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

Full Text:

PDF


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

Article Metrics

Abstract views : 1142 | views : 1032


Bookmark and Share


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

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.