Serum vitamin D levels are correlated with cholesterol and not with body composition in individuals with type 2 diabetes mellitus and overweight
DOI:
https://doi.org/10.12957/demetra.2025.84778Keywords:
Diabetes Mellitus. Type 2. Overweight. Obesity. Vitamin D. Cholesterol.Abstract
Introduction: vitamin D (25OHD) plays an important role in carbohydrate and lipid metabolism. Vitamin D deficiency is frequently found in individuals with metabolic disorders. It is necessary to identify how serum levels of 25OHD correlate with these indicators in individuals with type 2 diabetes mellitus (T2DM) and excess weight. Objective: to analyze the correlation between 25OHD and body composition, anthropometric, and biochemical indicators in individuals with T2DM and excess weight. Métodos: cross-sectional study conducted at the University Hospital of Florianópolis, Brazil, in individuals with T2DM and excess weight. Body composition was determined by dual-energy X-ray absorptiometry. Anthropometric data were measured by standardized techniques. Biomarkers were analyzed from a serum sample. The correlation between 25OHD and the outcomes was verified using Spearman's correlation. Results: 20 individuals with 35 to 75 years old, of which 55% were female. Preserved muscle compartments were observed according to the appendicular muscle mass index, along with a high percentage of body fat in both sexes. Fifty percent of the individuals had vitamin D deficiency and 75% used supplementation. An inverse correlation was observed between 25OHD and total cholesterol (r= -0.52; p= 0.02) and non-HDL-c (r= -0.47 p= 0.04). Conclusion: The 25OHD levels are associated with the lipid profile of individuals with type 2 diabetes and overweight, showing an inverse correlation.
Downloads
References
1. International Diabetes Federation. IDF Diabetes Atlas. 10th ed. [Internet]. Brussels: IDF; 2021. [acesso em 20 out 2023]. Disponível em: https://www.diabetesatlas.org
2. GBD 2015 Obesity Collaborators. Health Effects of Overweight and Obesity in 195 Countries over 25 Years. New England Journal of Medicine. 2017;377:13-27. https://doi.org/10.1056/NEJMoa1614362
3. Boden G. Obesity, insulin resistance, and free fatty acids. Curr Opin Endocrinol Diabetes Obes. 2011;18:139-143. http://dx.doi.org/10.1097/MED.0b013e3283444b09
4. Torres S, Fabersani E, Marquez A, Gauffin-Cano P. Adipose tissue inflammation and metabolic syndrome. The proactive role of probiotics. European Journal of Nutrition. 2019;58:27-43. https://doi.org/10.1007/s00394-018-1790-2
5. McNelis JC, Olefsky JM. Macrophages, Immunity, and Metabolic Disease. Immunity.2014;41:36-48. https://doi.org/10.1016/j.immuni.2014.05.010
6. Martini LA, Catania AS, Ferreira SRG. Role of vitamins and minerals in prevention and management of type 2 diabetes mellitus. Nutrition Reviews. 2010;68:341-354. https://doi.org/10.1111/j.1753-4887.2010.00296.x
7. Galușca D, Popoviciu MS, Babeș EE, Vidican M, Zaha AA, Babeș VV, et al. Vitamin D Implications and Effect of Supplementation in Endocrine Disorders: Autoimmune Thyroid Disorders (Hashimoto’s Disease and Graves Disease). Diabetes Mellitus and Obesity. Medicina (Lithuania). 2022;58(2):194. https://doi.org/10.3390/medicina58020194
8. Walsh JS, Evans AL, Bowles S, Naylor KE, Jones KS, Schoenmakers I, et al. Free 25-hydroxyvitamin D is low in obesity, but there are no adverse associations with bone health. American Journal of Clinical Nutrition. 2016;103:1465-1471. https://doi.org/10.3945/ajcn.115.120139
9. Siranaula GMF, Rosales CGC, Sarez CMT. Role of vitamin D in patients with type 2 diabetes mellitus. Salud, Ciencia y Tecnologia. 2022;2(S1):202. https://doi.org/10.56294/saludcyt2022202
10. Turkes GF, Uysal S, Demir T, Demiral Y, Pamuk BO, Yılmaz H, et al. Associations Between Bioavailable Vitamin D and Remnant Cholesterol in Patients with Type 2 Diabetes Mellitus. Cureus. 2021;13(2). https://doi.org/10.7759/cureus.13248
11. Ribeiro CI, Nobre EL, Martins-Martins J. A Vitamina D na Diabetes Mellitus Tipo 2. Revista Portuguesa de Diabetes. 2021;16(1):13-24.
12. Papaioannou I, Pantazidou G, Kokkalis Z, Georgopoulos N, Jelastopulu E. Vitamin D Deficiency in Elderly with Diabetes Mellitus Type 2: A Review. Cureus. 2021;5;13(1). https://doi.org/10.7759/cureus.12506.
13. Brasil. Resolução nº 466, de 12 de dezembro de 2012. Dispõe sobre diretrizes e normas regulamentadoras de pesquisas envolvendo seres humanos. Diário Oficial da República Federativa do Brasil, Brasília, DF [Internet]. 2013 Jun 13 [acesso em 20 out 2023]. Disponível em: http://bit.ly/1mTMIS3
14. World Health Organization. Waist circumference and waist-hip ratio: report of a WHO expert consultation, Geneva, 8-11 December 2008. World Health Organization, 2011.
15. World Health Organization. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. Geneva: World Health Organization. 1995;854:1-452.
16. World Health Organization. Obesity: preventing and managing the global epidemic: report of a WHO consultation. Geneva: World Health Organization. 2000.
17. Gould H, Brennan SL, Kotowicz MA, Nicholon GC, Pasco AP. Total and appendicular lean mass reference ranges for Australian men and women: The Geelong osteoporosis study. Calcif Tissue Int.2014;94:363-372. https://doi.org/10.1007/s00223-013-9830-7
18. Baumgartner RN, Koehler KM, Gallagher D, Romero L, Heymsfield SB, Ross RR, et al. Epidemiology of Sarcopenia among the Elderly in New Mexico. Am J Epidemiol. 1998;147(8):755-63. https://doi.org/10.1093/oxfordjournals.aje.a00977
19. Lohman TG. Advances in body composition assessment. Champaign, IL: Human Kinetics Publishers [Internet]. 1992 [acesso em 25 out 2023]. Disponível em: https://www.scielosp.org/pdf/csp/1993.v9suppl1/S116-S117/en
20. World Health Organization. Diretrizes da OMS para a tiragem de sangue: boas práticas em flebotomia. World Health Organization, 2010.
21. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the Concentration of Low Density Lipoprotein Cholesterol in Plasma, Without Use of the Preparative Ultracentrifuge. Clin Chem. 1972;18(6). https://doi.org/10.1093/clinchem/18.6.499
22. Pititto B, Dias M, Moura F, Lamounier R, Calliari S, Bertoluci M. Metas no tratamento do diabetes. Diretriz Oficial da Sociedade Brasileira de Diabetes (2022) [Internet]. São Paulo: SBD; 2023 [acesso em 26 out 2023]. https://doi.org/10.29327/557753.2022-3, ISBN: 978-85-5722- 906-8.
23. Geloneze B, Vasques ACJ, Stabe CFC, Pareja JC, Rosado LEFPL, Queiroz EC, et al. HOMA1-IR and HOMA2-IR indexes in identifying insulin resistance and metabolic syndrome – Brazilian Metabolic Syndrome Study (BRAMS). Arq Bras Endocrinol Metab. 2009;53(2):281–7. https://doi.org/10.1590/S0004-27302009000200020
24. Geloneze B, Repetto EM, Geloneze SR, Tambascia MA, Ermetice MN. The threshold value for insulin resistance (HOMA-IR) in an admixture population. IR in the Brazilian Metabolic Syndrome Study. Diabetes Res Clin Pract. 2006;72(2):219–20. https://doi.org/10.1016/j.diabres.2005.10.017
25. Faludi AA, Izar MCO, Saraiva JFK, Chacra APM, Bianco HT, Afiune A Neto, et al. Atualização da Diretriz Brasileira de Dislipidemias e Prevenção da Aterosclerose – 2017. Arq Bras Cardiol. 2017;109(5 Suppl 1):1–76.
26. Moreira CA, Ferreira CEDS, Madeira M, Silva BCCS, Maeda SS, Batista MC, et al. Reference values of 25-hydroxyvitamin D revisited: a position statement from the Brazilian Society of Endocrinology and Metabolism (SBEM) and the Brazilian Society of Clinical Pathology/Laboratory Medicine (SBPC). Arch Endocrinol Metab. 2020;64(4):462–78. https://doi.org/10.20945/2359-3997000000258
27. Mukaka MM. Statistics Corner: a guide to appropriate use of correlation coefficient in medical research. Malawi Med J. 2012;24(3):69–71.
28. Mohamad MI, El-Sherbeny EE, Bekhet MM. The effect of vitamin D supplementation on glycemic control and lipid profile in patients with type 2 diabetes mellitus. J Am Coll Nutr. 2016;35(5):399–404. https://doi.org/10.1080/07315724.2015.1026427
29. Alotaibi AB, Melnasieh A, Alduraibi K. The correlation between vitamin D levels and the glycemic marker HbA1c and lipid profile in patients with type 2 diabetes mellitus: a study at the King Saud Medical City, Riyadh. Cureus. 2024;16(4):e57927. https://doi.org/10.7759/cureus.57927
30. Barchetta I, Angelico F, Del Ben M, Baroni MG, Pozzilli P, Morini S, Cavallo MG. Strong association between non-alcoholic fatty liver disease (NAFLD) and low 25(OH) vitamin D levels in an adult population with normal serum liver enzymes. BMC Med. 2011;9:85. https://doi.org/10.1186/1741-7015-9-85
31. Baker JF, Mehta NN, Baker DG, Toedter G, Shults J, Von Feldt JM, et al. Vitamin D, metabolic dyslipidemia, and metabolic syndrome in rheumatoid arthritis. Am J Med. 2012;125(10):1036.e9–1036.e15. https://doi.org/10.1016/j.amjmed.2012.01.025
32. Skaaby T, Husemoen LL, Martinussen T, Thyssen JP, Melgaard M, Thuesen BH, et al. Vitamin D status, filaggrin gene type, and cardiovascular risk factors: a Mendelian randomization approach. PLoS One. 2013;8(2):e57647. https://doi.org/10.1371/journal.pone.0057647
33. Reczkowicz J, Mika A, Antosiewicz J, Kortas J, Proczko-Stepaniak M, Śledziński T, et al. Bariatric surgery induced changes in blood cholesterol are modulated by vitamin D status. Nutrients. 2022;14(10):2000. https://doi.org/10.3390/nu14102000
34. El-Fakhri N, McDevitt H, Shaikh MG, Halsey C, Ahmed SF. Vitamin D and its effects on glucose homeostasis, cardiovascular function and immune function. Horm Res Paediatr. 2014;81(6):363–78. https://doi.org/10.1159/000357731.
35. Samuel L, Borrell LN. The effect of body mass index on optimal vitamin D status in U.S. adults: The National Health and Nutrition Examination Survey 2001–2006. Ann Epidemiol. 2013;23:409–14. https://doi.org/10.1016/j.annepidem.2013.05.011
36. Macdonald HM, Mavroeidi A, Barr RJ, Black AJ, Fraser WD, Reid DM. Vitamin D status in post menopausal women living at higher latitudes in the UK in relation to bone health, overweight, sunlight exposure and dietary vitamin D. Bone. 2008;42:996–1003.
37. Greco EA, Lenzi A, Migliaccio S. Role of hypovitaminosis D in the pathogenesis of obesity-induced insulin resistance. Nutrients. 2019;11(7):1506. https://doi.org/10.3390/nu11071506
38. Misnikova IV, Kovaleva YA, Polyakova EY, Dreval AV. Assessment of muscle and fat mass in type 2 diabetes patients by dual-energy X-ray absorptiometry. J Gen Health. 2021;1(3):364–72. https://doi.org/10.47829/JJGH.2020.5702
39. Gupta P, Lanca C, Gan ATL, Soh P, Thakur S, Tao Y, et al. The association between body composition using dual-energy X-ray absorptiometry and type 2 diabetes: a systematic review and meta-analysis of observational studies. Sci Rep. 2019;9(1):12634. https://doi.org/10.1038/s41598- 019-49162-5
40. Cortet B, Lucas S, Legroux-Gerot I, Penel G, Chauveau C, Paccou J. Bone disorders associated with diabetes mellitus and its treatments. Joint Bone Spine. 2019;86:315–20. https://doi.org/10.1016/j.jbspin.2018.08.002
41. Evans AL, Paggiosi MA, Eastell R, Walsh JS. Bone density, microstructure, and strength in obese and normal weight men and women in younger and older adulthood. J Bone Miner Res. 2015;30:920–8. https://doi.org/10.1002/jbmr.2407
42. Pritchard JM, Giangregorio LM, Atkinson SA, Beattie KA, Inglis D, Ioannidis G, et al. Changes in trabecular bone microarchitecture in post menopausal women with and without type 2 diabetes: a two-year longitudinal study. BMC Musculoskelet Disord. 2013;14:114. https://doi.org/10.1186/1471-2474-14-114
43. Conte C, Epstein S, Napoli N. Insulin resistance and bone: a biological partnership. Acta Diabetol. 2018;55:305–14. https://doi.org/10.1007/s00592-018-1101-7
44. Vigevano F, Gregori G, Colleluori G, Chen R, Autemrongsawat V, Napoli N. In men with obesity, T2DM is associated with poor trabecular microarchitecture and bone strength and low bone turnover. J Clin Endocrinol Metab. 2021;106:1362–76. https://doi.org/10.1210/clinem/dgab061
45. Cipriani C, Colangelo L, Santori R, Renella M, Mastrantonio M, Minisola S, et al. The interplay between bone and glucose metabolism. Front Endocrinol (Lausanne).2020;11:122. https://doi.org/10.3389/fendo.2020.00122
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Mauro Celso de Souza, Giovanna Mozzaquattro Nascimento, Júlia Pessini, Simone Vande Sande-Lee, Marcelo Fernando Ronsoni, Erasmo Benicio Santos de Moraes Trindade

This work is licensed under a Creative Commons Attribution 4.0 International License.
STATEMENT OF AUTHORSHIP RESPONSIBILITY
Title of the manuscript:
________________________________________________________
1. Statement of responsability
I certify that I have participated in the work above specified and take public responsibility for its content.
I certify that the manuscript represents an original work and that none of the material in the manuscript has been previously published, is included in another manuscript, or is currently under consideration for publication elsewhere, whether in printed form or in electronic media, except that described in the attachment.
In case of acceptance of this text by Demetra: Alimentação, Nutrição & Saude, I declare to be in accordance with the policy of public access and copyright adopted by Demetra, which provides as follows: (a) the authors retain the copyright and grant to the Journal the right of first publication, the work being simultaneously licensed under the Creative Commons Attribution License, which allows the sharing of the work with acknowledgment of authorship and initial publication in this journal; (b) authors are authorized to enter additional contracts separately for non-exclusive distribution of the version of the work published in this journal (eg, publishing in institutional repository or book chapter), with acknowledgment of authorship and initial publication in this journal; and (c) authors are permitted and encouraged to post and distribute their work online (eg, in institutional repositories or on their personal page) at any point before or during the editorial process, as this may lead to productive changes, as well as increase the impact and citation of the published work.
2. Conflict of Interest Statement
I certify that there is no conflict of interest in connection with the submitted article.
Date, signature and full address of all authors.


