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Background and Objectives: To assess whether the consumption of dietary macronutrient could change metabolic syndrome (MetS) related to vitamin D deficiency according to menopausal status. Methods and Study Design: In a cross-sectional study of 8326 Korean women from the Korean National Health and Nutrition Examination Survey V (2010– 2012), we investigated the combined interaction effect of serum 25-hydroxyvitamin D [25(OH)D] concentration and menopausal status on MetS-related variables. Results: The prevalence rates of 25(OH)D deficiency (vitamin D < 50 nmol/L) among premenopausal and postmenopausal women were 84.5% and 67.9%, respectively. Significant differences in MetS-related variables such as body mass index (P< 0.001), waist circumference (P=0.005), fast glucose (P=0.048), triglycerides (P=0.001), and high-density lipoprotein cholesterol (P=0.027) based on 25(OH)D concentration were observed among postmenopausal women but not among premenopausal women. Among the postmenopausal women with high consumption of dietary carbohydrate, the adjusted odds ratios (ORs) [95% confidence intervals (95% CIs)] of MetS among participants with 25(OH)D deficiency increased 1.380-fold (95% CI = 1.086– 1.753) using the 25(OH)D-sufficient group as a reference. In contrast, the participants with 25(OH)D deficiency showed an increased risk of MetS [OR (95% CI) = 1.313 (1.041– 1.655)] with low-fat consumption. However, the aforementioned findings did not differ among premenopausal women. Conclusion: Thus, MetS due to 25(OH)D deficiency among postmenopausal women may be modified by the consumption of dietary macronutrient. [ABSTRACT FROM AUTHOR]