Hypovitaminosis D and adipose tissue - cause and effect relationships in obesity.

In recent years, attention has been focused on pleiotropic directions of effects exerted by vitamin D. Epidemiological data indicate that deficiency of vitamin D in various population groups represents an increasingly widespread phenomenon, while a decreased serum concentration of calcitriol correlates with manifestation of civilization-linked diseases, including visceral obesity. This study aims at a review and synthesis of data linked to relationships between lowered vitamin D concentrations in blood and manifestation of obesity, and potential mechanisms which affect the concentration of the vitamin in conditions of an excessive accumulation of adipose tissue. Several variables are distinguished which can affect the status of vitamin D in obesity, but the key role in this respect is ascribed to the metabolic activity of visceral adipose tissue. Among others, the activity favours sequestration and modulation of calcitriol turnover. On the other hand, the effects of vitamin D on the process of adipogenesis and its involvement in remodelling of adipose tissue are pointed out. Also, several factors of an environmental nature (e.g. time of year/day, dietetic supply of vitamin D), genetic nature (e.g. genetic polymorphisms) and other conditioning (e.g. coexisting diseases, age, content of melanin in skin) cannot be bypassed as they may affect the concentration of vitamin D. Nevertheless, it still remains unresolved to what extent hypovitaminosis D represents the cause and to which it is the effect of obesity.