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Title: Association between body weight and composition and plasma 25 hydroxyvitamin D level in the diabetes prevention program

Author
item CEGLIA, LISA - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item NESLON, JASON - Tufts - New England Medical Center
item WARE, JAMES - Harvard University
item ALYSANDRATOS, KONSTANTINOS - Boston University Medical Center
item BRAY, GEORGE - Louisiana State University
item GARGANTA, CHERYL - University Of Florida
item NATHAN, DAVID - Massachusetts General Hospital
item HU, FRANK - Harvard University
item DAWSON-HUGHES, BESS - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item PITTAS, ANASTASSIOS - Tufts - New England Medical Center

Submitted to: European Journal of Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 9/30/2015
Publication Date: 11/2/2015
Citation: Ceglia, L., Neslon, J., Ware, J., Alysandratos, K., Bray, G., Garganta, C., Nathan, D.M., Hu, F.B., Dawson-Hughes, B., Pittas, A. 2015. Association between body weight and composition and plasma 25 hydroxyvitamin D level in the diabetes prevention program. European Journal of Nutrition. doi: 10.1007/s00394-015-1066-z.

Interpretive Summary: We examined the relationship between body weight and circulating levels of 25-hydroxyvitamin D (25OHD) in prediabetes and sought to estimate the impact of body fat on this relationship. The study was conducted in the placebo (n = 1082) and intensive lifestyle (n = 1079) groups of the Diabetes Prevention Program (DPP), a multicenter trial to prevent type 2 diabetes in adults with prediabetes. Weight and 25OHD were measured at baseline, month 6, years 1 and 2. In a subset (n = 584), visceral (VAT) and subcutaneous (SAT) fat were assessed by computed tomography at baseline and year 1. At baseline, higher body weight, total fat, VAT, and SAT were associated with lower circulating levels of 25OHD after controlling for various influential factors. Also at baseline, the relationship of body weight with plasma 25OHD concentration was in part dependent on VAT. There was no significant contribution by total fat or SAT. Two-year changes in circulating levels of 25OHD varied inversely with changes in body weight. One-year changes in total fat, VAT, or SAT did not contribute significantly to the relationship between change in circulating levels of 25OHD and body weight. In summary, our study found an inverse relationship between body weight and circulating levels of 25OHD at baseline and over a 2-year period in adults with prediabetes. These findings in the DPP, a weight loss intervention study, raise the possibility that weight loss increases circulating levels of 25OHD. Whether adiposity mediates this association remains inconclusive.

Technical Abstract: Objective: We examined associations between body weight and plasma 25-hydroxyvitamin D concentration (25OHD) in prediabetes and sought to estimate the impact of adiposity on these associations. Methods: The study was conducted in the placebo (n = 1082) and intensive lifestyle (n = 1079) groups of the Diabetes Prevention Program (DPP), a multicenter trial to prevent type 2 diabetes in adults with prediabetes. Weight and 25OHD were measured at baseline, month 6, years 1 and 2. In a subset (n = 584), visceral (VAT) and subcutaneous (SAT) adiposity were assessed by computed tomography at baseline and year 1. Results: In cross-sectional analyses, baseline body weight, total fat, VAT, and SAT were inversely associated with plasma 25OHD concentration after multivariable adjustment. VAT accounted for 40% [95 % CI 11, 69] of the association of body weight with plasma 25OHD concentration. There was no significant contribution by total fat or SAT. Two-year changes in plasma 25OHD concentration varied inversely with changes in body weight (p < 0.0001). One-year changes in total fat, VAT, or SAT were not significant mediators of the association between change in plasma 25OHD concentration and body weight. Conclusion: Our study found an inverse association between body weight and plasma 25OHD concentration at baseline and over a 2-year period in adults with prediabetes. These findings in the DPP, a weight loss intervention study, raise the possibility that weight loss increases plasma 25OHD concentration. Whether adiposity mediates this association remains inconclusive.