Modest reversal of metabolic syndrome manifestations with vitamin D status correction: a 12-month prospective study

Metabolism; doi:10.1016/j.metabol.2011.09.017
Nasser M. Al-Daghria, b, e, aldaghri2011 at gmail.com , Khalid M. Alkharfya, b, c, , Yousef Al-Salehb, d, , Omar S. Al-Attasa, b, e, , Majed S. Alokaila, b, , Abdulaziz Al-Othmanb, f, , Osama Moharramg, , Emad El-Kholieh, , Shaun Sabicoa, , Sudhesh Kumari, , George P. Chrousosa, j,
a Biomarkers Research Program, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia (KSA)
b Prince Mutaib Chair for Biomarkers of Osteoporosis, King Saud University, Riyadh, KSA
c Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, KSA
d College of Medicine, King Saud University of Health Sciences, Riyadh, KSA
e Center of Excellence in Biotechnology Research, King Saud University, Riyadh, KSA
f College of Applied Medical Sciences, King Saud University, Riyadh, KSA
g King Abdulaziz University Hospital, King Saud University, Riyadh, KSA
h College of Science Research Center, King Saud University, Riyadh, Kingdom of Saudi Arabia (KSA)
i Clinical Sciences Research Institute, Diabetes and Metabolism Unit, Warwick University, Coventry CV47AL, UK
j First Department of Pediatrics, Athens University Medical School, Athens 11527, Greece
Received 27 June 2011; Accepted 28 September 2011. Available online 8 November 2011.

PDF is attached at bottom of this page

Numerous cross-sectional studies have noted significant negative associations between circulating levels of 25-hydroxyvitamin D and cardiometabolic risk factors, highlighting potential extraskeletal functions of this sterol hormone. Prospective studies, however, have been limited; and hence, no cause-and-effect relations can be inferred. This study aims to determine whether vitamin D status correction can reverse already established manifestations of the metabolic syndrome (MetS).

A total of 59 adult nondiabetic, overweight, and obese Saudis (31 male, 28 female) were prospectively enrolled in this 1-year interventional study.
Anthropometry and biochemical evaluation were performed, including determination of serum 25-hydroxyvitamin D, calcium, and phosphorous concentrations, as well as fasting blood glucose and lipid profile.

Subjects were advised to regularly expose themselves to sunlight and increase intake of vitamin D–rich foods.
All measurements were repeated 6 and 12 months later.
At the initial baseline visit, the prevalence of both low high-density lipoprotein cholesterol and hypertension was significantly increased among patients with 25-vitamin D deficiency (P < .05), even after adjusting for sex and body mass index.

Overall prevalence of MetS patients by the modified National Health and Nutrition Examination Survey Adult Treatment Panel III definition decreased from 25.2% to 13.0%; and this was largely due to a parallel decrease in the prevalence of low high-density lipoprotein cholesterol, triglycerides, and hypertension.

Optimization of vitamin D status through sun exposure and increased intake of a vitamin D–rich diet can lead to an improved cardiometabolic profile, offering a promising nonpharmacologic approach in the prevention of MetS manifestations.
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Subjects were told to get 5 to 30 minutes of sunlight twice a week. To encourage compliance, the subjects were told to keep diaries.

Significant results due to 1 year of sunshine

	At start	12 months later	Improvement
Vitamin D level	7.5 ng	13.3 ng	1.6 X
Metabolic Syndrome	25 %	13 %	1.9 X
Hypertension	28 %	11 %	2.5 X
Low HDL-C	93%	57 %	1.6 X

  Note: % = percentage of study participants

It is VERY difficult to get much vitamin D through food. Most likely the improvements were a result of increased sunlight

No record was made of possible huge differences

• How much, if any, Vitamin D or co-factors were taken during the study
• 8X - due to amount of clothing worn
• 2X - due to standing vs, lying down
• 2X - due to differences in darkness of skin
• 2X - due to age of the participants (older skin does not produce as much vitamin D)

Time difference

• 6X difference in how long the person may have spent in the sun (5 to 30 minutes)
• 3X difference in time of day: they were told to take the sun before 10AM or after 3PM
    8 AM will produce about 3X less vitamin D than 10 AM

See Also Vitamin D Life

• Metabolic Syndrome and vitamin D
• Metabolic syndrome 50 percent more likely if under 20 ng of vitamin D – May 2011
• All items in category Metabolic Syndrome 84 items
• 70 percent increased chance of metabolic syndrome if low on vitamin D – May 2011
• Metabolic Syndrome adults 4X more likely to have less than 20 ng of vitamin D – Jan 2011
• Global metabolic risks, BMI, etc. - slides 2011.pdf file
• Overview Diabetes and vitamin D
• Is Osteoarthritis a metabolic syndrome – June 2010
• No – 10 minutes per day of sun is NOT enough