Association of 25-hydroxyvitamin D and chemerin with metabolic syndrome components in individuals with type 2 diabetes mellitus
TL;DR
Findings support an association, rather than a causal or diagnostic relationship, between 25(OH)D, chemerin, and cardiometabolic disturbance in this cohort and reveal that diabetic status and female sex were independently related to 25(OH)D status.
Abstract
Background This study investigated the associations of serum 25-hydroxyvitamin D [25(OH)D], the principal circulating marker used to assess vitamin D status, and chemerin with metabolic syndrome (MetS) components in individuals with type 2 diabetes mellitus (T2DM) and in a non-diabetic comparison group. The MetS components assessed were central obesity/waist circumference, blood pressure, fasting plasma glucose, triglycerides, and HDL-C, because these are the diagnostic elements of the International Diabetes Federation (IDF) definition. Methods This cross-sectional analytical study was conducted at King Abdulaziz University, Rabigh, between August 2021 and December 2022. Participants were classified as having MetS according to IDF criteria, and vitamin D status was classified using serum 25(OH)D concentrations as deficient, insufficient, or sufficient. Serum 25(OH)D, chemerin, and CRP were measured by ELISA. Results A total of 176 participants were included in the study (88 with diabetes and 88 non-diabetic comparison participants), with equal sex distribution in both groups (44 females and 44 males per group). Compared with the non-diabetic comparison group, participants with T2DM had significantly higher chemerin (p < 0.001) and significantly lower 25(OH)D (p < 0.001). The MetS was more common in diabetic participants than in non-diabetic comparison participants: 70/88 (79.5%) vs. 43/88 (48.9%) (p < 0.001). Blood chemerin levels were also elevated in those with MetS compared with those without MetS (p = 0.032). Within the diabetic group, 18/88 (20.5%) had 25(OH)D deficiency and 47/88 (53.4%) had insufficient levels, whereas among non-diabetic comparison participants, 7/88 (8%) had deficiency and 32/88 (36.4%) had insufficient levels (p < 0.001). Higher FPG, insulin, HOMA-IR, HbA1c, TC, and CRP were associated with lower 25(OH)D in diabetic subjects. The latter inverse relationships were also observed in the MetS subgroup. Chemerin was associated with HOMA-IR, FPG, TC, CRP, and HbA1c in diabetic subjects. In the MetS subgroup, FPG, insulin, HOMA-IR, HbA1c, TC, and CRP remained positively correlated with chemerin. The regression analysis revealed that diabetic status and female sex were independently related to 25(OH)D status. In the adjusted chemerin model, chemerin was inversely and significantly associated with 25(OH)D (B −2.451, 95% CI −3.916–−0.986, p = 0.001). Diabetes and female sex were the only variables independently associated with MetS status in the logistic regression analysis. Conclusion Individuals with T2DM showed lower serum 25(OH)D and increased chemerin concentrations than non-diabetic comparison participants. Chemerin was higher in participants with MetS, whereas neither 25(OH)D nor chemerin was independently associated with MetS in the adjusted logistic model. These findings support an association, rather than a causal or diagnostic relationship, between 25(OH)D, chemerin, and cardiometabolic disturbance in this cohort. Further longitudinal and interventional studies are required.