Effects of obesity with reduced 25(OH)D levels on bone health in elderly Chinese people: a nationwide cross-sectional study

Chunchun Yuan; Jing Wang; Weiqiang Zhang; Honggang Yi; Bing Shu; Chenguang Li; Qianqian Liang; De Liang; Bolai Chen; Xingwen Xie; Xinchao Lin; Xu Wei; Hui Wang; Peizhan Chen; Chen Huang; Hao Xu; Yueli Sun; Yongjian Zhao; Qi Shi; Dezhi Tang; Yongjun Wang

doi:10.3389/fimmu.2023.1162175

Effects of obesity with reduced 25(OH)D levels on bone health in elderly Chinese people: a nationwide cross-sectional study

Front Immunol. 2023 Apr 27:14:1162175. doi: 10.3389/fimmu.2023.1162175. eCollection 2023.

Authors

Chunchun Yuan^{1

2

3}, Jing Wang^{3

4

5}, Weiqiang Zhang^{3

6}, Honggang Yi⁷, Bing Shu^{1

2

3

5}, Chenguang Li^{1

2

3

5}, Qianqian Liang^{1

2

3

5}, De Liang⁸, Bolai Chen^{9

10}, Xingwen Xie^{11

12}, Xinchao Lin¹³, Xu Wei¹⁴, Hui Wang¹⁵, Peizhan Chen¹⁶, Chen Huang^{1

2

3}, Hao Xu^{1

2

3}, Yueli Sun^{1

2

3}, Yongjian Zhao^{1

2

3}, Qi Shi^{1

2

3

5}, Dezhi Tang^{1

2

3

5}, Yongjun Wang^{1

2

3

5}

Affiliations

¹ Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
² Spine Institute, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
³ Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education (Shanghai University of Traditional Chinese Medicine), Shanghai, China.
⁴ Shanghai Geriatric Institute of Chinese Medicine, Shanghai, China.
⁵ Academic Research Center of Shixiaoshan' Traumatology, Shanghai, China.
⁶ State Key Laboratory of Genetic Engineering, Collaborative Innovation Center for Genetics and Development, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China.
⁷ Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China.
⁸ The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
⁹ Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.
¹⁰ The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
¹¹ The Second People's Hospital of Gansu Province, Gansu, Lanzhou, China.
¹² Affiliated Hospital of Northwest University for Nationalities, Gansu, Lanzhou, China.
¹³ Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
¹⁴ Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
¹⁵ State Key Laboratory of Oncogenes and Related Genes, Center for Single-Cell Omics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
¹⁶ Shanghai Institute of Digestive Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Abstract

Background: Obesity is often accompanied by lower 25(OH)D levels, whereas these two parameters exhibit opposite effects on bone health. It is uncertain what are the effects of lower 25(OH)D levels in obesity on bone health in elderly Chinese people.

Methods: A nationally representative cross-sectional analysis of China Community-based Cohort of Osteoporosis (CCCO) was performed from 2016 to 2021, which consisted of 22,081 participants. Demographic data, disease history, Body mass index (BMI), bone mineral density (BMD), the levels of the biomarkers of vitamin D status and those of bone metabolism markers were measured for all participants (N = 22,081). The genes (rs12785878, rs10741657, rs4588, rs7041, rs2282679 and rs6013897) related to 25(OH)D transportation and metabolism were performed in a selected subgroup (N = 6008).

Results: Obese subjects exhibited lower 25(OH)D levels (p < 0.05) and higher BMD (p < 0.001) compared with those of normal subjects following adjustment. The genotypes and allele frequency of rs12785878, rs10741657, rs6013897, rs2282679, rs4588 and rs7041 indicated no significant differences among three BMI groups following correction by the Bonferroni's method (p > 0.05). The levels of total 25(OH)D (ToVD) were significantly different among the GC1F, GC1S and GC2 haplotype groups (p < 0.05). Correlation analysis indicated that ToVD levels were significantly correlated with parathyroid hormone levels, BMD, risk of osteoporosis (OP) and the concentration levels of other bone metabolism markers (p < 0.05). Generalized varying coefficient models demonstrated that the increasing BMI, ToVD levels and their interactions were positively associated with BMD outcomes (p < 0.001), whereas the reduced levels of ToVD and BMI increased the risk of OP, which was noted notably for the subjects with reduced ToVD levels (less than 20.69 ng/ml) combined with decreased BMI (less than 24.05 kg/m²).

Conclusion: There was a non-linear interaction of BMI and 25(OH)D. And higher BMI accompanied by decreased 25(OH)D levels is associated with increased BMD and decreased incidence of OP, optimal ranges exist for BMI and 25(OH)D levels. The cutoff value of BMI at approximately 24.05 kg/m² combined with an approximate value of 25(OH)D at 20.69 ng/ml are beneficial for Chinese elderly subjects.

Keywords: cohort study; obesity; older people; osteoporosis; reduced 25(OH)D.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Bone Density* / genetics
Cross-Sectional Studies
East Asian People
Humans
Obesity / genetics
Osteoporosis* / epidemiology
Osteoporosis* / genetics

Substances

25-hydroxyvitamin D

Grants and funding

This work was partially supported by the National Key R&D Program of China (2018YFC1704300), the National Natural Science Foundation of China(NSFC) (81730107, 81973883, 81929004), the Shanghai Municipal Science and Technology Major Project (2017SHZDZX01), the Program for Innovative Research Team of Ministry of Education of China (IRT1270), the Program for Innovative Research Team of Ministry of Science and Technology of China (2015RA4002), Natural Science Foundation of Shanghai (20ZR1434100), and the Inheritance and Innovation Team Project of National Traditional Chinese Medicine (ZYYCXTD-C-202202).