The role of vitamin D and adiponectin in ethnic-specific differences in body fat distribution and risk for cardiovascular disease

Background: Body fat distribution, in particular visceral adipose tissue (VAT), contributes to risk of cardiovascular disease (CVD). The Multicultural-Community Health Assessment Trial (M-CHAT) reported that South Asians have greater VAT than Europeans despite similar BMIs, putting them at greater risk of CVD. However, the molecular mechanisms underlying ethnic-specific differences in body fat distribution are unclear. Low circulating 25-hydroxyvitamin D (25OHD) and adiponectin concentrations are prevalent in individuals with obesity (BMI ≥ 30kg/m²), and are associated with increased risk of CVD. Furthermore, 25OHD is inversely associated with blood pressure. Adiponectin is an adipokine that has insulin-sensitizing, anti-inflammatory, and anti-atherogenic properties. Adiponectin circulates as isoforms low (LMW), medium (MMW), and the reported most biologically active isoform, high (HMW) molecular weight. This thesis aims to investigate ethnic-specific differences in the relationship between plasma 25OHD and adiponectin concentrations with body fat distribution and CVD risk factors. Methods/Results: Europeans (n=171) and South Asians (n=176) from the M-CHAT cohort were assessed for demographics, plasma 25OHD, total and HMW adiponectin concentrations, and CVD risk factors. A computed tomography (CT) scan was used to quantify VAT and subcutaneous adipose tissue (SAT) deposition. South Asians had lower (p < 0.001) 25OHD in comparison to the Europeans (63.0 nmol/L vs. 39 nmol/L, respectively). VAT was inversely associated (p < 0.05) with 25OHD even after adjustment for age, sex, BMI, season of blood collection, SAT and total body fat (%). This suggests that VAT mediates the relationship between plasma 25OHD and CVD risk. Furthermore, the inverse association between systolic and diastolic blood pressure and 25OHD was no longer significant after adjustment for VAT. However, circulating plasma adiponectin concentrations remained strongly associated with fasting plasma HDL-cholesterol, triglycerides, insulin, and HOMA-insulin resistance (HOMA-IR), even after adjustment for VAT. Interestingly, South Asians also had lower (p