Journal of Nutrition and Health

The Korean Nutrition Society (한국영양학회)
권호 표지
DOI QR코드

DOI QR Code

Differences in serum ferritin and vitamin D levels of Korean women with obesity and severe obesity

비만과 고도비만 한국 여성의 혈청 페리틴과 비타민 D 수준의 비교

  • Received : 2020.05.07
  • Accepted : 2020.07.02
  • Published : 2020.08.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: This study examined the relationships among serum ferritin, vitamin D, folate, iron, and vitamin B12 as indicators of obesity. The results provide the basic data for the prevention and treatment of obese and severely obese people. Methods: This study selected 44 people from 18 years of age or older to 59 years. This study used the indicators of the body mass index (BMI) to analyze obesity as the obesity group (BMI of 25.0-29.9 kg/㎡) and as the severe obesity group (BMI ≥ 30.0 kg/㎡). Of the 44 subjects, 23 and 21 subjects were in the obesity and severe obesity groups, respectively. Their height, weight, body fat, skeletal muscle mass measured using bioimpedance analysis, and measured serum nutrients and biochemical parameters. Results: The obesity group showed a significantly lower age, body weight, BMI and body composition, body fat mass, and body fat percentage, and the height was significantly lower in the severe obesity group. The results of the biochemical parameters of the subjects showed that the levels of aspartate transaminase, alanine transaminase, hemoglobin A1c, total cholesterol, and triglyceride were within the normal range, and there was no significant difference between the 2 groups. The levels of folate, vitamin B12, 25-hydroxyvitamin D3, iron, and ferritin were almost normal, and there was no significant difference between the 2 groups. Conclusion: This study revealed an association with the serum nutrients and obesity, but there was no difference between the obesity group and severe obesity group. Observations of the nutrient levels in not only the blood in obesity and severe obesity but also in red blood cells and tissues will be necessary.

본 연구는 국내 비만과 고도비만 여성의 혈청 영양소 수준을 관찰하고자 시행하였다. 본 연구 결과를 통해 비만인과 고도비만인의 비만 예방 및 관리 지표로서의 혈청 영양소와의 관련성을 파악하고자 하였다. 본 연구의 대상자의 연령은 만18세 이상에서 59세 이하 성인 여성이며 서울 B 외과의원 비만클리닉에서 제공된 ID에 의하여 판별되는 2차 가공된 자료로 병원에서 환자의 동의를 받고 후향적으로 자료를 분석하여 총 44명을 대상자로 선정하였다. 본 연구는 BMI의 지표를 활용하여 BMI가 25.0-29.9 kg/㎡의 비만을 비만군, 30.0 kg/㎡ 이상의 고도 비만을 고도비만군으로 구분하여 비만군 23명, 고도비만군 21명을 분석하였다. 연구 대상자들의 신장과 체중, BMI, SMM, BFM, PFM을 체성분 분석을 통해 조사하였고, 혈중 생화학적 지표와 엽산, 비타민 B12, 25(OH)D3, 철, 페리틴 수준을 분석하였다. 비만군과 고도 비만군의 연령, 체중, BMI 및 체조성 중 체지방량, 체지방률은 비만군이 유의적으로 낮게 나타났으며 신장은 고도 비만군에서 유의적으로 낮게 나타났다. 생화학적 지표 검사결과 AST, ALT, 당화혈색소, 총 콜레스테롤, 중성지방은 대부분 정상 범위에 해당하였으며 두 군 사이의 유의적 차이가 나타나지 않았다. 비만과 관련된 혈청 영양소 수준을 조사한 결과 혈청 엽산, 비타민 B12, 25(OH)D3, 철, 페리틴의 수치는 대부분 정상 범위에 해당하며 두 군 간의 유의적인 차이는 없었다. 본 연구에서 비만과 고도비만 성인 여성의 혈청 영양소 수준은 유의적 차이가 없는 것으로 나타났다. 국내에서 비만 예방이나 치료를 위한 근거를 마련하기 위해서 비만과 영양소의 관련성에 대해 보다 심도 깊은 전향적 연구가 필요할 것으로 사료된다.

Keywords

References

  1. World Health Organization. Fact Sheets: Obesity and Overweight [Internet]. Geneva: WHO; 2017 [cited 2020 Apr 1]. Available from: http://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight.
  2. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. Korea Health Statistics 2016: Korea National Health and Nutrition Examination Survey (KNHANESVI-3). Cheongju: Korea Centers for Disease Control and Prevention; 2017.
  3. Oh SW. Recent Epidemiological changes in Korean obesity. Korean J Helicobacter Up Gastrointest Res 2017; 17(2): 62-65. https://doi.org/10.7704/kjhugr.2017.17.2.62
  4. Mohamed-Ali V, Pinkney JH, Coppack SW. Adipose tissue as an endocrine and paracrine organ. Int J Obes Relat Metab Disord 1998; 22(12): 1145-1158. https://doi.org/10.1038/sj.ijo.0800770
  5. Na YK, Hong HS, Suk HJ. Blood biochemical parameters, physical activity, stress and sleep management by body mass index. J Korean Biol Nurs Sci 2014; 16(2): 133-140. https://doi.org/10.7586/jkbns.2014.16.2.133
  6. Combs GF, McClung JP. The Vitamins: Fundamental Aspects in Nutrition and Health. Cambridge: Academic Press; 2016.
  7. Lee SR. Effect of high frequency and the consumption of catechin on the composition of the body, blood stroma, hormone and antioxidant activity in the management of abdominal obesity [dissertation]. Seoul: Sungshin Women's University; 2010.
  8. Arita Y, Kihara S, Ouchi N, Takahashi M, Maeda K, Miyagawa J, et al. Paradoxical decrease of an adipose-specific protein, adiponectin, in obesity. Biochem Biophys Res Commun 1999; 257(1): 79-83. https://doi.org/10.1006/bbrc.1999.0255
  9. Woodside JV, Yarnell JW, McMaster D, Young IS, Harmon DL, McCrum EE, et al. Effect of B-group vitamins and antioxidant vitamins on hyperhomocysteinemia: a double-blind, randomized, factorial-design, controlled trial. Am J Clin Nutr 1998; 67(5): 858-866. https://doi.org/10.1093/ajcn/67.5.858
  10. Bronstrup A, Hages M, Prinz-Langenohl R, Pietrzik K. Effects of folic acid and combinations of folic acid and vitamin B-12 on plasma homocysteine concentrations in healthy, young women. Am J Clin Nutr 1998; 68(5): 1104-1110. https://doi.org/10.1093/ajcn/68.5.1104
  11. Lim HS, Heo Y. Plasma total homocysteine, folate and vitamin B12 concentrations in patients with coronary stenosis. Korean J Community Nutr 2005; 10(6): 963-970.
  12. Dierkes J, Kroesen M, Pietrzik K. Folic acid and vitamin B6 supplementation and plasma homocysteine concentrations in healthy young women. Int J Vitam Nutr Res 1998; 68(2): 98-103.
  13. Holick MF. Vitamin D status: measurement, interpretation, and clinical application. Ann Epidemiol 2009; 19(2): 73-78. https://doi.org/10.1016/j.annepidem.2007.12.001
  14. Jung IK. Prevalence of vitamin D deficiency in Korea: results from KNHANES 2010 to 2011. J Nutr Health 2013; 46(6): 540-551. https://doi.org/10.4163/jnh.2013.46.6.540
  15. Park S, Lee BK. Vitamin D deficiency is an independent risk factor for cardiovascular disease in Koreans aged ${\geq}$ 50 years: results from the Korean National Health and Nutrition Examination Survey. Nutr Res Pract 2012; 6(2): 162-168. https://doi.org/10.4162/nrp.2012.6.2.162
  16. Oh MG, Han MA, Park J, Ryu SY, Choi SW. The prevalence of vitamin D deficiency among cancer survivors in a nationwide survey of the Korean population. PLoS One 2015; 10(6): e0129901. https://doi.org/10.1371/journal.pone.0129901
  17. Institute of Medicine Committee to Review Dietary Reference Intakes for Vitamin D and Calcium (US). Dietary Reference Intakes for Calcium and Vitamin D. Washington, D.C.: National Academies Press; 2011.
  18. WHO Scientific Group on the Prevention and Management of Osteoporosis. Prevention and Management of Osteoporosis: Report of a WHO Scientific Group. Geneva: WHO; 2003.
  19. Bell NH, Epstein S, Greene A, Shary J, Oexmann MJ, Shaw S. Evidence for alteration of the vitamin D-endocrine system in obese subjects. J Clin Invest 1985; 76(1): 370-373. https://doi.org/10.1172/JCI111971
  20. Park JY, Heo YR. Relationship of vitamin D status and obesity index Korean women. J Nutr Health 2016; 49(1): 28-35. https://doi.org/10.4163/jnh.2016.49.1.28
  21. Jurado RL. Iron, infections, and anemia of inflammation. Clin Infect Dis 1997; 25(4): 888-895. https://doi.org/10.1086/515549
  22. Park SK, Choi WJ, Oh CM, Kim J, Shin H, Ryoo JH. Association between serum ferritin levels and the incidence of obesity in Korean men: a prospective cohort study. Endocr J 2014; 61(3): 215-224. https://doi.org/10.1507/endocrj.EJ13-0173
  23. Furukawa S, Fujita T, Shimabukuro M, Iwaki M, Yamada Y, Nakajima Y, et al. Increased oxidative stress in obesity and its impact on metabolic syndrome. J Clin Invest 2004; 114(12): 1752-1761. https://doi.org/10.1172/JCI21625
  24. Schaich KM. Metals and lipid oxidation. Contemporary issues. Lipids 1992; 27(3): 209-218. https://doi.org/10.1007/BF02536181
  25. Jang SY, Lee JY, Bae JM, Lee C, Hong SN, Kim A, et al. 25-hydroxyvitamin D levels and body mass index in healthy postmenopausal women. Korean J Obstet Gynecol 2012; 55(6): 378-383. https://doi.org/10.5468/KJOG.2012.55.6.378
  26. de Luis DA, Pacheco D, Izaola O, Terroba MC, Cuellar L, Cabezas G. Micronutrient status in morbidly obese women before bariatric surgery. Surg Obes Relat Dis 2013; 9(2): 323-327. https://doi.org/10.1016/j.soard.2011.09.015
  27. Wortsman J, Matsuoka LY, Chen TC, Lu Z, Holick MF. Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr 2000; 72(3): 690-693. https://doi.org/10.1093/ajcn/72.3.690
  28. Blum M, Dolnikowski G, Seyoum E, Harris SS, Booth SL, Peterson J, et al. Vitamin $D_{3}$ in fat tissue. Endocrine 2008; 33(1): 90-94. https://doi.org/10.1007/s12020-008-9051-4
  29. Wamberg L, Christiansen T, Paulsen SK, Fisker S, Rask P, Rejnmark L, et al. Expression of vitamin D-metabolizing enzymes in human adipose tissue -- the effect of obesity and diet-induced weight loss. Int J Obes 2013; 37(5): 651-657. https://doi.org/10.1038/ijo.2012.112
  30. Targher G, Bertolini L, Scala L, Cigolini M, Zenari L, Falezza G, et al. Associations between serum 25-hydroxyvitamin D3 concentrations and liver histology in patients with non-alcoholic fatty liver disease. Nutr Metab Cardiovasc Dis 2007; 17(7): 517-524. https://doi.org/10.1016/j.numecd.2006.04.002
  31. Rock CL, Emond JA, Flatt SW, Heath DD, Karanja N, Pakiz B, et al. Weight loss is associated with increased serum 25-hydroxyvitamin D in overweight or obese women. Obesity (Silver Spring) 2012; 20(11): 2296-2301. https://doi.org/10.1038/oby.2012.57
  32. Yoon JS, Song MK. Vitamin D intake, outdoor activity time and serum 25-OH vitamin D concentrations of Korean postmenopausal women by season and by age. Korean J Community Nutr 2015; 20(2): 120-128. https://doi.org/10.5720/kjcn.2015.20.2.120
  33. Lee OH, Chung YS, Moon JW. Iron status according to serum selenium concentration and physique in young female adults. Korean J Nutr 2010; 43(2): 114-122. https://doi.org/10.4163/kjn.2010.43.2.114
  34. Stankowiak-Kulpa H, Kargulewicz A, Styszynski A, Swora-Cwynar E, Grzymislawski M. Iron status in obese women. Ann Agric Environ Med 2017; 24(4): 587-591. https://doi.org/10.5604/12321966.1232092
  35. Aeberli I, Hurrell RF, Zimmermann MB. Overweight children have higher hepcidin concentrations and lower iron status but have dietary iron intakes ancirculating and bioavailability comparable with normal weight children. Int J Obes (Lond) 2009; 33(10): 1111-1117. https://doi.org/10.1038/ijo.2009.146
  36. Ganz T, Olbina G, Girelli D, Nemeth E, Westerman M. Immunoassay for human serum hepcidin. Blood 2008; 112(10): 4292-4297.
  37. Kim HK, Lim JH, Kwon ER, Park YJ, Kim NE, Noh WY, et al. Serum ferritin and risk of the metabolic syndrome in Korean adults. Korean J Obes 2010; 19(2): 48-55.
  38. Jehn M, Clark JM, Guallar E. Serum ferritin and risk of the metabolic syndrome in U.S. adults. Diabetes Care 2004; 27(10): 2422-2428. https://doi.org/10.2337/diacare.27.10.2422
  39. Shiwaku K, Anuurad E, Enkhmaa B, Kitajima K, Yamane Y. Appropriate BMI for Asian populations. Lancet 2004; 363(9414): 1077.
  40. Lecube A, Hernandez C, Pelegri D, Simo R. Factors accounting for high ferritin levels in obesity. Int J Obes 2008; 32(11): 1665-1669. https://doi.org/10.1038/ijo.2008.154
  41. Khan A, Khan WM, Ayub M, Humayun M, Haroon M. Ferritin is a marker of inflammation rather than iron deficiency in overweight and obese people. J Obes 2016; 2016: 1937320.