Vitamin D levels of obesity and non-obesity health workers: a cross-sectional study in Dr. Sardjito General Hospital/Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada, Yogyakarta

https://doi.org/10.19106/JMedSci005404202202

Siti Nur Rohmah(1*), Dwita Dyah Adyarini(2), Prenali Dwisthi Sattwika(3), Anastasia Evi Handayaningsih(4), Hemi Sinorita(5), Vina Yanti Susanti(6)

(1) Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta,
(2) Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta,
(3) Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta,
(4) Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta,
(5) Endocrinology Metabolic Division, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General, Hospital, Yogyakarta, Indonesia
(6) Endocrinology Metabolic Division, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General, Hospital, Yogyakarta, Indonesia
(*) Corresponding Author

Abstract


Obesity is one of the causes of chronic diseases, such as diabetes, hypertension, stroke, cancer, dyslipidemia, and heart disease. It is considered a financial burden on national health insurance since it drains the largest health fund. The study aimed to determine the difference in vitamin D levels in obese and non-obese health workers and analyze the factors that influence it. This was a cross-sectional study of the obese and non-obese health workers at Dr. Sardjito General Hospital, Yogyakarta. A total of 50 subjects, including 25 obese and 25 non-obese subjects were involved. Serum vitamin D levels was determined by ELISA. There was no significant difference between the obese and non-obese groups on vitamin D status (p<0.365). Vitamin D deficiency was found in 10% of subjects, whereas insufficient vitamin D levels were found in 46 and 44% of subjects, respectively. Vitamin D deficiency was more common in the obese (12%) than non-obese (8%) group. Contrarily, vitamin D insufficiency was more common in the non-obese (56%) than obese (36%) group. The serum vitamin D levels in the obese [30.08 (14.67-101.71) ng/mL] was not significantly different compare to those non-obese [28.54 (14.38-54.41) ng/mL] (p = 0.691). The multivariate analysis significantly showed that outdoor activities <30 min had a 7.061 times greater risk of having vitamin D deficiency/insufficiency compared to outdoor activities >30 min (OR 7.061; 95% CI: 1.064-46.872; p=0.043). In conclusion, there is no significant difference in vitamin D levels between the obese and non-obese groups. Vitamin D deficiency/insufficiency is more common in non-obese subjects than in obese subjects. Outdoor activity <30 min is a risk factor for vitamin D insufficiency/deficiency despite living in a tropical country with abundant sunlight throughout the year. 


Keywords


vitamin D; serum 25(OH)D; obesity; deficiency; health workers

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References


1.WHO. Global health observatory data overweight and obesity.2017. www.who.int/gho/en
2.CDC. CDC overweight and obesity. 2020; www.cdc.gov/obesity/data/adult.html
3.P2PTM. Obesity fact sheet. 2018. p2ptm.kemkes.go.id. http://p2ptm.kemkes.go.id/dokumen-ptm/factsheet-obesitas-kit-informasi-obesitas
4.Sugondo S. Obesity. In: Sudoyo AW, Setiyohadi B, Alwi I, Simadibrata MK, Setiati S, eds. Textbook of internal medicine. Jakarta: PAPDI, 2015: 2559-69.
5.Clemmensen C, Petersen MB, Sørensen TIA. Will the COVID-19 pandemic worsen the obesity epidemic? Nat Rev Endocrinol 2020; 16(9):469-70.
https://doi.org/10.1038/s41574-020-0387-z
6.Abdelaal M, le Roux CW, Docherty NG. Morbidity and mortality associated with obesity. Ann Transl Med 2017; 5(7):161.
https://doi.org/10.21037/atm.2017.03.107
7.Cipriani C, Pepe J, Piemonte S, Colangelo L, Cilli M, Minisola S. Vitamin D and its relationship with obesity and muscle. Int J Endocrinol 2014; 2014:841248.
https://doi.org/10.1155/2014/841248
8.Yao Y, Zhu L, He L, Duan Y, Liang W, Nie Z, et al. A meta-analysis of the relationship between vitamin D deficiency and obesity. Int J Clin Exp Med 2015; 8(9):14977-84.
9.Reijven PLM, Soeters PB Vitamin D: a magic bullet or a myth? Clin Nutr 2020; 39(9):2663-74.
https://doi.org/10.1016/j.clnu.2019.12.028
10.Poh BK, Rojroongwasinkul N, Nguyen BKL, Sandjaja, Ruzita AT, Yamborizut U, et al. 25-hydroxy-vitamin D demography and the risk of vitamin D insufficiency in the South East Asian Nutrition Surveys (SEANUTS). Asia Pac J Clin Nutr 2016; 25(3):538-48.
https://doi.org/10.6133/apjcn.092015.02
11.Arjana AZ, Devita N, Nurmasitoh T, Fidianingsih I, Dewi M, Khoiriyah U. High proportion of vitamin D deficiency in male adolescent in Yogyakarta Indonesia. Advances in Health Sciences Research, Proceedings of the International Conference on Sustainable Innovation 2020-Health Science and Nursing (ICoSIHSN 2020).2020; 33.
https://doi.org/10.2991/ahsr.k.210115.011
12.Sari DK, Tala ZZ, Lestari S, Hutagalung SV, Ganie RA. Vitamin D receptor gene polymorphism among Indonesian women in North Sumatra. Asian J Clin Nutr 2017; 9:44-50.
https://doi.org/10.3923/ajcn.2017.44.50
13.World Health Organization. The Asia-Pacific perspective: redefining obesity and its treatment. 2000; Sydney: Health Communications Australia.
https://apps.who.int/iris/handle/10665/206936
14.Gupta A, Harish R, Saini A. Comparison of vitamin D status in obese and nonobese children: a hospital-based prospective cohort study. Med J Dr. DY Patil Vidyapeeth 2019; 12(4):324-8.
https://doi.org/10.4103/mjdrdypu.mjdrdypu_115_18
15.Al-Othman A, Al-Musharaf S, Al-Dagri NM, Krishnaswamy S, Yusuf DS, Alkharfy KM, et al. Effect of physical activity and sun exposure on vitamin D status of Saudi children and adolescents. BMC Pediatrics 2012; 12:92.
https://doi.org/10.1186/1471-2431-12-92
16.Masood SH, Iqbal MP. Prevalence of vitamin D deficiency in south Asia. Pak J Med Sci 2008; 24(6):891-897.
17.Alfawaz HA, Abdel MFY. Vitamin D deficiency in obese children and its relationship to the components of the metabolic syndrome. World Appl Sci J 2013; 21(3):320-8.
https://doi.org/10.5829/idosi.wasj.2013.21.3.2858
18.Burgaz A, Orsini N, Larsson SC, Wolk A. Blood 25-hydroxyvitamin D concentration and hypertension: a meta-analysis. J Hypertens 2011; 29(4):636-45.
https://doi.org/10.1097/HJH.0b013e32834320f9
19.Karatas S, Hekimsoy Z, Dinc G, Onur E, Ozmen B. Vitamin D levels in overweight/obese adults with and without metabolic syndrome. J Endocrinol Metab 2013; 3(3):47–56.
https://doi.org/10.4021/jem166e
20.Ghadieh R, Mosleh JMB Al Hayek S, Merhi S, Fares JEH. The relationship between hypovitaminosis D and metabolic syndrome: a cross-sectional study among employees of a private university in Lebanon. BMC Nutr 2018; 4:36.
https://doi.org/10.1186/s40795-018-0243-x
21.Gagnon C, Lu ZX, Magliano DJ, Dunstan DW, Shaw JE, Zimet PZ, et al. Low serum 25-Hydroxyvitamin D is associated with increased risk of the development of the metabolic syndrome at five years: results from a national, population-based prospective study (Australian diabetes, obesity, and lifestyle study: AusDiab). J Clin Endocrinol Metab 2012; 97(6):1953-61.
https://doi.org/10.1210/jc.2011-3187
22.Gannagé-Yared MH, Maalouf G, Khalife S, Challita S, Yaghi Y, Ziade N, et al. Prevalence and predictors of vitamin D inadequacy amongst Lebanese osteoporotic women. Br J Nutr 2009; 101(4):487-91.
https://doi.org/10.1017/S0007114508023404
23.Hoteit M, Al-Shaar L, Yazbeck C,Sleiman MB, Ghalayini T, Fuleihan GEH. Hypovitaminosis D in a sunny country: time trends, predictors, and implications for practice guidelines. Metabolism 2014; 63(7):968-78.
https://doi.org/10.1016/j.metabol.2014.04.009
24.Rueda S, Fernández-Fernández C, Romero F, de Osaba JM, Vidal J. Vitamin D, PTH, and the metabolic syndrome in severely obese subjects. Obesity Surg 2008; 18(2):151-4.
https://doi.org/10.1007/s11695-007-9352-3
25.Ruiz-Ojeda FJ, Anguita-Ruiz A, Leis R, Aguilera CM. Genetic factors and molecular mechanism of vitamin D and obesity relationship. Ann Nutr Metab 2018; 73(2):89-99.
https://doi.org/10.1159/000490669
26.Abu Shady MM, Youssef MM, Saleh El-Din EM, Samie OMA, Megahed HS, Salem SME et al. Predictors of serum 25-Hydroxyvitamin D concentrations among a sample of Egyptian schoolchildren. Sci World J 2016; 8175768.
https://doi.org/10.1155/2016/8175768
27.Sari DK, Alrasyid H, Nur Indrawaty L, Lubis Z. Occurrence of vitamin D deficiency among women in North Sumatra, Indonesia. J Nutr Mall 2014; 20(1):63-70.
http://repository.usu.ac.id/handle/123456789/52906
28.Khor GL, Chee WSS, Sharif ZM, Poh BK, Arumugam M, Rahman JA, et al. High prevalence of vitamin D insufficiency and its association with BMI-for-age among primary school children in Kuala Lumpur, Malaysia. BMC Public Health 2011; 11:95.
https://doi.org/10.1186/1471-2458-11-95
29.Wallace AM, Gibson S, de la Hunty A, Allardt CL, Ashwell M. Measurement of 25-hydroxyvitamin D in the clinical laboratory: current procedures, performance characteristics, and limitations. Steroids 2010; 75(7):477-88.
https://doi.org/10.1016/j.steroids.2010.02.012
30.Hidayat A, Setiati S, Soewondo P. The association between vitamin D deficiency and type 2 diabetes mellitus in elderly patients. Acta Med Indones 2010; 42(3):123-9.
31.Setiati S, Oemardi M, Sutrisna B. The role of ultraviolet B from sun exposure on vitamin D and parathyroid hormone levels in Indonesia's older women. Asian J Gerontol Geriatr 2007; 2:126-32.
32.Nurbazlin M, Chee WSS, Rokiah P, Tan ABT, Chew YY, Nusaibah ARS, et al. Effects of sun exposure on 25(OH) vitamin D concentration in urban and rural women in Malaysia. Asia Pac J Clin Nutr 2013; 22(3):391-9.
https://doi.org/10.6133/apjcn.2013.22.3.15
33.Moy FM. Vitamin D status and its associated factors of free-living Malay adults in a tropical country Malaysia. J Photochem Photobiol B 2011; 104(3):444-8.
https://doi.org/10.1016/j.jphoto biol.2011.05.002
34.Chailurkit L, Aekplakorn W, Ongphiphadhanakul B. Regional variation and determinants of vitamin D status in sunshine-abundant Thailand. BMC Public Health 2011; 11:853.
https://doi.org/10.1186/1471-2458-11-853
35.Rockell JEP, Skeaff CM, Williams SM, Green TJ. Association between quantitative measures of skin color and plasma 25-hydroxyvitamin D. Osteoporos Int 2008; 19(11):1639-42.
https://doi.org/10.1007/s00198-008-0620-4



DOI: https://doi.org/10.19106/JMedSci005404202202

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Copyright (c) 2022 Siti Nur Rohmah, Dwita Dyah Adyarini, Prenali Dwisthi Sattwika, Anastasia Evi Handayaningsih, Hemi Sinorita, Vina Yanti Susanti

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