Influence of Vitamin D Deficiency on Cardiometabolic Risk in Obesity

Vitamin D deficiency and dysfunctional adipose tissue are involved in the development of cardiometabolic disturbances (eg, hypertension, insulin resistance, type 2 diabetes mellitus, obesity, and dyslipidemia). We studied 50 obese (body mass index [BMI]: 43.5 ± 9.2 kg/m2 ) and 36 normal weight participants (BMI: 22.6 ± 1.9 kg/m2 ). Obese individuals were classified into different subgroups according to medians of observed anthropometric parameters (BMI, body fat percentage, waist circumference, and trunk fat mass). The prevalence of vitamin D deficiency (25-hydroxyvitamin D, 25 (OH)D < 50 nmol/L) was 88% among obese patients and 31% among nonobese individuals; 25(OH)D were lower in the obese group (27.3 ± 13.7 vs 64.6 ± 21.3 nmol/L, p < .001). There was a negative correlation between vitamin D and anthropometric indicators of obesity: BMI: (r = - 0.64, p < .001), waist circumference (r = -0.59; p < .001), and body fat percentage (r = -0.64; p < .001) as well with fasting plasma insulin (r = -0.35; p < .001) and homeostasis model assessment of insulin resistance (r = - 0.35; p < .001). There was a negative correlation between vitamin D level and leptin and resistin (r = -.61; p < .01), while a positive association with adiponectin concentrations were found (r = .7; p < .001). Trend estimation showed that increase in vitamin D level is accompanied by intensive increase in adiponectin concentrations (growth coefficient: 12.13). In conclusion, we observed a higher prevalence of vitamin D deficiency among obese participants and this was associated with a proatherogenic cardiometabolic risk profile. In contrast, a positive trend was established between vitamin D and the protective adipocytokine adiponectin. The clinical relevance of this relationship needs to be investigated in larger studies

Metabolic dysregulation in obese women and the carcinogenesis of gynecological tumors: A review

Obesity is a significant health issue associated with increased cancer risks, including gynecological malignancies. The worldwide rise in obesity rates is significantly impacting both cancer development and treatment outcomes. Adipose tissue plays a crucial role in metabolism, secreting various substances that can influence cancer formation. In obese individuals, dysfunctional adipose tissue can contribute to cancer development through inflammation, insulin resistance, hormonal changes, and abnormal cholesterol metabolism. Studies have shown a strong correlation between obesity and gynecological cancers, particularly endometrial and breast cancers. Obesity not only increases the risk of developing these cancers but is also associated with poorer outcomes. Additionally, obesity affects the perioperative management of gynecological cancers, requiring specialized care due to increased complications and resistance to therapy. Treatment strategies for managing metabolic dysregulation in patients with gynecological cancers include weight management, statin therapy, and insulin-sensitizing medications. Emerging studies suggest that interventions like intermittent fasting and caloric restriction may enhance the effectiveness of cancer treatments. Furthermore, targeting cholesterol metabolism, such as with statins or proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, shows potential in cancer therapy. In conclusion, addressing metabolic issues, particularly obesity, is crucial in preventing and treating gynecological malignancies. Personalized approaches focusing on weight management and metabolic reprogramming may improve outcomes in these patients

Association between vitamin D hypovitaminosis and severe forms of COVID-19

Objective: Hypovitaminosis D may be associated with an increased susceptibility to infection, more severe COVID-19 forms, and a higher risk of death. The objective of this study was to investigate any possible connections between vitamin D status [as measured by serum 25-hydroxyvitamin D (25(OH)D) levels] and COVID-19 severity. Patients and methods: In 2021, a cross-sectional study of consecutive adult COVID-19 patients was conducted. Anthropometric data, comorbidities, hospital setting, length of stay, respiratory support, outcome data, and vitamin D status were all evaluated. Results: The length of hospitalization among participants (n = 74; mean age 57.64 ± 17.83 years, 55.4% male) was 18.58 ± 10 days, the majority of the hospital setting was a medical ward (67.6%), and the respiratory support in the form of mechanical ventilation was represented by 12.2%. Hypertension (54.1%), obesity (64.9%), and overweight (64.9%) were the most common cardiometabolic risk factors. In the study group, 44.6% of participants had severe vitamin D deficiency (< 30 nmol/l), while 8.1% had vitamin D insufficiency (50 - 74.9 nmol/l). Furthermore, patients with severe COVID-19 (semi-intensive care unit, intensive care unit) had significantly lower serum 25(OH)D levels (32.9 vs. 20.5 nmol/l; p = 0.007). Participants with severe vitamin D deficiency were older and had more prevalent hypertension, requiring mechanical ventilation; 24.2% experienced a fatal outcome. Conclusions: Severe vitamin D deficiency may contribute significantly to the influence of other cardiometabolic risk factors in COVID-19

Relation between osteocalcin and the energy metabolism in obesity

Background/Aim. Numerous findings have indicated the potential relation between the osteocalcin, the traditional parameter of bone turnover and the regulation of energy metabolism. The aim of this study was to identify the relationship between osteocalcin and calculated indexes, which evaluate insulin sensitivity, insulin resistance and/or secretory capacity of the pancreas, in non-diabetic, obese subjects. Methods. The study included 57 (11 men and 46 women) euglycemic, obese patients (the body mass index – BMI : 41.03 ± 6.61 kg/m²) and 48 healthy individuals, age and sex matched (BMI : 23.15 ± 2.04 kg/m²). Plasma glucose and the insulin levels during the two-hour oral glucose tolerance test (OGTT) were determined in order to calculate the Homeostatic Model Assessment (HOMA) indexes (HOMA-IR, HOMA-B%), EISI (estimated insulin sensitivity index), EFP (estimated first phase) and ESP (estimated second phase). Osteocalcin was measured by using the Electro-chemiluminescence (ECLIA) methodology. Results. Statistically lower osteocalcin was found in the obese subjects (24.72 ± 9.80 vs 33.31 ± 10.89 ng/mL; p < 0.01). Тhere was a statistically significant positive correlation between osteocalcin and EISI (r = 0.340; p < 0.01). The inverse correlations were found between the osteocalcin and HOMA-IR (r = -0.276; p < 0.01), HOMA-B% (r = -0.337; p < 0.01), EFP (r = -0.332; p < 0.01) and ESP (r = -0.266; p < 0.01). Multiple regression showed that the BMI and osteocalcin have a significant inverse prediction with the EISI and HOMA-IR, but the level of prediction of the BMI was substantially higher. Conclusion. The effect of osteocalcin in the glycoregulation is evident, but its contribution is significantly smaller in relation to other obesity associated factors. Therefore, when assessing its position and the role in glycemic control it is always necessary to bear in mind that osteocalcin represents only one of the many contributing factors, some of which exhibit dominant influence than osteocalcin itself

Influence of Vitamin D Deficiency on Cardiometabolic Risk in Obesity

Vitamin D deficiency and dysfunctional adipose tissue are involved in the development of cardiometabolic disturbances (eg, hypertension, insulin resistance, type 2 diabetes mellitus, obesity, and dyslipidemia). We studied 50 obese (body mass index [BMI]: 43.5 ± 9.2 kg/m2 ) and 36 normal weight participants (BMI: 22.6 ± 1.9 kg/m2 ). Obese individuals were classified into different subgroups according to medians of observed anthropometric parameters (BMI, body fat percentage, waist circumference, and trunk fat mass). The prevalence of vitamin D deficiency (25-hydroxyvitamin D, 25 (OH)D < 50 nmol/L) was 88% among obese patients and 31% among nonobese individuals; 25(OH)D were lower in the obese group (27.3 ± 13.7 vs 64.6 ± 21.3 nmol/L, p < .001). There was a negative correlation between vitamin D and anthropometric indicators of obesity: BMI: (r = - 0.64, p < .001), waist circumference (r = -0.59; p < .001), and body fat percentage (r = -0.64; p < .001) as well with fasting plasma insulin (r = -0.35; p < .001) and homeostasis model assessment of insulin resistance (r = - 0.35; p < .001). There was a negative correlation between vitamin D level and leptin and resistin (r = -.61; p < .01), while a positive association with adiponectin concentrations were found (r = .7; p < .001). Trend estimation showed that increase in vitamin D level is accompanied by intensive increase in adiponectin concentrations (growth coefficient: 12.13). In conclusion, we observed a higher prevalence of vitamin D deficiency among obese participants and this was associated with a proatherogenic cardiometabolic risk profile. In contrast, a positive trend was established between vitamin D and the protective adipocytokine adiponectin. The clinical relevance of this relationship needs to be investigated in larger studies

The impact of currently used oral antihyperglycemic drugs on dysfunctional adipose tissue

Obesity is a disease with pandemic frequency, often accompanied by chronic metabolic and organic complications. Type 2 diabetes mellitus (T2DM) is among the most common metabolic complications of obesity. The first step in the treatment of T2DM is medical nutrition therapy combined with moderate physical activity and with advice to patients to reduce their body weight. Pharmacotherapy starts with metformin, and in the case of inadequate therapeutic response, another antihyperglycemic agent should be added. The most clinical experience exists with sulfonylurea agents, but their use is limited due to high incidence of hypoglycemia and increase in body weight. Based on the fact that dysfunction of adipose tissue can lead to the development of chronic degenerative complications, precise use of drugs with a favorable effect on the functionality of adipose tissue represents an imperative of modern T2DM treatment. Antihyperglycemic drugs of choice in obese individuals are those which cause maturation of adipocytes, improvement of secretion of protective adipokines, and redistribution of fat mass from visceral to subcutaneous depots. Oral antihyperglycemic agents that can affect the functionality of adipose tissue are metformin, SGLT-2 inhibitors, DPP-4 inhibitors, and thiazolidinediones