EC Paediatrics

Research Article Volume 14 Issue 7 - 2025

The Interrelationships of Vitamin D, Inflammation and Obesity in a Middle Eastern Population - A Pilot Study

Wafaa F Abusudah1,2, Oyonumo E Ntekim1, Allan A Johnson1, Sanaz Dabiri3, Julius Ngwa4 and Thomas V Fungwe1*

1Department of Nutritional Sciences, Howard University, College of Nursing and Allied Health Sciences, Washington, DC, USA
2Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia.
3Department of Psychology, Howard University, Washington, DC, USA
4Department of Cardiology, Howard University College of Medicine, Washington, DC, USA

*Corresponding Author: Thomas V Fungwe, Department of Nutritional Sciences, College of Nursing and Allied Health Sciences, Howard University, Washington, DC, USA.
Received: May 02, 2025; Published: June 12, 2025



Background: The prevalence of obesity and its health implications have risen to undesirable levels across genders and ages worldwide. Genetic, environmental, and behavioral factors are known to influence the development of obesity. Vitamin D deficiency is also linked to central obesity, which has public health implications.

Objectives: The study was conducted to determine the relationship between obesity, and inflammation on Vitamin D levels.

Methods: A cross-sectional study was conducted using sixty subjects, aged 19-65. Informed consent was obtained to access their medical records for Vitamin D levels, body mass index (BMI) and socio-demographic data. The inflammatory cytokines associated with obesity, Tumor necrosis factor-alfa (TNF-α), Interleukin 6 (IL-6) and C-reactive protein (CRP), were measured.

Results: A significant association between IL-6 (β = -3.12, SE = 1.39, P = 0.031), TNF-ᾳ (β = 5.64, SE = 2.18, P = 0.014), and CRP (β = -0.32, SE = 0.14, P = 0.031) with Vitamin D was observed, after adjusting for demographics. The correlation of IL-6, CRP and Vitamin D was significant irrespective of age or gender. Dietary intake of cod liver or fish oil contributed significantly to Vitamin D sufficiency.

Conclusion: In this study, inflammatory markers TNF-α, IL-6, and CRP were significantly associated with Vitamin D levels. Dietary intake was also significantly associated with Vitamin D levels. Obesity was associated with increased levels of inflammatory markers TNF-α, IL-6, and CRP. Furthermore, the findings of this study suggest that intake of cod liver or fish oil significantly improved blood Vitamin D levels, especially in obese subjects.

 Keywords: Vitamin D Deficiency; 25-Hydroxyvitamin D; Obesity; Inflammation Markers; Tumor Necrosis Factor-α; Interleuki

  1. Popkin BM. “Recent dynamics suggest selected countries catching up to US obesity”. The American Journal of Clinical Nutrition1 (2010): 284S-288S.
  2. Kayaniyil S., et al. “Association of 25 (OH) D and PTH with metabolic syndrome and its traditional and nontraditional components”. The Journal of Clinical Endocrinology and Metabolism1 (2011): 168-175.
  3. Finucane MM., et al. “National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9.1 million participants”. The Lancet9765 (2011): 557-567.
  4. Aronson D., et al. “Obesity is the major determinant of elevated C-reactive protein in subjects with the metabolic syndrome”. International Journal of Obesity5 (2004): 674-679.
  5. Kwateng WN. “Obesity statistics: Global and US overview, types, trends, and complications”.
  6. Wolpowitz D and BA Gilchrest. “The vitamin D questions: how much do you need and how should you get it?” Journal of the American Academy of Dermatology2 (2006): 301-317.
  7. Saliba W., et al. “The relationship between obesity and the increase in serum 25 (OH) D levels in response to vitamin D supplementation”. Osteoporosis International4 (2013): 1447-1454.
  8. Holick MF. “Vitamin D: extraskeletal health”. Rheumatic Disease Clinics1 (2012): 141-160.
  9. Andıran N., et al. “Vitamin D deficiency in children and adolescents”. Journal of Clinical Research in Pediatric Endocrinology1 (2012): 25.
  10. Cashman KD., et al. “Vitamin D deficiency in Europe: pandemic?” The American Journal of Clinical Nutrition4 (2016): 1033-1044.
  11. Wortsman, J., et al. “Decreased bioavailability of vitamin D in obesity”. The American Journal of Clinical Nutrition3 (2000): 690-693.
  12. Singh, R., et al. “Association of obesity with COVID-19 severity and mortality: an updated systemic review, meta-analysis, and meta-regression”. Frontiers in Endocrinology 13 (2022): 780872.
  13. Kull M., et al. “Body mass index determines sunbathing habits: implications on vitamin D levels”. Internal Medicine Journal4 (2009): 256-258.
  14. Earthman, C., et al. “The link between obesity and low circulating 25-hydroxyvitamin D concentrations: considerations and implications”. International Journal of Obesity3 (2012): 387-396.
  15. Cipriani C., et al. “Vitamin D and its relationship with obesity and muscle”. International Journal of Endocrinology (2014): 841248.
  16. Drincic AT., et al. “Volumetric dilution, rather than sequestration best explains the low vitamin D status of obesity”. Obesity7 (2012): 1444-1448.
  17. Berg AH and PE Scherer. “Adipose tissue, inflammation, and cardiovascular disease”. Circulation Research9 (2005): 939-949.
  18. Engin A. “The definition and prevalence of obesity and metabolic syndrome”. Obesity and Lipotoxicity 960 (2017): 1-17.
  19. Rodríguez-Hernández H., et al. “Obesity and inflammation: epidemiology, risk factors, and markers of inflammation”. International Journal of Endocrinology (2013): 678159.
  20. Blaha MJ., et al. “Association between obesity, hsCRP≥ 2 mg/L, and subclinical atherosclerosis: implications of JUPITER from the Multi-Ethnic Study of Atherosclerosis (MESA)”. Arteriosclerosis, Thrombosis, and Vascular Biology6 (2011): 1430.
  21. Charoenngam N and MF Holick. “Immunologic effects of vitamin D on human health and disease”. Nutrients7 (2020): 2097.
  22. Khansari N., et al. “Chronic inflammation and oxidative stress as a major cause of age-related diseases and cancer”. Recent Patents on Inflammation and Allergy Drug Discovery 1 (2009): 73-80.
  23. Institute S. SAS/IML 9.3 user's guide. Sas Institute (2011).
  24. Hintze J. NCSS 9 Statistical Software. Kaysville, Utah, USA (2013).
  25. Yu Y., et al. “Effect of vitamin D supplementation on some inflammatory biomarkers in type 2 diabetes mellitus subjects: a systematic review and meta-analysis of randomized controlled trials”. Annals of Nutrition and Metabolism1 (2018): 62-73.
  26. Park HS., et al. “Relationship of obesity and visceral adiposity with serum concentrations of CRP, TNF-α and IL-6”. Diabetes Research and Clinical Practice1 (2005): 29-35.
  27. Ford ES., et al. “The metabolic syndrome and concentrations of C-reactive protein among US youth”. Diabetes Care4 (2005): 878-881.
  28. Fontes-Carvalho R., et al. “Association between plasma leptin and adiponectin levels and diastolic function in the general population”. Expert Opinion on Therapeutic Targets10 (2015): 1283-1291.
  29. Esser, N., et al. “Inflammation as a link between obesity, metabolic syndrome and type 2 diabetes”. Diabetes Research and Clinical Practice2 (2014): 141-150.
  30. De Vita F., et al. “Relationship between vitamin D and inflammatory markers in older individuals”. Age4 (2014): 9694.
  31. Peterson CA and ME Heffernan. “Serum tumor necrosis factor-alpha concentrations are negatively correlated with serum 25 (OH) D concentrations in healthy women”. Journal of Inflammation1 (2008): 10.
  32. Ding C., et al. “Vitamin D signalling in adipose tissue”. British Journal of Nutrition11 (2012): 1915-1923.
  33. Chandler PD., et al. “Effect of vitamin D supplementation alone or with calcium on adiposity measures: a systematic review and meta-analysis of randomized controlled trials”. Nutrition Reviews9 (2015): 577-593.
  34. Savastano S., et al. “Low vitamin D status and obesity: Role of nutritionist”. Reviews in Endocrine and Metabolic Disorders2 (2017): 215-225.
  35. Migliaccio S., et al. “Obesity and hypovitaminosis D: causality or casualty”. International Journal of Obesity Supplements1 (2019): 20-31.
  36. Foresta C., et al. “Bone mineral density and testicular failure: evidence for a role of vitamin D 25-hydroxylase in human testis”. The Journal of Clinical Endocrinology and Metabolism4 (2011): E646-E652.
  37. Sedrani SH. “Low 25-hydroxyvitamin D and normal serum calcium concentrations in Saudi Arabia: Riyadh region”. Annals of Nutrition and Metabolism3 (1984): 181-185.
  38. Burt LA., et al. “Effect of high-dose vitamin D supplementation on volumetric bone density and bone strength: a randomized clinical trial”. Journal of the American Medical Association8 (2019): 736-745.
  39. Tosunbayraktar G., et al. “Low serum 25 (OH) D levels are associated to higher BMI and metabolic syndrome parameters in adult subjects in Turkey”. African Health Sciences4 (2015): 1161-1169.
  40. Wang Q., et al. “Relationship between serum vitamin D levels and inflammatory markers in acute stroke patients”. Brain and Behavior2 (2018): e00885.
  41. Laird E., et al. “Vitamin D and inflammation: potential implications for severity of Covid-19”. Irish Medical Journal 5 (2020): 81.
  42. Azizieh F., et al. “Association between levels of vitamin D and inflammatory markers in healthy women”. Journal of Inflammation Research 9 (2016): 51-57.
  43. Bouillon R., et al. “Vitamin D: from photosynthesis, metabolism, and action to clinical applications” (2001).
  44. Borel P., et al. “Vitamin D bioavailability: state of the art”. Critical Reviews in Food Science and Nutrition9 (2015): 1193-1205.
  45. Smith TJ., et al. “Estimation of the dietary requirement for vitamin D in adolescents aged 14-18 y: a dose-response, double-blind, randomized placebo-controlled trial”. The American Journal of Clinical Nutrition5 (2016): 1301-1309.
  46. Lee YM., et al. “Can current recommendations on sun exposure sufficiently increase serum vitamin D level?: One-month randomized clinical trial”. Journal of Korean Medical Science8 (2020): e50.
  47. Engelsen O. “The relationship between ultraviolet radiation exposure and vitamin D status”. Nutrients5 (2010): 482-495.
  48. Holick MF and TC Chen. “Vitamin D deficiency: a worldwide problem with health consequences”. The American Journal of Clinical Nutrition4 (2008): 1080S-1086S.
  49. Prentice A. “Vitamin D deficiency: a global perspective”. Nutrition Reviews2 (2008): S153-S164.

Thomas V Fungwe., et al. "The Interrelationships of Vitamin D, Inflammation and Obesity in a Middle Eastern Population - A Pilot Study". EC Paediatrics 14.6 (2025): 01-12.