Vitamin D Deficiency in Association with HSCRP Linked to Obesity

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International Journ Internat ISSN No: 245 @ IJTSRD | Available Online @ www Vitamin D Deficiency in Dr. Pushpa Dr. Lamiaa 1,4 Professor, 2 Associate P 3 Asso 1,2,3,4 Umm al Qur ABSTRACT Vitamin D deficiency is gaining increa for its novel association with Obesity. found that maintaining vitamin D statu ones risk of developing various diseases In 2010, overweight and obesity were cause 3•4 million deaths, 3•9% of yea and 3•8% of disability-adjusted life-ye worldwide. The rise in obesity has led calls for regular monitoring of changes and obesity prevalence in all pop treatment of obesity and cardiovascul one of the most difficult and importa nowadays. This paper seeks to consistently reported relationship betwe low vitamin D concentrations in ass HSCRP, with reference to the possib mechanisms. The possibility that vitamin in preventing or treating obesity is also recommendations for future research a tested the hypothesis that suggests Adul obesity have lower 25-hydroxyvitamin have higher hs-CRP levels. Keyword: Vitamin D deficiency, High Reactive Protein, Obesity. INTRODUCTION Vitamin D deficiency is the most comm deficiency and the very likely, the m medical condition in the world. There i association in the published litera increasing BMI and lower serum 25-hy D (25D) concentrations. A bi-direct study, which limits confounding, has s higher BMI leads to lower 25D, with lower 25D on BMI likely to be sm nal of Trend in Scientific Research and De tional Open Access Journal | www.ijtsr 56 - 6470 | Volume - 2 | Issue – 6 | Sep w.ijtsrd.com | Volume – 2 | Issue – 6 | Sep-Oct n Association with HSCRP Link amala Ramaiah 1 , Dr. Ayman Johargy 2 , a Ahmed Elsayed 3 , Dr. Grace Lindsey 4 Professor of Medical Microbiology, Faculty of M ociate Professor at Faculty of Nursing ra University, Makkah, Kingdom of Saudi Arabi asing attention . Studies have us may reduce s. Background e estimated to ars of life lost, ears (DALYs) to widespread in overweight pulations. The lar diseases is ant challenges examine the een obesity and sociation with ble underlying n D may assist examined and are made. We lts with s evere n D levels will h Sensitive C mon nutritional most common is a consistent ature between ydroxyvitamin tional genetic suggested that the effects of mall [1] . Lower vitamin D in obese people across age, ethnicity, and ge always reflect a clinical probl higher loading doses of vitami serum 25-hydroxyvitamin D His work suggests that vi throughout the body, and that deficiency in overweight and more mass than normal-weig hand, a number of studies h reactive protein (CRP), an inf strong predictor of CVD Thu prevent CVD with the h treatments. [ 3 ] . Previous that vitamin D deficiency is developing obesity and the complications, but studies on supplementation have bee association between reduced obesity is therefore well-est mechanisms for the lower 25D fully described, and there is un health consequences of thes might be. This paper attem current state of knowledge r these reduced 25D concentr possible effects of vitamin obesity. [4] Background: It has been e people worldwide have Vit insufficiency. This is mostly getting less sun exposure beca and concerns about skin canc association in the publish increasing BMI and lower se evelopment (IJTSRD) rd.com p – Oct 2018 2018 Page: 792 ked to Obesity Medicine, ia is a consistent finding eography. This may not lem. Obese people need in D to achieve the same as normal weight. [ 2 ] . itamin D gets diluted t dilution shows up as a obese people, who have ght people. On the other have confirmed that C- flammatory marker, is a us, it is likely feasible to help of CRP-reducing studies have shown associated with both risk of obesity related the effects of vitamin D en inconclusive. The 25D concentrations and tablished, although the D concentrations are not ncertainty as to what the se lower concentrations mpts to summarize the regarding the causes of rations, as well as the D supplementation on estimated that 1 billion tamin D deficiency or y attributable to people ause of climate, lifestyle, er. There is a consistent hed literature between erum 25-hydroxyvitamin

description

Vitamin D deficiency is gaining increasing attention for its novel association with Obesity. Studies have found that maintaining vitamin D status may reduce ones risk of developing various diseases. Background In 2010, overweight and obesity were estimated to cause 3•4 million deaths, 3•9 of years of life lost, and 3•8 of disability adjusted life years DALYs worldwide. The rise in obesity has led to widespread calls for regular monitoring of changes in overweight and obesity prevalence in all populations. The treatment of obesity and cardiovascular diseases is one of the most difficult and important challenges nowadays. This paper seeks to examine the consistently reported relationship between obesity and low vitamin D concentrations in association with HSCRP, with reference to the possible underlying mechanisms. The possibility that vitamin D may assist in preventing or treating obesity is also examined and recommendations for future research are made. We tested the hypothesis that suggests Adults with severe obesity have lower 25 hydroxyvitamin D levels will have higher hs CRP levels. Dr. Pushpamala Ramaiah | Dr. Ayman Johargy | Dr. Lamiaa Ahmed Elsayed | Dr. Grace Lindsey "Vitamin D Deficiency in Association with HSCRP Linked to Obesity" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-2 | Issue-6 , October 2018, URL: https://www.ijtsrd.com/papers/ijtsrd18479.pdf Paper URL: http://www.ijtsrd.com/biological-science/microbiology/18479/vitamin-d-deficiency-in-association-with-hscrp-linked-to-obesity/dr-pushpamala-ramaiah

Transcript of Vitamin D Deficiency in Association with HSCRP Linked to Obesity

Page 1: Vitamin D Deficiency in Association with HSCRP Linked to Obesity

International Journal of Trend in International Open Access Journal

ISSN No: 2456

@ IJTSRD | Available Online @ www.ijtsrd.com

Vitamin D Deficiency in Association w

Dr. PushpamalaDr. Lamiaa Ahmed Elsayed

1,4Professor, 2Associate P3Associate

1,2,3,4Umm al Qura University, Makkah, Kingdom of Saudi Arabia

ABSTRACT Vitamin D deficiency is gaining increasing attention for its novel association with Obesity. Studies have found that maintaining vitamin D status may reduce ones risk of developing various diseases. Background In 2010, overweight and obesity were estimatedcause 3•4 million deaths, 3•9% of years of life lost, and 3•8% of disability-adjusted life-years (DALYs) worldwide. The rise in obesity has led to widespread calls for regular monitoring of changes in overweight and obesity prevalence in all populationtreatment of obesity and cardiovascular diseases is one of the most difficult and important challenges nowadays. This paper seeks to examine the consistently reported relationship between obesity and low vitamin D concentrations in association with HSCRP, with reference to the possible underlying mechanisms. The possibility that vitamin D may assist in preventing or treating obesity is also examined and recommendations for future research are made. We tested the hypothesis that suggests Adults with sobesity have lower 25-hydroxyvitamin D levels will have higher hs-CRP levels. Keyword: Vitamin D deficiency, High Sensitive C Reactive Protein, Obesity. INTRODUCTION Vitamin D deficiency is the most common nutritional deficiency and the very likely, the most common medical condition in the world. There is a consistent association in the published literature between increasing BMI and lower serum 25-hydroxyvitamin D (25D) concentrations. A bi-directional genetic study, which limits confounding, has suggested that higher BMI leads to lower 25D, with the effects of lower 25D on BMI likely to be small

International Journal of Trend in Scientific Research and Development (IJTSRD)International Open Access Journal | www.ijtsrd.com

ISSN No: 2456 - 6470 | Volume - 2 | Issue – 6 | Sep

www.ijtsrd.com | Volume – 2 | Issue – 6 | Sep-Oct 2018

Deficiency in Association with HSCRP Linked t

Pushpamala Ramaiah1, Dr. Ayman Johargy2, Lamiaa Ahmed Elsayed3, Dr. Grace Lindsey4

Professor of Medical Microbiology, Faculty of MedicineAssociate Professor at Faculty of Nursing

Umm al Qura University, Makkah, Kingdom of Saudi Arabia

Vitamin D deficiency is gaining increasing attention for its novel association with Obesity. Studies have found that maintaining vitamin D status may reduce ones risk of developing various diseases. Background In 2010, overweight and obesity were estimated to cause 3•4 million deaths, 3•9% of years of life lost,

years (DALYs) worldwide. The rise in obesity has led to widespread calls for regular monitoring of changes in overweight and obesity prevalence in all populations. The treatment of obesity and cardiovascular diseases is one of the most difficult and important challenges nowadays. This paper seeks to examine the consistently reported relationship between obesity and low vitamin D concentrations in association with HSCRP, with reference to the possible underlying mechanisms. The possibility that vitamin D may assist in preventing or treating obesity is also examined and recommendations for future research are made. We tested the hypothesis that suggests Adults with severe

hydroxyvitamin D levels will

Vitamin D deficiency, High Sensitive C

Vitamin D deficiency is the most common nutritional likely, the most common

medical condition in the world. There is a consistent association in the published literature between

hydroxyvitamin directional genetic has suggested that

higher BMI leads to lower 25D, with the effects of lower 25D on BMI likely to be small[1] . Lower

vitamin D in obese people is a consistent finding across age, ethnicity, and geography. This may not always reflect a clinical problem. higher loading doses of vitamin D to achieve the same serum 25-hydroxyvitamin D as normal weight. His work suggests that vitamin D gets diluted throughout the body, and that dilution shows up as a deficiency in overweight and obesemore mass than normal-weight people. On the other hand, a number of studies have confirmed that Creactive protein (CRP), an inflammatory marker, is a strong predictor of CVD Thus, it is likely feasible to prevent CVD with the help of CRPtreatments.[ 3 ]. Previous studies have shown that vitamin D deficiency is associated with both developing obesity and the risk of obesity related complications, but studies on the effects of vitamin D supplementation have been inconclusive. The association between reduced 25D concentrations and obesity is therefore well-established, although the mechanisms for the lower 25D concentrations are not fully described, and there is uncertainty as to what the health consequences of these lower concentrations might be. This paper attempts to summarize the current state of knowledge regarding the causes of these reduced 25D concentrations, as well as the possible effects of vitamin D supplementation on obesity. [4] Background: It has been estimated that 1 billion people worldwide have Vitamin D deficiency or insufficiency. This is mostly attributable to people getting less sun exposure because of climate, and concerns about skin cancer.association in the published literature between increasing BMI and lower serum 25

Research and Development (IJTSRD) www.ijtsrd.com

6 | Sep – Oct 2018

Oct 2018 Page: 792

Linked to Obesity

of Medical Microbiology, Faculty of Medicine,

Umm al Qura University, Makkah, Kingdom of Saudi Arabia

vitamin D in obese people is a consistent finding across age, ethnicity, and geography. This may not always reflect a clinical problem. Obese people need higher loading doses of vitamin D to achieve the same

hydroxyvitamin D as normal weight. [ 2 ]. His work suggests that vitamin D gets diluted throughout the body, and that dilution shows up as a deficiency in overweight and obese people, who have

weight people. On the other hand, a number of studies have confirmed that C-reactive protein (CRP), an inflammatory marker, is a strong predictor of CVD Thus, it is likely feasible to prevent CVD with the help of CRP-reducing

Previous studies have shown deficiency is associated with both

developing obesity and the risk of obesity related omplications, but studies on the effects of vitamin D

supplementation have been inconclusive. The association between reduced 25D concentrations and

established, although the mechanisms for the lower 25D concentrations are not

ly described, and there is uncertainty as to what the health consequences of these lower concentrations might be. This paper attempts to summarize the current state of knowledge regarding the causes of these reduced 25D concentrations, as well as the

ble effects of vitamin D supplementation on

It has been estimated that 1 billion people worldwide have Vitamin D deficiency or insufficiency. This is mostly attributable to people getting less sun exposure because of climate, lifestyle, and concerns about skin cancer. There is a consistent association in the published literature between increasing BMI and lower serum 25-hydroxyvitamin

Page 2: Vitamin D Deficiency in Association with HSCRP Linked to Obesity

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D (25D) concentrations.[5]. Some people get tested for vitamin D and find, despite taking vitaregularly, that they are still not getting enough vitamin D. This means their body is having hard time absorbing their vitamin D supplements. The vitamin D council recommends testing every three to six months, if they are trying different regimens. Tvitamin D council believes that trying to get enough vitamin D from diet is unlikely to get sufficient vitamin D which is needed. [6].Recently, there has been increased interest in the relevance for vitamin D to human health accompanied by increase demavitamin D testing, which has led to the use of less precise assays, which recommend the use of gold standard LC-MS assay, and insist a large national community based study of the prevalence of low vitamin D using this method. [7]. Al-Daggrey (2014) pointed out that the recommended period for sun exposure to the sun is half-an-hour, three to four days a week. There is a clear need for adequatelyprospective interventions which include baseline measurement of 25D concentrations and CRP also involve adequate doses of supplemental vitamin D. Until such studies have been reported, the role of vitamin D supplementation in obesity prevention remains uncertain. The aim of the study was: To identify the prevalence of vitamin D deficiency

and HSCRP among adults. To examine relationships between dietary habits

and 25-hydroxyvitamin D [25(OH)D] level. Investigate the associations between the 25(OH)D

concentrations and the biomarker of iHSCRP.

To evaluate whether vitamin D insufficiency and increased serum high-sensitivity Cprotein (hs-CRP) linked to Obesity.

Patients and Methods: Using a longitudinal, crosssectional design, systolic and diastolic blood pressure, dietary information, serum 25(OH) D, serum CRP, fasting glucose and insulin, 2-h glucose from oral glucose tolerance test, hemoglobin A1c, thyroid profile, liver profile were recorded for 124 volunteer subjects at an referral clinic. Data was collected during their visit at clinic between April 2017 and April 2018. Adults of ages between 20 to 65 years were selected as participants, written informed consent was obtained from the subjects from whom data were collected prospectively. The subjects who were on use of any medication known to effect

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Some people get tested for vitamin D and find, despite taking vitamin D regularly, that they are still not getting enough vitamin D. This means their body is having hard time absorbing their vitamin D supplements. The vitamin D council recommends testing every three to six months, if they are trying different regimens. The vitamin D council believes that trying to get enough vitamin D from diet is unlikely to get sufficient

.Recently, there has been increased interest in the relevance for vitamin D to human health accompanied by increase demand of vitamin D testing, which has led to the use of less precise assays, which recommend the use of gold

MS assay, and insist a large national community based study of the prevalence of low

Daggrey (2014) ointed out that the recommended period for sun

hour, three to four days There is a clear need for adequately-powered,

prospective interventions which include baseline measurement of 25D concentrations and CRP also

olve adequate doses of supplemental vitamin D. Until such studies have been reported, the role of vitamin D supplementation in obesity prevention

To identify the prevalence of vitamin D deficiency

To examine relationships between dietary habits hydroxyvitamin D [25(OH)D] level.

Investigate the associations between the 25(OH)D concentrations and the biomarker of inflammation

To evaluate whether vitamin D insufficiency and sensitivity C-reactive

Using a longitudinal, cross-sectional design, systolic and diastolic blood pressure,

ietary information, serum 25(OH) D, serum CRP, h glucose from oral

glucose tolerance test, hemoglobin A1c, thyroid profile, liver profile were recorded for 124 volunteer subjects at an referral clinic. Data was collected

ng their visit at clinic between April 2017 and April 2018. Adults of ages between 20 to 65 years were selected as participants, written informed consent was obtained from the subjects from whom data were collected prospectively. The subjects who

se of any medication known to effect

vitamin D metabolism were excluded from the project. Those subjects having 25 (OH) vitamins D level > 150 ng/mL were also excluded from the study.Institutional Review Board approved the projects. Tools of data collection: Data was collected by using: 1. A structured pre-developed by King Saud University, Biomarkers Research Department after obtaining the consent from the author of the questionnaire. Prestructured questionnaire was divsections as follows: a. Socio demographic data.Polar questions with regard to knowledge about Vitamin D and associated diseases.sunshine exposure and duration.Serum analysis to find out the level of HSCRP and other biomarker values. The recommended, best test for assessing vitamin D status is to measure 25(OH) D levels using a reliable assay in population at risk for vitamin D deficiency is Electro chemical luminescence assay.3. Anthropometric Assessment: was performed by the physician and the nurse. Height and weight was taken using appropriate international standard scale. Waist circumference were measured using non stretchable tape, BMI was measured. Statistical Analysis: Both descriptive and inferential statistical analysis was carried out using SPSS.Inferential statistics will include Independent T test/Mann Whitney U Test, Paired sample T test/Wilcoxon Signed Rank test, multiple regression analysis/ Logistic regression, repeated measures ANOVA, Chi-Square test of independence. Paired sample t-test (two-tailed) or the repeated measures ANOVA, whichever is appropriate. Equivalent nonparametric analysis was used in case of violations of normality assumption. Results: The prevalence of vitamin D insufficiency and deficiency were determined for the obese and non-overweight study population. Prevalence of vitamin D deficiency was defined by three different thresholds of 25(OH)D, severe, moderate deficiency, deficiency and optimal level of vitamin D.criteria of vitamin D status is as follows(Povoroznyuk.V. 2013)

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vitamin D metabolism were excluded from the Those subjects having 25 (OH) vitamins D

ng/mL were also excluded from the study. Institutional Review Board approved the projects.

Data was collected by -validated questionnaire

developed by King Saud University, Biomarkers Research Department after obtaining the consent from the author of the questionnaire. Pre-validated structured questionnaire was divided into three

Socio demographic data. b. Polar questions with regard to knowledge about Vitamin D and associated diseases. c. MCQ about sunshine exposure and duration. 2. Measurement of Serum analysis to find out the level of Vitamin D, HSCRP and other biomarker values. The recommended, best test for assessing vitamin D status is to measure 25(OH) D levels using a reliable assay in population at risk for vitamin D deficiency is Electro chemical luminescence assay.

etric Assessment: Physical examination was performed by the physician and the nurse. Height and weight was taken using appropriate international standard scale. Waist circumference were measured using non stretchable tape, BMI was measured.

Both descriptive and inferential statistical analysis was carried out using SPSS. Inferential statistics will include Independent T test/Mann Whitney U Test, Paired sample T test/Wilcoxon Signed Rank test, multiple regression

ression, repeated measures Square test of independence. Paired

tailed) or the repeated measures ANOVA, whichever is appropriate. Equivalent non-parametric analysis was used in case of violations of

The prevalence of vitamin D insufficiency and deficiency were determined for the obese and

overweight study population. Prevalence of vitamin D deficiency was defined by three different thresholds of 25(OH)D, severe, moderate deficiency,

and optimal level of vitamin D. Diagnostic criteria of vitamin D status is as follows [ 8 ]

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Vitamin D Severe deficiency25(OH)D3

Concentration 0-10

A χ2 test was used to compare the prevalence rate of vitamin D insufficiency and deficiency in the obese group to the non-overweight group. In the present study records of 124 ostensibly healthy subjects enrolled for executive health checkdifferent laboratories in India were chosen as research

Study subjects(124) % MeanMale 77 18.96

Female 47 14.24Total 124 -

This result is not significant at p < .05. The reviews of (Babu& Calvo 2012) documents supports our research findings of widespread vitamin D deficiency in Indian populations in higher and lower socioeconomic strata, in all age groups, in both genders and people in various professions. The subjects with Vitamin D deficiency were administered the recommended dose of Vitamin D and found the significant outcome in their serum level with the medianvalue of 31.28 (27.88–34.68) which was evident statistically by Overall increase by 68% of 25(OH) vitwith no observed significant changes in the increased level of vitamin D between male and female. Serum 25(OH) vitamin D decreased with increasing age in all subjects (r = −0.29; P < 0.001).

Participants Moderate deficiencyMale 26(53%)

Female 23(47%)Total 49

This result is not significant at p < .05. Average 25(OH)D levels did not differ by gender among overweight, severe and moderate obesity or nonoverweight group participants.Figure:1

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Severe deficiency Deficiency Insufficiency Optimal level

10-20 20-30 30-80

test was used to compare the prevalence rate of vitamin D insufficiency and deficiency in the obese

In the present study records of 124 ostensibly healthy subjects enrolled for executive health check-up at different laboratories in India were chosen as research

subjects. Amongst these, 77 % were male and 23female. The mean 25(OH) vitamin D level inpopulation was found to be 17.37(median 14.59) whereas upon segregation, in males the mean level was 18.96 ±17.76) and 14.24 ± 6.79 ng/mL (median 13.72) in females (p < 0.0001).

Mean SD Severe Deficiency Optimal Level18.96 10.36 18(51%) 5(55%) 14.24 6.79 17(49%) 4(45%)

- 35 9

.05. The reviews of (Babu& Calvo 2012) documents supports our research findings of widespread vitamin D deficiency in Indian populations in higher and lower socioeconomic strata, in all age groups, in both genders and people in

bjects with Vitamin D deficiency were administered the recommended dose of Vitamin D and found the significant outcome in their serum level with the medianvalue of 31.28

34.68) which was evident statistically by of 25(OH) vitamin D level

with no observed significant changes in the increased level of vitamin D between male and female. Serum 25(OH) vitamin D decreased with increasing age in

On further evaluating these 124 subjects on the of their 25(OH) vitamin D status, 53.69to have 25(OH) vitamin D severe deficiency (<12 ng/mL) which included 61female. Similarly 25(OH) vitamin D moderate insufficiency (<20ng/mL) was observed in about 39 % individuals including 52.5female. Only 7.31 % of the total population had optimal 25(OH) vitamin D levels (>30included 96 % male and 425(OH) vitamin D level in the male severe vitamin D deficiency group was 9.79± significantly higher as compared to the female group with 7.48 ± 1.77 ng/mL as mean value (the moderate Vitamin D deficiency group, there was no statistically significant difference between male and female vitamin D level.

Moderate deficiency Severe deficiency Total Chi square26(53%) 40(60.60%) 66

Not significant23(47%) 26(39.40) 49

49 66 115

Average 25(OH)D levels did not differ by gender among overweight, severe and moderate obesity or non

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Optimal level Risk of Toxicity

>100

% were male and 23 % female. The mean 25(OH) vitamin D level in the population was found to be 17.37 ± 7.12 ng/mL (median 14.59) whereas upon segregation, in males

± 10.36 ng/mL (median 6.79 ng/mL (median 13.72) in

Optimal Level Chi square

.048 Not significant

On further evaluating these 124 subjects on the basis of their 25(OH) vitamin D status, 53.69 % were found to have 25(OH) vitamin D severe deficiency

ng/mL) which included 61 % male and 39 % female. Similarly 25(OH) vitamin D moderate insufficiency (<20ng/mL) was observed in about

including 52.5 % male and 47.5 % % of the total population had

optimal 25(OH) vitamin D levels (>30 ng/mL) which % male and 4 % female. The mean

25(OH) vitamin D level in the male severe vitamin D 1.57 ng/mL which was

significantly higher as compared to the female group ng/mL as mean value (p < 0.0001).In

the moderate Vitamin D deficiency group, there was no statistically significant difference between male

Chi square

.654 Not significant

Average 25(OH)D levels did not differ by gender among overweight, severe and moderate obesity or non-

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The overall prevalence of obesity was 66.66%. Among Subjects in optimal Vitamin D level it shows a prevalence of 22.22% in Severe Obesity group, hence severe obesity could be considered as an associated factor for vitamin D deficiency. Our research result supports the research finding of Rock Cl et al 2012, involved data from 383 overweight or obese women who participated in a 2trial of a weight-loss program which showed that those who did not lose weight at 24 months had an increase in serum 25D of 1.9 ng/mL (4.8 nmol/L). However, 25D increased by 2.7 ng/mL (6.8 nmol/L) for those who lost 5%–10% of baseline weight, and by 5.0 ng/mL (12.5 nmol/L) for those who lost >10% of baseline weight (P = 0.014)Early, smaller studies (Liely et al 1988) also reported an association between obesity and low serum 25D concentrations, as well as high concentrations of parathyroid hormone (PTH) and 1,25-dihydroxyvitamin D (1,25D). The overall participants CRP level ranged from .2 to 15.93mg/L with the Mean 5.15±2.98, where only 7.32% of the participants optimal level of CRP, average risk participants were 24.39%(HSCRP level between 1.0mg?L and 3mg/L), and the highest percentage 68.29% of subjects (>3mg/L) were in high risk group. The participants of obesity grouhigh level of HSCRP with the Mean 7.07±SD .83, however there is no statistical significant differences among gender distribution of low level vitamin D, HSCRP linked to severe obesity. Two-way ANOVA was used to compare 25(OH) D levels in the obese group to the nongroup, compare seasonal levels, and assess the interaction between obesity and season. Gender patterns were also assessed with two-models. The interquartile ranges of 25(OH)D levels for specified subgroups(severe vitamin D deficiency) is Xl 5.75, Xu 8.51, Xu- Xl= 2.725.Box Whisker plot Calculation: Minimum 4.2Maximum 10.23 First quartile 4.5Median 8.04Third quartile 13.5Ascending order 4.200. Subjects were classified as low (L) if the serum level of CRP was <1 mg/dL or as high (H) if the serum level of CRP was ≥1 mg/dL. The detection sensitivity of the assay was 0.1 mg/dL

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The overall prevalence of obesity was 66.66%. Among Subjects in optimal Vitamin D level it shows a prevalence of 22.22% in Severe Obesity group, hence severe obesity could be considered as an associated factor for vitamin D deficiency. Our

supports the research finding of Rock ata from 383 overweight or

obese women who participated in a 2-year clinical loss program which showed that

those who did not lose weight at 24 months had an 25D of 1.9 ng/mL (4.8 nmol/L).

However, 25D increased by 2.7 ng/mL (6.8 nmol/L) 10% of baseline weight, and

by 5.0 ng/mL (12.5 nmol/L) for those who lost >10% of baseline weight (P = 0.014)Early, smaller studies

so reported an association between obesity and low serum 25D concentrations, as well as high concentrations of parathyroid hormone

dihydroxyvitamin D (1,25D).

The overall participants CRP level ranged from .2 to ±2.98, where only

7.32% of the participants optimal level of CRP, average risk participants were 24.39%(HSCRP level between 1.0mg?L and 3mg/L), and the highest percentage 68.29% of subjects (>3mg/L) were in high risk group. The participants of obesity group had their high level of HSCRP with the Mean 7.07±SD .83, however there is no statistical significant differences among gender distribution of low level vitamin D,

way ANOVA was used to compare 25(OH) D bese group to the non-overweight

group, compare seasonal levels, and assess the interaction between obesity and season. Gender

-way ANOVA

The interquartile ranges of 25(OH)D levels for vitamin D deficiency) is

Box Whisker plot 4.2Maximum 10.23

First quartile 4.5Median 8.04Third quartile

Subjects were classified as low (L) if the serum level g/dL or as high (H) if the serum

≥1 mg/dL. The detection sensitivity

Among participants 9.75% were only having normal weight. Among 124 adults, 40.81% were overweight and 34% were Obese. A prevalence of 15.44% amthe participants was found to be in Severe Obesity. Study revealed with the great statistics of only 5.55% were observed to be in low risk HSCRP, 11.11% of average risk participants, and the higher proportion of the subjects was in high risk group of 8Average and High risk subjects were with the mean value of 7.44(SD2.59). In summary increased BMI was positively associated with unfavorable biomarkers, such as LDL, HDL and TG. Similar association between obesity and biochemical markers has been spopulations worldwide. In correlation co-efficient was relationship between 25(OH)D and 2HgbA1c, HSCRP. Data were adjusted for BMI Z score and age. When data did not meet tests of normality, data were log-parametric tests were used. A of 0.05 was considered significant for all statistical tests. Discussion: Our study described the prevalence of vitamin D deficiency and the associated link between Obesity and HSCRP among Indian Adults at different referral clinic. In our study the percent change in hsCRP correlated similarly with changes in all measures of body fat, and total abdominal, subcutaneous abdominal, and visceral fat. We have found high prevalence of vitamin D severe deficiency 53.69%, overweight 40.88%, obesity 66.66%, and HSCRP. In addition obese adults are more likely to present HSCRP with vitamin D deficiency and undesirable biochemical markers values than NonObese. Only 9.5% of the study subjecthaving normal weight. Vitamin D status may be a determining factor of systemic inflammation in patients with T2DM. [ 9 ]. In support of this notion we found that the highest proportion of the subjects was observed in high risk group of 83.33% in comparison with their level of HSCRP, which is alarming sign of leading them to potential cardiovascular risk factors. The link between obesity and vitamin D deficiency appears to be a one-way street. A large study of the genetics underpinning both conditions finds that obesity may drive down vitamin D levels, but a predisposition to the vitamin deficiency doesn’t lead to obesity. The findings also suggest that boosting vitamin D levels won’t reverse suggest that losing weight could potentially reverse

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Among participants 9.75% were only having normal weight. Among 124 adults, 40.81% were overweight

. A prevalence of 15.44% among found to be in Severe Obesity.

Study revealed with the great statistics of only 5.55% were observed to be in low risk HSCRP, 11.11% of average risk participants, and the higher proportion of the subjects was in high risk group of 83.33%. Average and High risk subjects were with the mean

In summary increased BMI was positively associated with unfavorable biomarkers, such as LDL, HDL and TG. Similar association between obesity and biochemical markers has been showed in multiple

obese adult, Pearson used to evaluate the

relationship between 25(OH)D and 2-h glucose, HgbA1c, HSCRP. Data were adjusted for BMI Z score and age. When data did not meet tests of

-transformed or non-parametric tests were used. A of 0.05 was considered significant for all statistical tests.

Our study described the prevalence of vitamin D deficiency and the associated link between

HSCRP among Indian Adults at different referral clinic. In our study the percent change in hsCRP correlated similarly with changes in all measures of body fat, and total abdominal, subcutaneous abdominal, and visceral fat. We have

vitamin D severe deficiency 53.69%, overweight 40.88%, obesity 66.66%, and HSCRP. In addition obese adults are more likely to present HSCRP with vitamin D deficiency and undesirable biochemical markers values than Non-Obese. Only 9.5% of the study subjects found to be having normal weight. Vitamin D status may be a determining factor of systemic inflammation in

. In support of this notion we highest proportion of the subjects was

high risk group of 83.33% in comparison with their level of HSCRP, which is alarming sign of leading them to potential cardiovascular risk factors. The link between obesity and vitamin D deficiency

way street. A large study of the etics underpinning both conditions finds that

obesity may drive down vitamin D levels, but a predisposition to the vitamin deficiency doesn’t lead to obesity. The findings also suggest that boosting vitamin D levels won’t reverse obesity. The data

that losing weight could potentially reverse

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vitamin D deficiency in obese people, says Hyppönen. Or, she says, obese people could improve their overall health by having their vitamin D checked and correcting any deficiency. Vitamin D is important for, among other things, fighting infection, absorbing calcium and maintaining a healthy immune system. In summary overweight was positively associated with low level vitamin D and High level SCRP. Low level vitamin D is not significantly associated with Overweight and HSCRP. Further to this our study found the positive associated significant relationship between Obesity and undesirable biomarker values. Recommendation: Lifestyle intervention would bring the adults the knowledge about the sources of vitamin D for their better health to prevent them from suffering with vitamin d deficiency related diseases and complications in their lifetime. Preventionsupplements) is better than cure and management of sources of acquiring and synthesizing VD is the key, preventing Saudi adolescents from widespread bone and other vitamin D deficiency disorder. Conclusions: Vitamin D deficiency is common in adults in this southern Indian region and is significantly more prevalent in obese adults. Lower 25(OH) D level is associated with risk factors for type 2 diabetes in obese adults. This rise in obesity prevalence has paralleled increases in adult hypertension, hyperlipidemia, and type 2 diabetes .Furthermore, epidemiological data have linked low vitamin D levels to type 2 diabetes The mechanisms by which obesity and its co morbiditiesvitamin D deficiency are poorly understood. Inpresent study, we determined the prevalence of vitamin D deficiency in adults referred to an obesity and compared this prevalence to that of an age, Obesity group and Non obese adults. We have also examined associations between 25-hydro[25(OH) vitamin D] and dietary habits in obese adults and tested whether there were correlations between 25(OH) vitamin D and markers of lipid, renal and insulin resistance. Conflict of Interest: The author declares no conflict of interest. References: 1. Vimeswaran K., Berry D., Lu C., Pilz S., Hiraki

L., Cooper J., Dastani Z., Li R., Houston D., Wood A. Causal relationship between obesity and vitamin D status: Bi-directional mendelian

International Journal of Trend in Scientific Research and Development (IJTSRD) ISSN: 2456

www.ijtsrd.com | Volume – 2 | Issue – 6 | Sep-Oct 2018

vitamin D deficiency in obese people, says Hyppönen. Or, she says, obese people could improve their overall health by having their vitamin D checked and correcting any deficiency. Vitamin D is important for,

ng other things, fighting infection, absorbing calcium and maintaining a healthy immune system. In summary overweight was positively associated with low level vitamin D and High level SCRP. Low level vitamin D is not significantly associated with

t and HSCRP. Further to this our study found the positive associated significant relationship between Obesity and undesirable biomarker values.

intervention would bring the adults the knowledge about the sources of vitamin

their better health to prevent them from suffering with vitamin d deficiency related diseases

lifetime. Prevention (VD supplements) is better than cure and management of sources of acquiring and synthesizing VD is the key,

ting Saudi adolescents from widespread bone and other vitamin D deficiency disorder.

D deficiency is common in adults in this southern Indian region and is significantly more prevalent in obese adults. Lower 25(OH) D level is associated with risk factors for type

rise in obesity ncreases in adult

hypertension, hyperlipidemia, and type 2 diabetes .Furthermore, epidemiological data have linked low vitamin D levels to type 2 diabetes The mechanisms

co morbidities are related to understood. In the

present study, we determined the prevalence of vitamin D deficiency in adults referred to an obesity and compared this prevalence to that of an age, Obesity group and Non obese adults. We have also

hydroxyvitamin D [25(OH) vitamin D] and dietary habits in obese adults and tested whether there were correlations between 25(OH) vitamin D and markers of lipid, renal and

The author declares no conflict of interest.

Vimeswaran K., Berry D., Lu C., Pilz S., Hiraki L., Cooper J., Dastani Z., Li R., Houston D., Wood A. Causal relationship between obesity and

directional mendelian

randomization analysis of multiple cohorts.PLoS Med. 10:1549–1676

2. Walsh J S1, Bowles S, Evans Aobesity. Current Opinion in Endocrinology Diabetes and Obesity. 2017. US National Library of Medicine, National Institutes of Health,Volume 24(6), 389-394.

3. Kaptoge, S.; Angelantonio, E.; Pennells, L.; Wood, A. M.; White, I. R.; Gao, P.; Walker, M.Thompson, A.; Sarwar, N.; Caslake, M.;reactive protein, fibrinogen, and cardiovascular disease prediction. 2012. The New journal of England Medicine. 4:367, P

4. Chen N, Wan Z, Han S F, L Q, Effect of vitamin D supplementation on the level of circulating highprotein: a meta-analysis of randomized controlled trials. Nutrients, 2014.US National Library of Medicine, National Institute of Health.10:6(6).

5. Simon Van lit, Obesity and VitamNational Library of Medicine, MDPI, Nutrients, Volume 5; (3) P; 949-956.

6. Vitamin D council 2015. https://www.vitamindcouncil.org/2015council-annual-report/.

7. Hussain A N, Alkhenizan AH, Gabr A, (2014). Increasing trends and significance of hypovitaminosis D: A populationbased study in the kingdom of Saudi Arabia; (9)190; e PubMed.

8. Pludowski P, karczmarewicz E, Bayer M, Carter G, Chlebna-Sokol D, CzechR, Decsi T, Dobrzanska A, Franek E, Gluszko P, Grant WB, Holick MF, Yankovskaya L et al, 2013, US National Library of Medicine, National Institutes of Health, Endokrynologia polska, 64: (4), 319-27.

9. Fatemeh Haidari, Mehrnoosh Zakerkish, Majid Karandish, Azadeh Saki, Sakineh PoAssociation between serum vitamin D level and Glycemic and Inflammatory markers in Non Obese patients with Type 2 diabetes. Iran Journal of Medical science, 41(5).

10. Erin S. LeBlanc, Joanne H.Pedula, Kristine E. Ensrud, Jane CHochberg and Teresa A Hiller, 2012, Association between 25- Hydroxyvitamin D and weight gain in Elderly women, Journal of women's health, 21(10), 1066-1073.

International Journal of Trend in Scientific Research and Development (IJTSRD) ISSN: 2456-6470

Oct 2018 Page: 796

randomization analysis of multiple cohorts. 2013. 1676

Evans A L, Vitamin D in Current Opinion in Endocrinology

2017. US National Library of Medicine, National Institutes of Health,Volume

Kaptoge, S.; Angelantonio, E.; Pennells, L.; R.; Gao, P.; Walker, M.;

Thompson, A.; Sarwar, N.; Caslake, M.; et al. C-reactive protein, fibrinogen, and cardiovascular

2012. The New journal of 4:367, P-1310–1320.

Li B Y, Zhang Z L, Qin amin D supplementation on the

level of circulating high-sensitivity C-reactive analysis of randomized controlled

trials. Nutrients, 2014.US National Library of Medicine, National Institute of Health.10:6(6).

Van lit, Obesity and Vitamin D, 2013. US National Library of Medicine, MDPI, Nutrients,

956.

Vitamin D council 2015. https://www.vitamindcouncil.org/2015-vitamin-d-

N, Alkhenizan A H, El Shaker M, Raef A, (2014). Increasing trends and

significance of hypovitaminosis D: A population-based study in the kingdom of Saudi Arabia;

Pludowski P, karczmarewicz E, Bayer M, Carter Sokol D, Czech-Kowalska J, Debski

a A, Franek E, Gluszko P, Grant WB, Holick MF, Yankovskaya L et al, 2013, US National Library of Medicine, National Institutes of Health, Endokrynologia polska, 64:

Fatemeh Haidari, Mehrnoosh Zakerkish, Majid Karandish, Azadeh Saki, Sakineh Pooraziz, 2016, Association between serum vitamin D level and Glycemic and Inflammatory markers in Non Obese patients with Type 2 diabetes. Iran Journal

LeBlanc, Joanne H. Rizzo, Kathryn L Ensrud, Jane Cauley, Marc

Hochberg and Teresa A Hiller, 2012, Association Hydroxyvitamin D and weight gain

in Elderly women, Journal of women's health,