Objective
The objective of this study was to evaluate the association between the metabolic syndrome (MS) and vitamin D [25(OH)D] or
parathyroid hormone (PTH) levels in severely obese subjects.
Research Design and Methods
Cross-sectional study in 298 severely obese patients [body mass index (BMI) 46.7 ± 5.3 kg/m2; women/men, 70.4/29.6%; age 42.9 ± 10.6 years]. Logistic and stepwise regression models were fit to estimate the odds for
the MS (revised ATPIII criteria) and each of its individual components across quartiles of 25(OH)D and PTH after adjusting
for age (years), gender, BMI, %FM, and season of blood sample collection.
Results
Insufficient 25(OH)D and elevated PTH plasma levels were encountered, respectively, in 64.3 and 47.4% of the studied subjects.
The prevalence of MS was 79.5%. In the unadjusted analysis, those in the highest quartile of 25(OH)D were less likely to present
the MS [0.42 (95% CI 0.19–0.96)], hyperglycemia [0.47, (0.24–0.92)], high triglycerides [0.48 (0.25–0.95)], low HDL-cholesterol
[1.51 (0.76–2.98)], and high blood pressure [0.35 (0.16–0.77)]. Nonetheless, these odds ratios lost significance after adjustment
for age, gender, BMI, fat mass, and season. Backward stepwise regression analysis showed that only male gender [2.66 (1.16–6.10)]
and age [1.07 (1.03–1.10)] were predictive variables for the MS. We did not find an association between the PTH quartiles
and the MS or its individual components.
Conclusions
Our data are consistent with previous reports on the high prevalence of alterations in calcium metabolism in severely obese
subjects. However, our data do not support an independent contribution of 25(OH)D or PTH in the pathogenesis of the MS in
severely obese subjects.
Keywords Obesity - Metabolic syndrome - Parathyroid hormone - Vitamin D