vitamin d, dm and obesity - thai heart · vitamin d, dm and obesity boonsong ongphiphadhanakul,...
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![Page 1: Vitamin D, DM and Obesity - Thai Heart · Vitamin D, DM and Obesity Boonsong Ongphiphadhanakul, M.D. Professor of Medicine Ramathibodi Hospital Mahidol UniversityMahidol University](https://reader030.vdocuments.net/reader030/viewer/2022040712/5e16fbfd80dfac0b3a77e7a3/html5/thumbnails/1.jpg)
Vitamin D, DM and Obesity
Boonsong Ongphiphadhanakul, M.D.Professor of MedicineRamathibodi HospitalMahidol UniversityMahidol University
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Vitamin D deficiency
Prevalence of Vitamin D Deficiency in EGAT 1-3
22%
Vitamin D deficiencyEGAT 1-3
12.1%
20 6%20.6%
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Adverse Outcomes Related to a Low 25D Level
Bone massFracturesWalking speedTBURIURIAdmission to ICUCVDCType 1 DMType 2 DMMultiple sclerosisPreeclampsiaCancerCancer
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Relationship between Vitamin D Status and BMIStatus and BMI
N = 646Beta = -0.14, P < 0.05
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BMIBMI 2525(OH)D(OH)D
25(OH)D25(OH)D BMIBMI
BMIBMI 2525(OH)D(OH)D
ConfounderConfounder
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Causal Model Based upon Mendelian RandomizationRandomization
PhenotypePhenotype DiseaseDiseaseGenotypeGenotype ypypypyp
ConfounderConfounder
PhenotypePhenotype DiseaseDiseaseGenotypeGenotype PhenotypePhenotype DiseaseDiseaseGenotypeGenotype
ConfounderConfounder
PhenotypePhenotype DiseaseDiseaseGenotypeGenotype PhenotypePhenotype DiseaseDiseaseGenotypeGenotype
ConfounderConfounder
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25(OH)D Levels vs Vitamin D Binding25(OH)D Levels vs. Vitamin D Binding Protein Genotype
35
25(OH)D (ng/ml) 25(OH)D (ng/ml)
25
30
35
25
30
35Caucasians Thais
10
15
20
10
15
20
0
5
CC CA AA0
5
CC CA AArs4588
Sinott M, et al. Am J Clin Nutr 2009;89:634-40 Chailurkit L, et al. 2009
rs4588 rs4588
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BMI vs. FTO Gene P l hi i Th iPolymorphism in Thais
AA AT TT
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Causal Model Based upon Mendelian RandomizationRandomization
Subjects with abnormal glucose tolerance
2525(OH)D(OH)D BMIBMIDBP genotypeDBP genotype
Subjects with abnormal glucose toleranceP < 0.05
ConfounderConfounderConfounderConfounder
BMIBMI 2525(OH)D(OH)DFTO genotypeFTO genotypeNS
ConfounderConfounder
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Prevalence of Vitamin D Insufficiency in Thais: National Health Examnation Surveyy
Chailurkit L, et al. BMC Public Health 2011;11:853
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Effect of Urbanization and Age on the Relationship between Vitamin D Status and
Adj t d OR (95%CI)
Relationship between Vitamin D Status and Diabetes: National Health Examnation Survey
Adjusted OR (95%CI)Age (years) 15–44
(n = 882)45–69
(n = 879)>=70
(n =874)UrbanAge (years) 1.10
(1 04 1 18)1.08
(1 04 1 11)0.96
(0 93 0 99)(1.04, 1.18) (1.04, 1.11) (0.93, 0.99)Male gender 2.33
(0.90, 6.06)1.09
(0.68, 1.77)0.84
(0.60, 1.19)BMI (kg/m2) 1.22
(1.10, 1.35)1.19
(1.10, 1.28)1.08
(1.03, 1.13)25(OH)D2 (nmol/L) 1.0 1.04 1.0425(OH)D2 (nmol/L) 1.0
(0.74, 1.29)1.04
(0.93, 1.16)1.04
(1.00, 1.07)25(OH)D3 (nmol/L) 1.03
(1 0 1 06)1.0
(0 99 1 01)0.98
(0 97 0 99)(1.0, 1.06) (0.99, 1.01) (0.97, 0.99)
Chailurkit L, et al. Chailurkit L, et al. 20112011
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25(OH)D and Fasting Plasma Glucose:25(OH)D and Fasting Plasma Glucose: EGAT 3
Subjects with body fat mass in the lowest tertile (n = 674)Subjects with body fat mass in the lowest tertile (n 674)Age 25-54
BetaBeta PP
Total Total 2525DD 00..1111 < < 00..0101AgeAge 00..2020 < < 00..001001FemaleFemale --00..1010 < < 00..0505
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Vitamin D Status in Relation to DBP G P l hiDBP Gene Polymorphism
R = 0.2, P < 0.001
n = n = 21692169
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Causal Model Based upon Mendelian RandomizationRandomization
25(OH)D25(OH)D Fasting glucoseFasting glucoseDBP genotypeDBP genotypeP < 0.05
ConfounderConfounderConfounderConfounder
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VDR -/- and CYP27b1 -/- Mice are Thin
Narvaez CJ, et al. Endocrinology Narvaez CJ, et al. Endocrinology 20092009;;150150::651651--61 61
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Brown adipose tissue White adipose tissue--
-- --
Vitamin D
Vitamin D reduces BMI in subjects with abnormal glucose toleranceVitamin D reduces diabetes in urban elderlyVi i D i f i l l i bj i h l b d fVitamin D increases fasting plasma glucose in subjects with low body fat