Association of vitamin D status and body mass index with cardiometabolic risk and cardiovascular disease in adults

Abstract

Objectives : Vitamin D deficiency has been associated with obesity, insulin resistance, chronic inflammation, and cardiovascular disease (CVD). This study aimed to evaluate the association between serum vitamin D concentrations, body mass index (BMI), and cardiometabolic risk factors in adults. Methods : A cross-sectional observational study was conducted among 264 adults (109 men and 155 women) aged 19–60 years (mean age, 41.19 years). Anthropometric measurements, body composition parameters, blood pressure, biochemical markers, and questionnaire-derived health information were assessed. Participants were classified according to serum 25-hydroxyvitamin D [25(OH)D] concentrations and BMI status. Statistical analyses included the χ 2 test, Fisher’s exact test, Student’s t -test, ANOVA, Spearman correlation analysis, and multiple linear regression. Results : CVD was more prevalent among participants with vitamin D deficiency than among those with sufficient vitamin D concentrations (15.9% vs. 7.1%, p < 0.01). Obesity (70.5% vs. 48.6%, p < 0.001), diabetes (8.0% vs. 4.3%, p < 0.001), and depression (25.0% vs. 10.0%, p < 0.001) were also more common in the vitamin D-deficient group. Serum 25(OH)D concentrations were inversely associated with BMI, waist circumference, waist-to-height ratio, fat mass, triglycerides, fasting insulin, HOMA-IR, and hsCRP. Serum 25(OH)D concentrations decreased significantly across BMI categories, from 48.8 nmol/L in normal-weight participants to 22.2 nmol/L in those with class III obesity ( p < 0.001). Individuals with vitamin D deficiency had a longer history of overweight or obesity (14.95 ± 9.40 vs. 10.85 ± 6.24 years, p < 0.01). BMI, waist-to-height ratio, body fat percentage, and lipid ratios demonstrated the strongest predictive value for serum 25(OH)D concentrations. Conclusion : Vitamin D deficiency is associated with an unfavorable cardiometabolic profile characterized by increased adiposity, insulin resistance, inflammation, and a higher prevalence of CVD. The coexistence of vitamin D deficiency and excess BMI may further increase cardiometabolic risk and should be considered in preventive and clinical risk assessment strategies.