title: Adiposity, cardiometabolic risk, and vitamin D status: the Framingham Heart Study.
abstract: OBJECTIVE
  Because vitamin D deficiency is associated with a variety of chronic diseases, understanding the characteristics that promote vitamin D deficiency in otherwise healthy adults could have important clinical implications. Few studies relating vitamin D deficiency to obesity have included direct measures of adiposity. Furthermore, the degree to which vitamin D is associated with metabolic traits after adjusting for adiposity measures is unclear.
  
  
  METHODS
  We investigated the relations of serum 25-hydroxyvitamin D (25[OH]D) concentrations with indexes of cardiometabolic risk in 3,890 nondiabetic individuals; 1,882 had subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) volumes measured by multidetector computed tomography (CT).
  
  
  RESULTS
  In multivariable-adjusted regression models, 25(OH)D was inversely associated with winter season, waist circumference, and serum insulin (P < 0.005 for all). In models further adjusted for CT measures, 25(OH)D was inversely related to SAT (-1.1 ng/ml per SD increment in SAT, P = 0.016) and VAT (-2.3 ng/ml per SD, P < 0.0001). The association of 25(OH)D with insulin resistance measures became nonsignificant after adjustment for VAT. Higher adiposity volumes were correlated with lower 25(OH)D across different categories of BMI, including in lean individuals (BMI <25 kg/m(2)). The prevalence of vitamin D deficiency (25[OH]D <20 ng/ml) was threefold higher in those with high SAT and high VAT than in those with low SAT and low VAT (P < 0.0001).
  
  
  CONCLUSIONS
  Vitamin D status is strongly associated with variation in subcutaneous and especially visceral adiposity. The mechanisms by which adiposity promotes vitamin D deficiency warrant further study.
authors.affiliation: Framingham Heart Study, Framingham, Massachusetts, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Cheng
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Massaro
authors.forename: Caroline S
authors.initials: CS
authors.lastname: Fox
authors.forename: Martin G
authors.initials: MG
authors.lastname: Larson
authors.forename: Michelle J
authors.initials: MJ
authors.lastname: Keyes
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: McCabe
authors.forename: Sander J
authors.initials: SJ
authors.lastname: Robins
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: O'Donnell
authors.forename: Udo
authors.initials: U
authors.lastname: Hoffmann
authors.forename: Paul F
authors.initials: PF
authors.lastname: Jacques
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Booth
authors.forename: Ramachandran S
authors.initials: RS
authors.lastname: Vasan
authors.forename: Myles
authors.initials: M
authors.lastname: Wolf
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Wang
mesh_terms: D050153:Abdominal Fat / Q000033:anatomy & histology*; D000273:Adipose Tissue / Q000033:anatomy & histology*; D000328:Adult; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D008076:Cholesterol, HDL / Q000097:blood; D015331:Cohort Studies; D005260:Female; D018149:Glucose Intolerance / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D014057:Tomography, X-Ray Computed; D014280:Triglycerides / Q000097:blood; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood / Q000378:metabolism*; D014808:Vitamin D Deficiency / Q000150:complications*; D044465:White People
chemical_list: D008076:Cholesterol, HDL; D014280:Triglycerides; D014807:Vitamin D; C104450:25-hydroxyvitamin D