Differences in the Association Among the Vitamin D Concentration, Dietary Macronutrient Consumption, and Metabolic Syndrome Depending on Pre- and Postmenopausal Status in Korean Women: A Cross-Sectional Study

Figures & data

Table 1 General Characteristics

	Sufficient ≥50 nmol/L (n = 1996)	Insufficient <50 nmol/L (n = 6330)	p-value *
Menopausal status, post	58.2	35.1	<0.001
Age, years	52.5 ± 0.6	44.3 ± 0.3	<0.001
Education level, ≥high school	49.2	70.0	<0.001
Living together	71	65.7	0.464
Household’s income, high	48.1	57.5	<0.001
Subjective stress, high	27.0	31.1	<0.001
Regular alcohol drinker	37.9	42.6	<0.001
Current smoker	4.1	6.4	0.009
Supplement consumption, yes	52.2	54.6	<0.001
Regular physical activity	47.2	45.1	0.106

Notes: The data are expressed as the means ± SEMs or %; * p-values of differences in 25-hydroxyvitamin D concentration using the χ²-test or t-test.

Table 2 Metabolic Syndrome-Related Variables and Dietary Macronutrient Consumption According to 25-Hydroxyvitamin D Concentration

	Sufficient ≥50 nmol/L (n = 1996)	Insufficient <50 nmol/L (n = 6330)	p-value *
BMI (kg/m^2)	23.0 ± 0.1	23.4 ± 0.1	0.001
WC (cm)	77.4 ± 0.3	78.0 ± 0.2	0.075
SBP (mmHg)	115.4 ± 0.4	116.0 ± 0.2	0.226
DBP (mmHg)	73.7 ± 0.3	73.8 ± 0.2	0.651
FG (mg/dL)	93.8 ± 0.5	95.5 ± 0.3	0.009
TG (mg/dL)	103.3 ± 1.7	114.3 ± 1.5	<0.001
TC (mg/dL)	188.0 ± 0.9	188.6 ± 0.6	0.562
HDL-C (mg/dL)	53.3 ± 0.3	52.2 ± 0.2	0.003
Dietary consumption
Energy (kcal)	1704.1 ± 20.3	1706.0 ± 10.2	0.929
%_CHO	68.6 ± 0.3	68.2 ± 0.2	0.281
%_PRO	14.4 ± 0.1	14.2 ± 0.1	0.250
%_FAT	17.4 ± 0.2	17.9 ± 0.1	0.103

Notes: The data are expressed as the means ± SEMs. * p-values of the difference between serum 25-hydroxyvitamin D concentrations using a general linear model after adjusting for age, education level, household income, marital status, residential region, subjective stress level, dietary supplement consumption, smoking status, alcohol consumption status, and physical activity.

Abbreviations: BMI, body mass index; WC, waist circumference; SBP, systolic blood pressure; DBP, diastolic blood pressure; FG, fasting glucose; TGs, triglycerides; TC, total cholesterol; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol.

Table 3 Metabolic Syndrome-Related Variables and Dietary Macronutrient Consumption According to Menopausal Status and 25-Hydroxyvitamin D Concentration

	Premenopausal Status (n = 4030)		p-value *	Postmenopausal Status (n = 4296)		p-value *	p-value for Interaction**
	≥50 nmol/L (n = 612)	<50 nmol/L (n = 3418)		≥50 nmol/L (n = 1384)	<50 nmol/L (n = 2912)
BMI (kg/m^2)	22.4 ± 0.2	22.6 ± 0.1	0.285	24.0 ± 0.1	24.52± 0.1	<0.001	<0.001
WC (cm)	745.0 ± 0.5	74.9 ± 0.2	0.830	81.4 ± 0.4	82.7 ± 0.3	0.005	0.003
SBP (mmHg)	108.3 ± 0.6	108.9 ± 0.3	0.354	125.9 ± 0.6	126.6 ± 0.4	0.380	0.004
DBP (mmHg)	71.9 ± 0.4	72.0 ± 0.2	0.824	76.5 ± 0.34	76.5 ± 0.2	0.857	0.010
FG (mg/dL)	90.1 ± 0.7	91.4 ± 0.4	0.097	99.6 ± 0.7	101.8 ± 0.7	0.048	0.054
TG (mg/dL)	85.1 ± 2.5	96.4 ± 1.2	0.001	130.1 ± 2.4	140.7 ± 2.1	0.001	<0.001
TC (mg/dL)	181.0 ± 1.3	179.7 ± 0.7	0.382	199.5 ± 1.2	202.1 ± 0.9	0.094	<0.001
HDL-C (mg/dL)	55.3 ± 0.6	54.0 ± 0.3	0.380	50.5 ± 0.4	49.4 ± 0.3	0.027	0.022
Dietary consumption
Energy (kcal)	1706.7 ± 28.7	1771.7 ± 13.2	0.360	1656.6 ± 24.0	1606.2 ± 14.1	0.054	0.003
%_CHO	64.9 ± 0.6	64.3 ± 0.2	0.278	74.2 ± 0.4	74.0 ± 0.3	0.593	0.219
%_PRO	14.9 ± 0.2	14.8 ± 0.1	0.792	13.6 ± 0.1	13.3 ± 0.1	0.044	0.351
%_FAT	19.9 ± 0.5	20.8 ± 0.2	0.380	13.4 ± 0.3	13.5 ± 0.2	0.723	0.159

Notes: The data are expressed as the means ± SEMs * p-values of the association between menopausal status and serum 25-hydroxyvitamin D concentration using a general linear model after adjusting for age, education level, household income, marital status, residential region, subjective stress level, dietary supplement consumption, smoking status, alcohol consumption status, and physical activity. ** p-values for the interaction between menopausal status and serum 25-hydroxyvitamin D concentration using a multivariate logistic regression after adjusting for age, education level, household income, marital status, residential region, subjective stress level, dietary supplement consumption, smoking status, alcohol consumption status, and physical activity.

Abbreviations: BMI, body mass index; WC, waist circumference; SBP, systolic blood pressure; DBP, diastolic blood pressure; FG, fasting glucose; TGs, triglycerides; TC, total cholesterol; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol.

Figure 1 Adjusted odds ratio for obesity and metabolic syndrome according to menopausal status and 25-hydroxyvitamin D concentration. Obesity was defined as BMI ≥25.0 kg/m² by the Korean Society for the Study of Obesity. Metabolic syndrome was defined if ≥ 3 following diagnostic criteria by the modified National Cholesterol Education Program/Adult Treatment Panel III: 1) WC ≥85 cm according to the Korean Society for the Study of Obesity, 2) TGs ≥150 mg/dL or receiving treatment for high TGs, 3) HDL-C <50 mg/dL or receiving treatment for low HDL-C, 4) BP ≥130/85 mmHg or receiving treatment for high BP, and 5) FG ≥100 mg/dL or receiving treatment for hyperglycemia. The odds ratios (95% confidence intervals) were calculated in reference to a serum vitamin D concentration ≥50 nmol/L using multivariate logistic regression adjusting for age, education level, household income, marital status, residential region, subjective stress level, dietary supplement consumption, smoking status, alcohol consumption status, and regular exercise (* p<0.05, ** p<0.01).

Table 4 Association of the Combined Effect the Menopausal Status and 25-Hydroxyvitamin D Concentration on Obesity and Metabolic Syndrome According to Dietary Macronutrient Consumption

		Obesity		Metabolic Syndrome
		Premenopausal Status (n = 4030)	Postmenopausal Status (n = 4296)	Premenopausal Status (n = 4030)	Postmenopausal Status (n = 4296)
CHO	Low	1.278 (0.926–1.764)	1.158 (0.838–1.601)	1.432 (0.880–2.329)	1.260 (0.930–1.708)
	High	0.810 (0.538–1.220)	1.428 (1.145–1.780)**	1.080 (0.631–1.847)	1.261 (1.013–1.570)*
Protein	Low	0.928 (0.627–1.374)	1.385 (1.091–1.756)**	1.120 (0.667–1.881)	1.266 (1.008–1.590)*
	High	1.191 (0.858–1.654)	1.268 (0.964–1.668)	1.400 (0.859–2.282)	1.243 (0.949–1.628)
Fat	Low	0.809 (0.551–1.189)	1.434 (1.150–1.788)**	0.938 (0.554–1.586)	1.239 (1.004–1.529)*
	High	1.319 (0.941–1.847)	1.141 (0.837–1.556)	1.561 (0.938–2.598)	1.332 (0.969–1.830)

Notes: The odds ratios (95% confidence intervals) were calculated in reference to a serum vitamin D concentration ≥50 nmol/L using a multinomial logistic regression model after adjusting for age, education level, household income, marital status, residential region, subjective stress level, dietary supplement consumption, smoking status, alcohol consumption status, and physical activity (*p<0.05, ** p<0.01).