Women may respond different from men to vitamin D supplementation regarding cardiometabolic biomarkers

Abstract

Evidence has revealed that vitamin D status is associated with the cardiometabolic risk factors. Moreover, few gender-specific analyses have been performed in the clinical trials regarding vitamin D supplementation. As a result, assessing gender differences regarding the effects of vitamin D supplementation on some cardiometabolic biomarkers in patients with non-alcoholic fatty liver disease (NAFLD) was the aim of present study. We conducted a post hoc subgroup analysis of a double blind placebo controlled study. Patients with NAFLD randomly allocated to receive one oral pearl consisting of 50,000 IU vitamin D3 (n = 27, 13 men and 14 women) or a placebo (n = 26, 13 men and 13 women) every 14 days for four months. Serum lipid profiles, aminotransferases, high-sensitive C-reactive protein (hs-CRP), adiponectin as well as insulin resistance and dietary intakes were assessed pre- and post-study. In both genders, serum 25(OH) D3 increased significantly (P < 0.001). This increase was accompanied by significant decrease in serum total cholesterol (TC) (% of change: -7% in vitamin D vs. + 0.4% in placebo, P = 0.04) and LDL-C (%of change: -9.6% in vitamin D vs. -4% in placebo, P = 0.006) in women. However, in men, vitamin D supplementation increased the levels of serum TC (% of change: +9.2% in vitamin D vs. -10% in placebo, P = 0.02) with no significant effects on LDL-C. Moreover, vitamin D significantly reduced serum hs-CRP in women. The median daily calcium intake in both genders was well below the dietary reference intake for adults. In conclusion, improved vitamin D status might decrease serum TC and LDL-C levels as well as hs-CRP in women with NAFLD. However, it might increase serum TC in men who have low daily calcium intake. Further studies with larger sample sizes are needed to confirm these results.

Keywords: Vitamin D; cardiometabolic biomarkers; gender; non-alcoholic fatty liver disease.

Figure 1

Log₁₀ transformed estimated marginal means of serum total cholesterol, LDL-C and hs-CRP in vitamin D and placebo at baseline and post-intervention in men and women with NAFLD*: a: total cholesterol in men, b: total cholesterol in women, c: LDL-c in men, d: LDL-c in women, e: hs-CRP in men, f: hs-CRP in women. *Results are based on the repeated measure ANOVA test and estimated marginal means adjusted for baseline values of BMI, waist circumference, serum ALT and AST in men and age, serum vitamin D, TG, LDL and insulin in women. Moreover, season is considered for adjustment in both genders