic, and geographic characteristics: a systematic review and meta-regression analysis.

          This review of the obesity epidemic provides a comprehensive description of the current situation, time trends, and disparities across gender, age, socioeconomic status, racial/ethnic groups, and geographic regions in the United States based on national data. The authors searched studies published between 1990 and 2006. Adult overweight and obesity were defined by using body mass index (weight (kg)/height (m)(2)) cutpoints of 25 and 30, respectively; childhood "at risk for overweight" and overweight were defined as the 85th and 95th percentiles of body mass index. Average annual increase in and future projections for prevalence were estimated by using linear regression models. Among adults, obesity prevalence increased from 13% to 32% between the 1960s and 2004. Currently, 66% of adults are overweight or obese; 16% of children and adolescents are overweight and 34% are at risk of overweight. Minority and low-socioeconomic-status groups are disproportionately affected at all ages. Annual increases in prevalence ranged from 0.3 to 0.9 percentage points across groups. By 2015, 75% of adults will be overweight or obese, and 41% will be obese. In conclusion, obesity has increased at an alarming rate in the United States over the past three decades. The associations of obesity with gender, age, ethnicity, and socioeconomic status are complex and dynamic. Related population-based programs and policies are needed.
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            Baseline Serum 25-Hydroxy Vitamin D Is Predictive of Future Glycemic Status and Insulin Resistance

            OBJECTIVE—Accumulating epidemiological evidence suggests that hypovitaminosis D may be associated with type 2 diabetes and related metabolic risks. However, prospective data using the biomarker serum 25-hydroxyvitamin D [25(OH)D] are limited and therefore examined in the present study. RESEARCH DESIGN AND METHODS—A total of 524 randomly selected nondiabetic men and women, aged 40–69 years at baseline, with measurements for serum 25(OH)D and IGF-1 in the population-based Ely Study, had glycemic status (oral glucose tolerance), lipids, insulin, anthropometry, and blood pressure measured and metabolic syndrome risk (metabolic syndrome z score) derived at baseline and at 10 years of follow-up. RESULTS—Age-adjusted baseline mean serum 25(OH)D was greater in men (64.5 nmol/l [95% CI 61.2–67.9]) than women (57.2 nmol/l [54.4,60.0]) and varied with season (highest late summer). Baseline 25(OH)D was associated inversely with 10-year risk of hyperglycemia (fasting glucose: β = −0.0023, P = 0.019; 2-h glucose: β = −0.0097, P = 0.006), insulin resistance (fasting insulin β = −0.1467, P = 0.010; homeostasis model assessment of insulin resistance [HOMA-IR]: β = −0.0059, P = 0.005), and metabolic syndrome z score (β = −0.0016, P = 0.048) after adjustment for age, sex, smoking, BMI, season, and baseline value of each metabolic outcome variable. Associations with 2-h glucose, insulin, and HOMA-IR remained significant after further adjustment for IGF-1, parathyroid hormone, calcium, physical activity, and social class. CONCLUSIONS—This prospective study reports inverse associations between baseline serum 25(OH)D and future glycemia and insulin resistance. These associations are potentially important in understanding the etiology of abnormal glucose metabolism and warrant investigation in larger, specifically designed prospective studies and randomized controlled trials of supplementation.
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              Concentrations of serum vitamin D and the metabolic syndrome among U.S. adults.

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                Author and article information

                Journal
                Nutrients
                Nutrients
                nutrients
                Nutrients
                MDPI
                2072-6643
                28 August 2018
                September 2018
                : 10
                : 9
                : 1182
                Affiliations
                Department of Clinical Medicine Aarhus University, 8200 Aarhus, Denmark; shamailarafiq@ 123456clin.au.dk
                Author notes
                [* ]Correspondence: per.bendix.jeppesen@ 123456clin.au.dk ; Tel.: +45-2815-1877
                Author information
                https://orcid.org/0000-0003-2654-2927
                https://orcid.org/0000-0001-8042-7554
                Article
                nutrients-10-01182
                10.3390/nu10091182
                6164132
                30154381
                bbd2bd2f-3e5b-480c-a574-09d81c1e46ed
                © 2018 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 12 August 2018
                : 24 August 2018
                Categories
                Review

                Nutrition & Dietetics
                hypovitaminosis d,type 2 diabetes,body mass index,vitamin d,bmi
                Nutrition & Dietetics
                hypovitaminosis d, type 2 diabetes, body mass index, vitamin d, bmi

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