kjhp Korean Journal of Health Promotion Korean J Health Promot 2234-2141 2093-5676 The Korean Society of Health Promotion and Disease Prevention 10.15384/kjhp.2017.17.3.129 kjhp-17-129 Original Article Association between Vitamin D Concentration and Visceral Fat Area in Healthy Korean Adults PaekJeong Ki WonJi Hye ShinHye Rin KimDea Youn KimKyunam LeeSeon Yeong Department of Family Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea Corresponding author : Seon Yeong Lee, MD, PhD Department of Family Medicine, Inje University Sanggye Paik Hospital, 1342 Dongil-ro, Nowon-gu, Seoul 01757, Korea Tel: +82-2-950-1150, Fax: +82-2-952-4093 E-mail: sylee@paik.ac.kr 012017 19012017 173129 136 10072017 21082017 Copyright © 2017 The Korean Society of Health Promotion and Disease Prevention 2017 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Background:

Studies on the relationship between vitamin D and visceral fat area (VFA; intra-abdominal fat area) have been actively conducted. But, there is a few Korean population-based studies about the association between serum vitamin D level and VFA. The aim of our study was to explore the correlation between serum 25-hydroxyvitamin D (25[OH]D) levels and VFA measured using bioelectrical impedance analysis (BIA; electric impedance) in healthy Korean adults.

 Methods:

This cross-sectional study involved 1,945 adults aged 20-70 years who visited a health promotion center. All subjects underwent the BIA to estimate the VFA. Serum 25(OH)D level was measured using chemiluminescent immunoassay. Multiple regression analysis was performed to identify independent correlation of VFA and serum 25(OH)D level.

 Results:

The prevalence of vitamin D deficiency (25[OH]D: 20-29 ng/mL) and insufficiency (25[OH]D <20 ng/mL) were 54.4% and 38.1%, respectively. After having adjusted age and season, VFA were negatively associated with serum 25(OH)D levels in both men (P<0.001) and women (P<0.001). The obese group with VFA ≥ 100 cm2 had significant lower serum 25(OH)D level in men (P<0.001) and women (P=0.0034).

 Conclusions:

VFA measured using BIA could be negatively associated with serum 25(OH)D levels in healthy Korean adult.

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Differential serum 25-hydroxyvitamin D (25[OH]D) concentrations in subjects with or without obesity. (A, B) Comparison of serum 25-hydroxyvitamin D (25[OH]D) levels according to body mass index (BMI) in men and women. Subjects with a BMI ≥25 kg/m2 were classified as obese. (C, D) Comparison of serum 25(OH)D levels according to percentage body fat (PBF) in men and women. Men with a PBF ≥25 % and women with a PBF ≥30 % were classified as obese. (E, F) Comparison of serum 25[OH]D levels according to visceral fat area (VFA) in men and women. Subjects with a VFA ≥100 cm2 were classified as obese. Data are presented as mean±standard deviation. ∗P value from an independent-sample t-test.

Correlation between 25(OH)D and fatness indices in men and women (A-C); in women aged ≥50 and <50 years (D). Smoothing curve with 95% confidence interval (shaded areas) are fitted by a Loess curve.

Characteristics of study subjects

  Total (n=1,945) Men (n=1,395) Women (n=550) Pa
Age (y) 46±9.5 46.3±9.1 47±10.4 0.204
BMI (kg/m2) 24.6±3.2 25±3 23.3±3.2 <0.001
Normal (18.5-22.9) 639 (32.9) 346 (24.8) 293 (53.3) <0.001
Overweight (23-24.9) Obese (≥25) 517 (26.6) 789 (40.6) 401 (28.7) 648 (46.5) 116 (21.1) 141 (25.6) 0.001 <0.001
Percentage body fat (%) 27±8 24.4±5.4 33.1±5.8 <0.001
Non-obese (<25 in males, <30 in females) 939 (48.3) 786 (56.3) 153 (27.8) <0.001
Obese (≥25 in males, ≥30 in females) 1,006 (51.7) 619 (43.7) 397 (72.2) <0.001
VFA (cm2) 82.5±31.7 78±29 94.1±10.4 <0.001
Normal (<100) High-VFA (≥100) 1,501 (77.2) 444 (22.8) 1,161 (83.2) 234 (16.8) 340 (61.8) 210 (38.2) <0.001 <0.001
Blood pressure (mmHg)        
Systolic 118.5±13.9 120.4±13.2 113.4±14.4 <0.001
Diastolic 78.4±11.3 80.1±11.1 74.3±10.9 <0.001
25(OH)D (ng/mL) 19.5±7.4 20.3±7 17.3±8 <0.001
Normal (≥30) 144 (7.4) 103 (7.4) 41 (7.5) 0.957
Insufficiency (20-29.9) Deficiency (<20) 742 (38.1) 1,059 (54.4) 596 (42.7) 696 (49.9) 146 (26.5) 363 (66) <0.001 <0.001
Total cholesterol (mg/dL) 193.4±34.8 193.4±35 193.6±34.4 0.916
Triglyceride (mg/dL) 138.9±91 153.1±98.3 102.8±54 <0.001
HDL cholesterol (mg/dL) 50.7±11.8 48.2±10.3 57.1±13.1 <0.001
LDL cholesterol (mg/dL) 119.2±25.6 120.4±25.7 116.2±25.3 0.001
Fasting glucose (mg/dL) 87.2±10.4 88.1±10.6 84.8±9.8 <0.001

Abbreviations: BMI, body mass index; VFA, visceral fat area; 25(OH)D; 25-hydroxyvitamin D; HDL, high density lipoprotein; LDL, low density lipoprotein. Variables are presented as mean±standard deviation or number (%).

P-value from an independent-sample t-test for continuous variables and χ

test for categorical variables.

Correlation between serum 25(OH)D and variables

  Men Women
  ra Pb r P
Age 0.142 <0.001 0.305 <0.001
Body mass index -0.127 <0.001 -0.134 0.002
Percentage body fat -0.195 <0.001 -0.096 0.025
Visceral fat area -0.185 <0.001 -0.153 <0.001
Systolic blood pressure -0.079 0.003 -0.038 0.379
Diastolic blood pressure Total cholesterol -0.115 -0.087 <0.001 0.001 -0.064 0.060 0.133 0.160
Triglyceride -0.312 <0.001 -0.163 <0.001
High density lipoprotein cholesterol 0.058 0.031 0.006 0.892
Low density lipoprotein cholesterol -0.029 0.284 0.105 0.014
Fasting glucose -0.062 0.020 -0.029 0.493

Abbreviation: 25(OH)D, 25-hydroxyvitamin D.

Correlation coefficients.

P-value are calculated by Pearson correlation analysis.

Regression analysis of relationship between vitamin D and obesity indices

  Men Women
  β±SE Pa β±SE P
Model 1b        
Body mass index -0.004±0.064 0.950 -0.342±0.111 0.002
Percentage body fat -0.142±0.035 <0.001 -0.158±0.059 0.008
Visceral fat area -0.018±0.007 0.008 -0.034±0.010 -0.149
Model 2c        
Body mass index Percentage body fat -0.188±0.060 -0.211±0.033 0.002 <0.001 -0.492±0.100 -0.225±0.056 <0.001 <0.001
Visceral fat area -0.032±0.006 <0.001 -0.046±0.009 <0.001

Abbreviation: SE, standard error.

P-value are calculated by multiple regression analysis.

Model 1 was adjusted for age, SBP, DBP, total cholesterol, TG, HDL-C, LDL-C, glucose and season.

Model 2 was adjusted for age and season. Model 2 was final model.