Association Between Visceral Obesity and Sarcopenia and Vitamin D Deficiency in Older Koreans: The Ansan Geriatric Study

Authors


Address correspondence to Nan Hee Kim, Department of Internal Medicine, Division of Endocrinology and Metabolism, Korea University Ansan Hospital, Gojan 1-dong, Danwon-gu, Ansan, Gyeonggi-do, 425–707, Korea. E-mail: nhkendo@gmail.com

Abstract

Objectives

To investigate whether vitamin D levels are independently associated with visceral obesity, sarcopenia, or sarcopenic obesity.

Design

Cross-sectional.

Setting

Population-based sample of elderly adults living in Ansan, Korea.

Participants

Two hundred sixteen men and 268 women aged 65 and older.

Measurements

Serum 25-hydroxyvitamin D (25(OH)D) levels, visceral fat area (VFA) according to abdominal computed tomography scanning, and body composition (body fat percentage, appendicular skeletal muscle mass (ASM)) using dual-energy X-ray absorptiometry. Visceral obesity was defined as VFA of 100 cm2 or greater and sarcopenia as ASM/height2 more than 1 standard deviation (SD) below the sex-specific mean of a young reference group.

Results

The adjusted 25(OH)D level for men was negatively associated with systolic blood pressure, VFA, and body fat percentage but positively associated with ASM. In women, waist circumference, triglyceride levels, and VFA were negatively correlated with 25(OH)D levels. In the joint regression model, VFA and ASM were independently associated with 25(OH)D levels (β = −0.078, P = .01 and β =  0.087, = .02, respectively) per 1SD difference in VFA and ASM in men but not women. When participants were categorized according to four visceral obesity and sarcopenia categories, adjusted mean 25(OH)D level was lower in men with visceral obesity than in men without but was not affected by the presence or absence of sarcopenia.

Conclusion

Greater visceral fat and lower muscle mass were associated with lower 25(OH)D levels in elderly Korean men, suggesting that screening for vitamin D deficiency may be appropriate in older Koreans with visceral obesity or sarcopenia. Sarcopenic obesity as defined according to prespecified criteria did not have an additive association with 25(OH)D levels.

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