Plasma 25-Hydroxyvitamin D, Hormonal Contraceptive Use, and Cardiometabolic Disease Risk in an Ethnically Diverse Population of Young Adults

Abstract

Objectives: The relationship between vitamin D and cardiometabolic disease risk across ethnic groups is unclear, and it is not known whether the use of hormonal contraceptives (HCs), which affect vitamin D metabolism and are also associated with cardiometabolic disease risk, modifies this relationship. Our objectives were to determine the prevalence of vitamin D deficiency (plasma 25-hydroxyvitamin D [25(OH)D] < 30 nmol/L) to assess seasonal variation in concentrations of 25(OH)D, and to examine whether 25(OH)D is associated with cardiometabolic biomarkers across ethnic groups and across men, female HC nonusers, and female HC users in an ethnically diverse population of young adults living in Canada.

Methods: The study population consisted of Caucasian, East Asian, and South Asian individuals (n = 1384, 69% female) aged 20–29 years. Participants provided overnight fasting blood samples, from which plasma 25(OH)D and cardiometabolic biomarkers were measured. Vitamin D status distributions were compared using χ² tests, and analysis of covariance (ANCOVA) was used to examine seasonal variations in 25(OH)D, as well as the association between 25(OH)D and cardiometabolic biomarkers, across groups.

Results: Plasma 25(OH)D concentrations fluctuated seasonally among Caucasians and East Asians and across men, female HC nonusers, and female HC users, but they remained low year-round in South Asians, half of whom were vitamin D deficient. Vitamin D deficiency was associated with higher insulin, homeostasis model assessment–estimated insulin resistance (HOMA-IR), and homeostasis model assessment (HOMA)-beta among Caucasians and East Asians and among men and female HC nonusers and with higher triglycerides among men only. No biomarkers were associated with 25(OH)D among South Asians and female HC users, although nonsignificant trends were observed for higher markers of glycemic dysregulation in those who were vitamin D deficient in both groups.

Conclusions: Vitamin D deficiency varies between ethnic groups and is particularly high among South Asians, and it is associated with biomarkers of glycemic dysregulation; however, HC use among women may attenuate this association. Given the widespread use of HCs by women throughout the world, a better understanding of the extent to which these medications may modify the relationship between vitamin D and processes related to disease is warranted.

Key words:

• vitamin D deficiency
• cardiometabolic disease
• hormonal contraceptives
• ethnocultural
• young adults

ACKNOWLEDGMENTS

This work was supported by the Advanced Foods and Materials Network. B.G.-B. holds a graduate scholarship from the Government of Ontario. A.E.-S. holds a Canada Research Chair in Nutrigenomics.

Abbreviations: 25(OH)D = 25-hydroxyvitamin D, UV = ultraviolet, HC = hormonal contraceptives, CRP = C-reactive protein, MET = metabolic equivalent task, HOMA = homeostasis model assessment.