Association of 25-hydroxyvitamin D status with overweight and obesity in Costa Rican adults
DOI:
https://doi.org/10.15517/5ejvz191Keywords:
body mass index, body weight, vitamin D deficiencyAbstract
Aim: This research aimed to investigate the association between plasma 25-hydroxyvitamin D levels and overweight/obesity in Costa Rican adults with and without type 2 diabetes. Methods: 604 adults were involved in a cross-sectional study from a clinical-base urban Costa Rican population. Clinical variables such as glycemic status and arterial hypertension were registered. Blood samples were collected to measure circulating vitamin D levels, fasting plasma glucose, glycated hemoglobin, and lipid profile. The association between plasma levels of 25-hydroxyvitamin D and clinical and biochemical variables was tested using a linear regression model. Results: There was an 80% prevalence of overweight and obesity in this sample. Plasma levels of 25-hydroxyvitamin D were in the deficiency range in 28% of subjects, in the insufficiency range in 49%, and only 23% of participants had sufficient levels. 25-hydroxyvitamin D levels were lower in subjects with a body mass index above 25 kg/m2 (t-test, p= 0.006). The association between 25-hydroxyvitamin D levels and body mass index remained significant (β: -0.15, CI 95%: -0.21 – -0.10) even after adjusting for classical risk factors such as lipid profile, glycemic status, and hypertension. Conclusion: Plasma 25-hydroxyvitamin D concentrations were suboptimal in 77% of the sample. Additionally, low plasma 25-hydroxyvitamin D levels were associated with overweight/obesity in Costa Rican subjects.
Downloads
References
Acuña, G. (2018). Análisis de los niveles séricos de vitamina D y determinantes clínicos, nutricionales y funcionales en pacientes mayores de 60 años, en el Servicio de Hospital de Día del Hospital Nacional de Geriatría y Gerontología, durante el período de julio a diciembre del 2017 (Tesis de Especialidades Médicas Universidad de Costa Rica). Repositorio Institucional Kérwá https://repositorio.sibdi.ucr.ac.cr/handle/123456789/10248.
American Diabetes Association. (2022). Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2022. Diabetes Care, 45, S17–S38. https://doi.org/10.2337/dc22-S002
Bezerra, F. F., Normando, P., Fonseca, A. C. P., Zembrzuski, V., Campos-Junior, M., Cabello-Acero, P. H., & Faerstein, E. (2022). Genetic, sociodemographic and lifestyle factors associated with serum 25-hydroxyvitamin D concentrations in Brazilian adults: the Pró-Saúde Study. Cadernos de Saúde Pública, 38, e00287820.
Borba, V. Z. C., Lazaretti-Castro, M., Moreira, S. D. S., de Almeida, M. C. C., & Moreira Jr, E. D. (2023). Epidemiology of vitamin D (EpiVida)—a study of vitamin D status among healthy adults in Brazil. Journal of the Endocrine Society, 7(1), bvac171. https://doi.org/10.1210/jendso/bvac171
Bouillon, R., Manousaki, D., Rosen, C., Trajanoska, K., Rivadeneira, F., & Richards, J. B. (2022). The health effects of vitamin D supplementation: evidence from human studies. Nature Reviews Endocrinology, 18(2), 96–110. https://doi.org/10.1038/s41574-021-00593-z
Carrelli, A., Bucovsky, M., Horst, R., Cremers, S., Zhang, C., Bessler, M., Schrope, B., Evanko, J., Blanco, J., Silverberg, S. J., & Stein, E. M. (2017). Vitamin D Storage in Adipose Tissue of Obese and Normal Weight Women. Journal of Bone and Mineral Research, 32(2), 237–242. https://doi.org/10.1002/jbmr.2979
Castro, N. A., & Holst, I. (2015). Niveles séricos de 25-hidroxivitamina D3 en población estudiantil de la Universidad de Costa Rica. Universidad de Costa Rica.
Chooi, Y. C., Ding, C., & Magkos, F. (2019). The epidemiology of obesity. Metabolism: Clinical and Experimental, 92, 6–10. https://doi.org/10.1016/j.metabol.2018.09.005
Christakos, S., Dhawan, P., Verstuyf, A., Verlinden, L., & Carmeliet, G. (2016). Vitamin D: metabolism, molecular mechanism of action, and pleiotropic effects vitamin D analogs. Physiol Rev, 96, 365–408. https://doi.org/10.1152/physrev.00014.2015
Cosentino, N., Campodonico, J., Milazzo, V., De Metrio, M., Brambilla, M., Camera, M., & Marenzi, G. (2021). Vitamin D and Cardiovascular Disease: Current Evidence and Future Perspectives. Nutrients, 13(10). https://doi.org/10.3390/NU13103603
Drincic, A. T., Armas, L. A. G., Van Diest, E. E., & Heaney, R. P. (2012). Volumetric dilution, rather than sequestration best explains the low vitamin D status of obesity. Obesity, 20(7), 1444–1448. https://doi.org/10.1038/oby.2011.404
Gamboa-Gamboa, T., Abarca-Soto, G., & G Jiménez-Montero, J. (2015). Prevalence of 25-hydroxyvitamin D deficiency in healthy personnel from an academic institution of an urban area in Costa Rica. Research and Reports in Endocrine Disorders. https://doi.org/10.2147/RRED.S90435
Giustina, A., Adler, R. A., Binkley, N., Bollerslev, J., Bouillon, R., Dawson-Hughes, B., Ebeling, P. R., Feldman, D., Formenti, A. M., Lazaretti-Castro, M., Marcocci, C., Rizzoli, R., Sempos, C. T., & Bilezikian, J. P. (2020). Consensus statement from 2 nd International Conference on Controversies in Vitamin D. Reviews in Endocrine & Metabolic Disorders, 21(1), 89–116. https://doi.org/10.1007/S11154-019-09532-W
Gómez, G., Ramírez Sanabria, A., Sheik Oreamuno, A., Chinnock, A., Nogueira Previdelli, A., Hermes Sales, C., & Quesada Quesada, D. (2019). Prevalencia de ingesta inadecuada de micronutrientes en la población urbana de Costa Rica. Archivos Latinoamericanos de Nutrición, 69(4), 221–232. https://doi.org/10.37527/2019.69.4.003
Gómez, G., Quesada, D., & Monge, R. (2020). Anthropometric profile and prevalence of overweight and obesity in Costa Rican urban population (Aged 20-65 years old) by sex group: Results from the Latin American Study of Nutrition and Health. Nutricion Hospitalaria, 37(3), 534–542. https://doi.org/10.20960/nh.02899
Hajhashemy, Z., Shahdadian, F., Ziaei, R., & Saneei, P. (2021). Serum vitamin D levels in relation to abdominal obesity: A systematic review and dose–response meta-analysis of epidemiologic studies. Obesity Reviews, 22(2). https://doi.org/10.1111/obr.13134
Holick, M. F., Binkley, N. C., Bischoff-ferrari, H. A., Gordon, C. M., Hanley, D. A., Heaney, R. P., Murad, M. H., & Weaver, C. M. (2011). Evaluation, Treatment , and Prevention of Vitamin D Deficiency: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab, 96(7), 1911–1930. https://doi.org/10.1210/jc.2011-0385
Hyppönen, E., & Power, C. (2007). Hypovitaminosis D in British adults at age 45 y: nationwide cohort study of dietary and lifestyle predictors. The American Journal of Clinical Nutrition, 85(3), 860–868. https://doi.org/10.1093/AJCN/85.3.860
Ismailova, A., & White, J. H. (2022). Vitamin D, infections and immunity. Reviews in Endocrine & Metabolic Disorders, 23(2), 265–277. https://doi.org/10.1007/S11154-021-09679-5
Ivankovich, N. (2015). Perfil del paciente con deficiencia e insuficiencia de vitamina D, atendido en la consulta del Hospital de Dia del Hospital Nacional de Geriatria y Gerontologia, desde septiembre del 2010 a septiembre del 2014. Universidad de Costa Rica.
Karampela, I., Sakelliou, A., Vallianou, N., Christodoulatos, G. S., Magkos, F., & Dalamaga, M. (2021). Vitamin D and Obesity: Current Evidence and Controversies. Current Obesity Reports, 10(2), 162–180. https://doi.org/10.1007/S13679-021-00433-1
Kovalskys, I., Fisberg, M., Gómez, G., Pareja, R. G., Yépez García, M. C., Cortés Sanabria, L. Y., Herrera-Cuenca, M., Rigotti, A., Guajardo, V., Zalcman Zimberg, I., Nogueira Previdelli, A., Moreno, L. A., & Koletzko, B. (2018). Energy intake and food sources of eight Latin American countries: Results from the Latin American Study of Nutrition and Health (ELANS). Public Health Nutrition, 21(14), 2535–2547. https://doi.org/10.1017/S1368980018001222
Lin, X., & Li, H. (2021). Obesity: Epidemiology, Pathophysiology, and Therapeutics. Frontiers in Endocrinology, 12. https://doi.org/10.3389/FENDO.2021.706978
Migliaccio, S., Di Nisio, A., Mele, C., Scappaticcio, L., Savastano, S., & Colao, A. (2019). Obesity and hypovitaminosis D: causality or casualty? International Journal of Obesity Supplements, 9(1), 20–31. https://doi.org/10.1038/s41367-019-0010-8
Monge-Rodríguez, S., Arriola Aguirre, R., & Gómez, G. (2024). Ingesta de calcio y vitamina D: relación con exceso de peso en población costarricense. Archivos Latinoamericanos de Nutrición, 74(1), 22-32. https://doi.org/10.37527/2024.74.1.003
Montero-Arias, F., Sedó-Mejía, G., & Ramos-Esquivel, A. (2013). Vitamin D insufficiency and asthma severity in adults from Costa Rica. Allergy, Asthma and Immunology Research, 5(5), 283–288. https://doi.org/10.4168/aair.2013.5.5.283
Oosterwerff, M. M., Eekhoff, E. M. W., Van Schoor, N. M., Boeke, A. J. P., Nanayakkara, P., Meijnen, R., Knol, D. L., Kramer, M. H. H., & Lips, P. (2014). Effect of moderate-dose vitamin D supplementation on insulin sensitivity in vitamin D-deficient non-Western immigrants in the Netherlands: A randomized placebo-controlled trial. American Journal of Clinical Nutrition, 100(1), 152–160. https://doi.org/10.3945/ajcn.113.069260
Pilz, S., Verheyen, N., Grübler, M. R., Tomaschitz, A., & März, W. (2016). Vitamin D and cardiovascular disease prevention. Nature Reviews Cardiology. https://doi.org/10.1038/nrcardio.2016.73
Pittas, A. G., Dawson-Hughes, B., Sheehan, P., Ware, J. H., Knowler, W. C., Aroda, V. R., Brodsky, I., Ceglia, L., Chadha, C., Chatterjee, R., Desouza, C., Dolor, R., Foreyt, J., Fuss, P., Ghazi, A., Hsia, D. S., Johnson, K. C., Kashyap, S. R., Kim, S., … Staten, M. (2019). Vitamin D Supplementation and Prevention of Type 2 Diabetes. New England Journal of Medicine, 381(6), 520–530. https://doi.org/10.1056/nejmoa1900906
Podd, D. (2015). Hypovitaminosis D: A common deficiency with pervasive consequences. JAAPA : Official Journal of the American Academy of Physician Assistants, 28(2), 20–26. https://doi.org/10.1097/01.JAA.0000459810.95512.14
Rafiq, S., & Jeppesen, P. B. (2018). Body Mass Index, Vitamin D, and Type 2 Diabetes: A Systematic Review and Meta-Analysis. Nutrients, 10(9). https://doi.org/10.3390/NU10091182
Rojas, L. Z., Quintero-Lesmes, D. C., Gamboa-Delgado, E. M., Guio, E., & Serrano, N. C. (2020). Prevalence of vitamin D status and its association with overweight or obesity in a population of Colombian children and adolescents. Journal of nutritional science, 9, e55. https://doi.org/10.1017/jns.2020.47
Rontoyanni, V. G., Avila, J. C., Kaul, S., Wong, R., & Veeranki, S. P. (2017). Association between obesity and serum 25 (OH) D concentrations in older Mexican adults. Nutrients, 9(2), 97. https://doi.org/10.3390/nu9020097
Ruiz-Ojeda, F. J., Anguita-Ruiz, A., Leis, R., & Aguilera, C. M. (2018). Genetic Factors and Molecular Mechanisms of Vitamin D and Obesity Relationship. Annals of Nutrition & Metabolism, 73(2), 89–99. https://doi.org/10.1159/000490669
Sassi, F., Tamone, C., & D’amelio, P. (2018). Vitamin D: Nutrient, Hormone, and Immunomodulator. Nutrients, 10(11). https://doi.org/10.3390/NU10111656
The Jamovi project. (2021). jamovi (2.2). Jamovi. https://www.jamovi.org
WHO. (2000). Obesity: preventing and managing the global epidemic.
Zhang, P., Guo, D., Xu, B., Huang, C., Yang, S., Wang, W., Liu, W., Deng, Y., Li, K., Liu, D., Lin, J., Wei, X., Huang, Y., & Zhang, H. (2022). Association of Serum 25-Hydroxyvitamin D With Cardiovascular Outcomes and All-Cause Mortality in Individuals With Prediabetes and Diabetes: Results From the UK Biobank Prospective Cohort Study. Diabetes Care, 45(5), 1219–1229. https://doi.org/10.2337/DC21-2193
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Monge-Rodríguez et al.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Population and Health in Mesoamerica informs its authors and readers that all publications must be submitted with the Letter of Acceptance of Copyright Conditions where the authors are asked for authorization to submit the article to the Journal for consideration so that it may carry out any of the following activities:
- The graphic and style editing of the work or part of it.
The publication and reproduction of the work or part of it, both in print and electronic media, including the Internet and any other known or unknown technology.
The translation of the work or part of it into any language or dialect.
The adaptation of the work to reading, sound, voice and any other available technical representation or mechanism, which makes possible its access for partially or totally blind people, or with any other form of special abilities that prevent their access to the conventional reading of the article.
The distribution and availability of the work to the public, in such a way that the public may have access to them from the time and place that each person chooses, through the physical or electronic mechanisms available to them.
Any other form of use, process or system known or to be known that is related to the activities and editorial purposes to which the Journal is linked.
You can access the Letter by clicking HERE. If you have a question, please write to revista.ccp@ucr.ac.cr
In addition, the content of this site is protected under the Attribution - Noncommercial - Share Alike (by-nc-sa) license which permits commercial use of the original work or derivative works and distribution of which must be made under the same license that governs the original work. The graphic design, images and texts generated by the e-Information Science magazine are property of the Universidad de Costa Rica and are licensed under Creative Commons Attribution - NonCommercial - Attribution-ShareAlike 4.0 International.
Authors who publish in this journal accept the following conditions:
-The authors retain their moral rights over the publication and assign the patrimonial rights mentioned in the Letter of Assignment of Rights with the Creative Commons Attribution - NonCommercial - Compatitr Equal 4.0 International license, which allows third parties to use what is published as long as they mention the authorship of the work and to the first publication in this journal.
-Authors may make other independent and additional contractual arrangements for non-exclusive distribution of the version of the article published in this journal (e.g., inclusion in an institutional repository or publication in a book) as long as they clearly indicate that the work was first published in this journal.
This policy is established in accordance with Law 6638 on Copyright and Related Rights of the Republic of Costa Rica.
