Impaired release of Vitamin D in dysfunctional adipose tissue: New cues on Vitamin D supplementation in obesity

Context: Vitamin D accumulates in adipose tissue (AT) and vitamin D deficiency is frequent in obesity. Objective: We hypothesize that trafficking of vitamin D is altered in dysfunctional AT. Design, Patients, Settings: 54 normal-weight and 67 obese males were recruited in a prospective study and randomly assigned to supplementation with 50 µg/week 25-hydroxyvitamin-D3 (25(OH)D) or 150 µg/week vitamin D3 for 1 year, raising dosage by 50% if vitamin D-sufficiency (serum 25(OH)D>50 nomol/l), was not achieved at 6 months; 97 subjects completed the study. Methods: Vitamin D3 (D3) and 25(OH)D were quantified by HPLC-MS in control and insulin-resistant (IR) 3T3-L1 cells and subcutaneous AT (SAT) from lean and obese subjects, incubated with or without adrenaline; expression of 25-hydroxylase (CYP27A1), 1α-hydroxylase (CYP27B1) and vitamin D receptor (VDR) were analysed by real-time PCR. Results: In IR adipocytes the uptake of D3 and 25(OH)D was higher, but after adrenaline stimulation, the decrement in D3 and 25(OH)D was stronger in control cells, which also showed increased expression of CYP27A1 and CYP27B1 and higher levels of 25(OH)D. In SAT from obese subjects, the adrenaline-induced release of D3 and 25(OH)D was blunted; in both IR cells and obese SAT, protein expression of β2-adrenergic receptor was reduced. Supplementation with 25-hydroxyvitamin-D3 was more effective in achieving vitamin D sufficiency in obese, but not in normal weight subjects. Conclusion: Dysfunctional AT shows a reduced catecholamine-induced release of D3 and 25(OH)D, and altered activity of vitamin D-metabolizing enzymes, for these reasons supplementation with 25-hydroxyvitamin-D3 is more effective in obese individuals.