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The Relationship between Obesity and Serum 1,25-Dihydroxy Vitamin D Concentrations in Healthy Adults

GlaxoSmithKline Pharmaceuticals (S.J.P.), King of Prussia, Pennsylvania 19406; Unit on Growth and Obesity, National Institute of Child Health and Human Development (M.E., R.J.F., M.S.-J., J.A.Y.), National Institutes of Health, Bethesda, Maryland 20892; Med-Star Research Institute (G.I.U.), Washington, DC 20003; and Department of Nuclear Medicine (J.R.), Clinical Center, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland 20892

Address all correspondence and requests for reprints to: Shamik J. Parikh, M.D., GlaxoSmithKline, 2301 Renaissance Boulevard, RN0410, King of Prussia, Pennsylvania 19406. E-mail: shamik.j.parikh{at}gsk.com.

Several previous reports of small cohorts have found significantly higher serum 1,25-dihydroxy vitamin D (1,25-vit D) in obese compared with nonobese whites. Based on these reports and on recent in vitro studies of adipocytes which suggest that administration of 1,25-vit D can stimulate lipogenesis and inhibit lipolysis, some investigators have proposed that high 1,25-vit D may play a role in promoting or maintaining adipocyte triglyceride stores in obese adults. To test the hypothesis that obesity is commonly associated with increased 1,25-vit D, we examined the relationships between calciotropic hormones and body adiposity in a large cohort of healthy adults. Serum intact PTH, 25-hydroxy vitamin D, and 1,25-vit D were measured in the postabsorptive state in 302 healthy adults who were Caucasian (n = 190; 71% female), African-American (n = 84; 89% female), and of other race/ethnicity (n = 28; 61% female). Results from the 154 obese subjects [body mass index (BMI) 37.3 ± 5.8 kg/m²; range, 30.1–58.2 kg/m²] were compared with those from 148 nonobese (BMI 25.6 ± 2.9 kg/m²; range, 18.0–29.9 kg/m²) age-, race-, and sex-matched participants. Body composition was measured by dual energy x-ray absorptiometry. Serum intact PTH was positively correlated with both BMI (r = 0.42; P < 0.0001) and body fat mass (r = 0.37; P < 0.0001). Serum 25-hydroxy vitamin D was negatively correlated with BMI (r = -0.4; P < 0.0001) and body fat mass (r = -0.41; P < 0.0001). Serum 1,25-vit D was also negatively correlated with BMI (r = -0.26; P < 0.0001) and body fat mass (r = -0.25; P = 0.0001). Serum 1,25-vit D was significantly lower in obese than nonobese subjects (105.7 ± 41.1 vs. 124.8 ± 36.7 pmol/liter; P < 0.0001) in both Caucasian and African-American adults. We conclude that, because 1,25-vit D concentrations fall with increasing adiposity, it appears unlikely that elevation in 1,25-vit D is an important hormonal mechanism causing or maintaining obesity in adults.

This work was supported by Grant ZO1 HD-00641 from the National Institute of Child Health and Human Development and by Grant Y2-OD-2067 from the Office of Dietary Supplements, National Institutes of Health, Department of Health and Human Services (DHHS).

J.A.Y. is a commissioned officer in the U.S. Public Health Service, DHHS.

Abbreviations: BMI, Body mass index; CV, coefficients of variation; DXA, dual energy x-ray absorptiometry; iPTH, intact PTH; 1,25-vit D, 1,25-dihydroxy vitamin D; 25-OH-vit D, 25-hydroxy vitamin D.

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