Assessment of the Relationship between Serum Vitamin D and Osteocalcin Levels with Metabolic Syndrome in Non-Osteoporotic Postmenopausal Women

Abstract

Introduction The aim of this study was to compare serum vitamin D and osteocalcin levels in non-osteoporotic postmenopausal women with and without metabolic syndrome and to analyze the relationship between serum vitamin D and osteocalcin levels and the relationships between these two factors and other clinical/biochemical parameters.

Material and Method This cross-sectional study was carried out in 191 postmenopausal non-osteoporotic (T-score > − 2.5) women. Patients were divided into two groups according to the presence or absence of metabolic syndrome. Blood samples were obtained and evaluated for 25-hydroxyvitamin D, osteocalcin, insulin resistance (using a homeostatic model assessment of insulin resistance), glycosylated hemoglobin (HbA_1c), calcium, phosphorus, deoxypyridinoline, thyroid-stimulating hormone, lipid profile, fasting insulin, fasting glucose and HbA_1c levels. Demographic and laboratory parameters were recorded for each woman.

Results Vitamin D was found to be lower in women with metabolic syndrome compared to controls (16.1 ± 11.2 vs. 20.4 ± 13.1 mg/dL; p = 0.013). Similarly, osteocalcin was found to be significantly lower in the metabolic syndrome group compared to the control group (4.2 ± 2.1 vs. 5.5 ± 3.0; p < 0.001). A significant positive correlation was observed between vitamin D and osteocalcin levels (r = 0.198; p = 0.008). There was an inverse correlation between vitamin D and some of the lipid parameters. However, osteocalcin levels were negatively correlated with C-reactive protein, insulin resistance, and HbA_1c in both groups (p = 0.003, p = 0.001 and p = 0.048, respectively).

Conclusion Vitamin D deficiency is common in postmenopausal women, even in women who are non-osteoporotic. Serum levels of vitamin D are significantly decreased in cases with metabolic syndrome. Vitamin D may directly improve serum lipid profiles and may indirectly decrease insulin resistance and subclinical systemic inflammation through the impact on the metabolic functions of osteocalcin.

Zusammenfassung

Einleitung Ziel dieser Studie war es, die Vitamin-D- und Osteocalcin-Blutwerte bei Frauen ohne Osteoporose nach der Menopause mit und ohne metabolischem Syndrom zu vergleichen und die Beziehungen zwischen Vitamin D und Osteocalcin sowie zwischen diesen beiden Faktoren und anderen klinischen und biochemischen Parametern zu analysieren.

Material und Methode Diese Querschnittsstudie wurde bei 191 Frauen ohne Osteoporose (T-Score > − 2,5) nach der Menopause durchgeführt. Die Patientinnen wurden in 2 Gruppen eingeteilt, je nach Vorhandensein oder Abwesenheit eines metabolischen Syndroms. Allen Frauen wurden Blutproben entnommen und auf 25-Hydroxy-Vitamin D, Osteocalcin, Insulinresistenz (basierend auf ein homöostatisches Modell zur Beurteilung der Insulinresistenz), glykosyliertes Hämoglobin (HbA_1c), Kalzium, Phosphor, Desoxypyridinolin, Thyreotropin, Lipidprofil, Nüchternblutzucker, Nüchternglukosewerte sowie die HbA_1c-Werte untersucht. Die gewonnenen demografischen und Laborwerte wurden für jede der Frauen aufgezeichnet.

Ergebnisse Frauen mit einem metabolischen Syndrom wiesen einen niedrigeren Vitamin D-Spiegel auf im Vergleich zur Kontrollgruppe (16,1 ± 11,2 vs. 20,4 ± 13,1 mg/dl; p = 0,013). Auch die Osteocalcin-Werte waren signifikant niedriger in der Gruppe mit metabolischem Syndrom verglichen mit der Kontrollgruppe (4,2 ± 2,1 vs. 5,5 ± 3,0; p < 0,001). Es gab eine signifikante positive Korrelation zwischen Vitamin-D- und Osteocalcin-Werten (r = 0,198; p = 0,008). Vitamin D und einige der Lipidparameter waren invers korreliert. Allerdings gab es eine negative Korrelation in beiden Gruppen zwischen dem Osteocalcin-Spiegel und C-reaktivem Protein, Insulinresistenz und HbA_1c (p = 0,003, p = 0,001 bzw. p = 0,048).

Schlussfolgerung Vitamin-D-Mangel kommt häufig vor bei Frauen nach der Menopause, selbst bei Frauen, die keine Osteoporose haben. In Fällen mit metabolischem Syndrom waren die Vitamin-D-Werte im Blut deutlich reduziert. Vitamin D könnte zu einer direkten Verbesserung der Lipidprofilwerte und indirekt zu einem Rückgang der Insulinresistenz und der subklinischen systemischen Entzündung führen, durch dessen Auswirkung auf die metabolische Funktion von Osteocalcin.

Key words

menopause - metabolic syndrome - osteocalcin - vitamin D - osteoporosis - insulin resistance

Schlüsselwörter

Menopause - metabolisches Syndrom - Osteocalcin - Vitamin D - Osteoporose - Insulinresistenz

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