Vitamin D deficiency: the invisible accomplice of metabolic endotoxemia?
The aetiology of obesity is multi-factorial. Recent research has identified a novel association between endotoxaemia (circulating lipopolysaccharide in the systemic circulation) and low-grade inflammation in the adipose organ, which may contribute to obesity. The mechanisms for the low-grade elevation of circulating lipopolysaccharide in obesity are poorly understood. Vitamin D has been increasingly recognised for its pleiotropic actions beyond maintenance of musculoskeletal health. The parathyroid-vitamin D axis is altered in obesity. Circulating vitamin D levels are lower in obese individuals. The regulatory role of vitamin D in the immune system and colonic mucosa may explain the under-appreciated contribution of vitamin D deficiency in the obese to the pathogenesis of endotoxaemia and adipose inflammation. We propose a hypothetical model linking metabolic endotoxaemia with vitamin D deficiency in obesity. A therapeutic approach involving the use of probiotics and vitamin D metabolites in the obese is described.
Lee
Paul
P
Department of Endocrinology, Garvan Institute of Medical Research, Sydney, New South Wales, Australia. p.lee@garvan.org.au
Campbell
Lesley V
LV
D000818:Animals; D019446:Endotoxemia / Q000150:complications* / Q000378:metabolism*; D041981:Gastrointestinal Tract / Q000382:microbiology; D006801:Humans; D008954:Models, Biological; D009765:Obesity / Q000150:complications / Q000209:etiology* / Q000378:metabolism; D019936:Probiotics / Q000627:therapeutic use; D014807:Vitamin D / Q000378:metabolism / Q000627:therapeutic use; D014808:Vitamin D Deficiency / Q000150:complications* / Q000188:drug therapy / Q000276:immunology
D014807:Vitamin D