Metabolic syndrome (MetS) is a medical term used for a combination of abdominal obesity, dyslipidemia, impaired glucose homeostasis and hypertension, of which its prevalence is increasing in the world. Insulin resistance (IR) and abdominal obesity are considered to be the main reasons for metabolic syndrome development. It is also thought that 1,25 dihydroxy cholecalciferol (vitamin D, calcitriol) deficiency generates a risk of metabolic syndrome development. Maintaining a balanced calcium and phosphorus level is the main function of vitamin D. Vitamin D also affects the cardiovascular system, immune system, intestines, brain and pancreas. Vitamin D metabolizing enzymes and vitamin D receptors exist in some cell groups including diverse immune cells such as B cells, T cells, monocytes and antigen presenting cells. Vitamin D deficiency occurs as a consequence of obesity and it is also a risk factor for the development of obesity. The mechanisms underlying the association between obesity and vitamin D deficiency is not fully understood however, the sequestration theory is the most accepted theory that may explain why obese individuals have lower serum 25-hydroxyvitamin D (calcidiol) levels. In addition, calcitriol deficiency may result in adipogenesis by increasing lipogenesis, inducing catecholamine levels and enhancing parathyroid hormone levels. In this review, the relationship between vitamin D deficiency, MetS, obesity and IR is to be reviewed. In addition, possible underlying mechanisms between these disorders and vitamin D deficiency will be examined.
Keywords: Metabolic syndrome; obesity; insulin resistance; vitamin D deficiency; calcitriol
Metabolik sendrom (MetS), abdominal obezite, dislipidemi, bozulmuş glukoz homeostazı, hipertansiyon kombinasyonu için kullanılan tıbbi bir terimdir ve dünyada yaygınlığı artmaktadır. İnsülin direnci (IR) ve abdominal obezite, metabolik sendrom gelişiminin ana nedenleri olarak kabul edilmektedir. 1,25 dihidroksi kolekalsiferol (D vitamini, kalsitriol) eksikliğinin de metabolik sendrom gelişme riskine katkıda bulunduğu düşünülmektedir. Kalsiyum ve fosfor seviyesini dengeli bir şekilde korumak, D vitamininin temel işlevidir. D vitamini ayrıca kardiyovasküler sistemi, bağışıklık sistemini, bağırsakları, beyni ve pankreası etkilemektedir. D vitamini metabolize eden enzimler ve vitamin D reseptörleri, B hücreleri, T hücreleri, monositler ve antijen sunan hücreler gibi çeşitli bağışıklık hücreleri dâhil olmak üzere bazı hücre gruplarında bulunmaktadır. D vitamini eksikliği obezitenin bir sonucu olarak ortaya çıktığı gibi obezite gelişimi için de bir risk faktörüdür. Obezite ile D vitamini eksikliği arasındaki ilişkinin altında yatan mekanizmalar tam olarak anlaşılamamıştır. Bununla birlikte, sekestrasyon teorisi, obez bireylerin neden daha düşük serum 25-hidroksivitamin D (kalsidiol) seviyelerine sahip olduğunu açıklayabilecek en çok kabul gören teoridir. Ek olarak kalsitriol eksikliği, lipogenezi artırarak, katekolamin seviyelerini indükleyerek ve paratiroid hormon seviyelerini yükselterek adipogeneze neden olabilir. Bu derlemede; D vitamini eksikliği ile MetS, obezite ve IR arasındaki ilişki gözden geçirilecektir. Ek olarak bu bozukluklar ile D vitamini eksikliği arasındaki olası altta yatan mekanizmalar incelenecektir.
Anahtar Kelimeler: Metabolik sendrom; obezite; insülin direnci; D vitamini eksikliği; kalsitriol
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