1. Body adiposity predictors of vitamin D status in nondialyzed patients with chronic kidney disease: A cross-sectional analysis in a tropical climate city.
- Author
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Barreto Silva MI, Cavalieri VV, Lemos CC, Klein MR, and Bregman R
- Subjects
- 25-Hydroxyvitamin D 2 blood, Aged, Body Mass Index, Brazil epidemiology, Calcifediol blood, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Obesity blood, Obesity complications, Obesity ethnology, Overweight blood, Overweight complications, Overweight ethnology, Prevalence, Renal Insufficiency, Chronic blood, Renal Insufficiency, Chronic complications, Renal Insufficiency, Chronic ethnology, Risk Factors, Severity of Illness Index, Tropical Climate, Vitamin D Deficiency epidemiology, Vitamin D Deficiency ethnology, Vitamin D Deficiency physiopathology, Waist-Height Ratio, Adiposity ethnology, Models, Biological, Nutritional Status ethnology, Obesity physiopathology, Overweight physiopathology, Renal Insufficiency, Chronic physiopathology, Vitamin D Deficiency etiology
- Abstract
Objectives: The association of vitamin D status with high body adiposity is poorly investigated in the chronic kidney disease (CKD) population. The aim of the present study was to describe vitamin D status and to identify body adiposity predictors of vitamin D deficiency, in a nondialyzed CKD population inhabiting a tropical city., Methods: This cross-sectional study included patients with CKD, defined as estimated glomerular filtration rate (eGFR) <60 mL/min, regularly treated by an interdisciplinary team in an outpatient university clinic, set in a Brazilian city (latitude: 22°54'S; 43°12'W). Adiposity parameters analyzed were body mass index (BMI), total body adiposity (dual-energy x-ray absorptiometry [DXA] and body adiposity index [BAI]), and central body adiposity (DXA-trunk fat and waist-to-height ratio [WHtR]). Laboratory parameters included serum concentrations of 25-hydroxyvitamin D, phosphate, parathyroid hormone, and insulin (insulin resistance [IR evaluation: homeostasis model assessment; HOMA])., Results: We studied 244 patients (54.9% men; n = 134) with median eGFR = 29.1 mL/min and BMI 26.1 kg/m
2 , comprising 58.2% (n = 142) with overweight/obesity. The vitamin D status was sufficient (≥30 ng/dL) in 43%, insufficient (20-30 ng/dL) in 37%, and deficient (<20 ng/dL) in 20%. Total body adiposity was the independent predictor of vitamin D deficiency (DXA: odds ratio [OR], 2.3; 95% confidence interval [CI], 1.1-5; P = 0.03; BAI: OR, 1.9; 95% CI, 1-3.8; P = 0.02), whereas BMI, DXA-trunk fat, and WHtR showed no correlation. Higher serum phosphorus and hyperparathyroidism were related (P < 0.05) to vitamin D deficiency. IR was not independently associated with 25-hydroxyvitamin D concentration., Conclusions: Just under half of the CKD population presented sufficient concentration of 25-hydroxyvitamin D. Total body adiposity, independent of age and eGFR, regardless if evaluated by DXA or BAI, was the predictor of vitamin D deficiency, which in turn was associated with higher serum phosphorus and hyperparathyroidism, but not with IR., (Copyright © 2016 Elsevier Inc. All rights reserved.)- Published
- 2017
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