Assessment of Relationship Between Serum Vitamin D Levels and Metabolic Syndrome Components in Hemodialysis Patients
Full Text


25-Hydroxyvitamin D
Metabolic Syndrome

How to Cite

Karahan Yılmaz, S., Mertoğlu, C., & Ayaz, A. (2021). Assessment of Relationship Between Serum Vitamin D Levels and Metabolic Syndrome Components in Hemodialysis Patients. Galician Medical Journal, 28(1), E202113.


Aim: This study is aimed to evaluate the relationship between serum vitamin D levels and metabolic syndrome in hemodialysis patients.

Materials and Methods: This study was conducted with participation of 80 patients undergoing hemodialysis for more than 6 months three times a week, aged > 18 years. Their height, dry weight, waist circumference were measured. Biochemical parameters such as serum 25-hydroxyvitamin D, lipid profile, and fasting blood glucose were analyzed. Metabolic syndrome was defined using the National Cholesterol Education Program Adult Treatment Panel III criteria. Severe vitamin D deficiency, 25 (OH) vitamin D < 5 ng/ml; mild vitamin D deficiency, 25 (OH) vitamin D 5-15 ng/ml; vitamin D insufficiency, 25 (OH) vitamin D 16-30 ng/ml, and vitamin D sufficiency, 25 (OH) vitamin D > 30 ng/ml were categorized. Statistical analysis of the data was performed with the use of SPSS version 21.0.

Results: 48.4% of hemodialysis patients were identified to have metabolic syndrome. According to the serum levels of vitamin D; 35.0% of patients had severe vitamin D deficiency, 37.4% of patients had mild vitamin D deficiency, 18.8% of patients had vitamin D insufficiency and 8.8% of patients had vitamin D sufficiency (> 30 ng/ml). Vitamin D insufficiency was significantly associated with metabolic syndrome and central obesity.

Conclusions: Deficiency/insufficiency is observed in serum 25-hydroxyvitamin D levels in hemodialysis patients. Vitamin D insufficiency is associated with metabolic syndrome.
Full Text


Delautre A, Chantrel F, Dimitrov Y, Klein A, Imhoff O, Muller C, et al. Metabolic syndrome in haemodialysis patients: prevalence, determinants and association to cardiovascular outcomes. BMC Nephrology [Internet]. 2020 Aug 13;21(1). Available from:

Duong TV, Wong T-C, Chen H-H, Chen T-W, Chen T-H, Hsu Y-H, et al. The cut-off values of dietary energy intake for determining metabolic syndrome in hemodialysis patients: A clinical cross-sectional study. PLOS ONE [Internet]. 2018 Mar 14;13(3):e0193742. Available from:

Kleine C-E, Obi Y, Streja E, Hsiung J-T, Park C, Holick MF, et al. Seasonal variation of serum 25-hydroxyvitamin D and parameters of bone and mineral disorder in dialysis patients. Bone [Internet]. 2019 Jul;124:158–165. Available from:

Molina P, Carrero JJ, Bover J, Chauveau P, Mazzaferro S, Torres PU, et al. Vitamin D, a modulator of musculoskeletal health in chronic kidney disease. Journal of Cachexia, Sarcopenia and Muscle [Internet]. 2017 Jul 3;8(5):686–701. Available from:

Milajerdi A, Ostadmohammadi V, Amirjani S, Kolahdooz F, Asemi Z. The effects of vitamin D treatment on glycemic control, serum lipid profiles, and C-reactive protein in patients with chronic kidney disease: a systematic review and meta-analysis of randomized controlled trials. International Urology and Nephrology [Internet]. 2019 Jul 23;51(9):1567–1580. Available from:

Franca Gois P, Wolley M, Ranganathan D, Seguro A. Vitamin D Deficiency in Chronic Kidney Disease: Recent Evidence and Controversies. International Journal of Environmental Research and Public Health [Internet]. 2018 Aug 17;15(8):1773. Available from:

Prasad P, Kochhar A. Interplay of vitamin D and metabolic syndrome: A review. Diabetes & Metabolic Syndrome: Clinical Research & Reviews [Internet]. 2016 Apr;10(2):105–112. Available from:

Marinelli A, Pistolesi V, Rossi V, Battista M, Buono A, Grutto Della F, et al. Severe 25-OH vitamin D deficiency in patients on chronic hemodialysis. G Ital Nefrol. 2014;31(5):gin/31.5.7. Available from:

Ahmadi F, Damghani S, Lessan-Pezeshki M, Razeghi E, Maziar S, Mahdavi-Mazdeh M. Association of low vitamin D levels with metabolic syndrome in hemodialysis patients. Hemodialysis International [Internet]. 2015 May 20;20(2):261–269. Available from:

Meng P, Wei F, Wang Z, Lu Z, Jia L, Bi X. Relationship between low vitamin D level and metabolic syndrome in maintenance hemodialysis patients. Chinese Journal of Nephrology. 2018;34(1):10-16. Available from:

Salama AS, Helmy AK, Tawfik HM, Hasan RM. Association between vitamin D level and metabolic syndrome in hemodialysis patients. MJMR. 2017;82(1):154-154.

Pekcan G. Hastanın beslenme durumunun saptanması. In: Baysal A, editör. Diyet El Kitabı. Ankara: Hatipoğlu Yayınevi; 2018. p. 67-142.

Amal L, Bergmann P. Evaluation of a chemiluminescence immunoassay for the determination of intact parathyroid hormone using the ADVIA Centaur. Clin Lab. 2004;50(11-12):695-702. Available from:

Nauck M, Warnick GR, Rifai N. Methods for Measurement of LDL-Cholesterol: A Critical Assessment of Direct Measurement by Homogeneous Assays versus Calculation. Clinical Chemistry [Internet]. 2002 Feb 1;48(2):236–254. Available from:

Roberts WL, Sedrick R, Moulton L, Spencer A, Rifai N. Evaluation of Four Automated High-Sensitivity C-Reactive Protein Methods: Implications for Clinical and Epidemiological Applications. Clinical Chemistry [Internet]. 2000 Apr 1;46(4):461–468. Available from:

Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Final Report. Circulation [Internet]. 2002 Dec 17;106(25):3143–3143. Available from:

National Kidney Foundation. K/DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease. Am J Kidney Dis. 2003;42(4 Suppl 3):1-201. Available from:

Alpar R. Spor, sağlık ve eğitim bilimlerinden örneklerle uygulamalı istatistik ve geçerlik-güvenirlik. 4. Baskı. Ankara: Nobel Yayınevi; 2016.

Alshelleh S, AlAwwa I, Oweis A, AlRyalat SA, Al-Essa M, Saeed I, et al. Prevalence of metabolic syndrome in dialysis and transplant patients. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy [Internet]. 2019 Apr;12:575–579. Available from:

Alswat KA, Althobaiti A, Alsaadi K, Alkhaldi AS, Alharthi MM, Abuharba WA, et al. Prevalence of Metabolic Syndrome Among the End-Stage Renal Disease Patients on Hemodialysis. Journal of Clinical Medicine Research [Internet]. 2017;9(8):687–694. Available from:

Kubrusly M, Oliveira CMC de, Simões PSF, Lima R de O, Galdino PNR, Sousa P de AF, et al. Prevalence of Metabolic Syndrome according to NCEP-ATP III and IDF criteria in Patients on Hemodialysis. Jornal Brasileiro de Nefrologia [Internet]. 2015;37(1). Available from:

El Ati Z, Machfar H, Boussafa H, Ati N, Omrane Sioud O, Zantour B, et al. Metabolic syndrome, malnutrition, and its associations with cardiovascular and all-cause mortality in hemodialysis patients: Follow-up for three years. Saudi Journal of Kidney Diseases and Transplantation [Internet]. 2020;31(1):129. Available from:

Vogt BP, Ponce D, Caramori JCT. Anthropometric Indicators Predict Metabolic Syndrome Diagnosis in Maintenance Hemodialysis Patients. Nutrition in Clinical Practice [Internet]. 2015 Sep 4;31(3):368–374. Available from:

Guo Y, Xiong Z, Su M, Huang L, Liao J, Xiao H, et al. Positive association of SCD1 genetic variation and metabolic syndrome in dialysis patients in China. Personalized Medicine [Internet]. 2020 Mar;17(2):111–119. Available from:

Thomas G, Sehgal AR, Kashyap SR, Srinivas TR, Kirwan JP, Navaneethan SD. Metabolic Syndrome and Kidney Disease: A Systematic Review and Meta-analysis. Clinical Journal of the American Society of Nephrology [Internet]. 2011 Aug 18;6(10):2364–2373. Available from:

Chang Y-M, Shiao C-C, Huang Y-T, Chen I-L, Yang C-L, et al. Impact of metabolic syndrome and its components on heart rate variability during hemodialysis: a cross-sectional study. Cardiovascular Diabetology [Internet]. 2016 Jan 27;15(1). Available from:

Dimitrijevic Z, Jovanovic A, Cvetkovic M, Vrecic T, Kostic E, Mitic B. Associations of Cardiovascular and All-Cause Mortality with Metabolic Syndrome in Hemodialysis Patients: A Prospective Single-Center Study. Medicina [Internet]. 2019 Oct 16;55(10):694. Available from:

Lee YJ, Oh IH, Baek HJ, Lee CH, Lee SS. Effects of sun exposure and dietary vitamin D intake on serum 25-hydroxyvitamin D status in hemodialysis patients. Nutrition Research and Practice [Internet]. 2015;9(2):158. Available from:

Kara AV, Soylu YE. The relationship between vitamin D and inflammatory markers in maintenance hemodialysis patients. International Urology and Nephrology [Internet]. 2019 Aug 5;51(9):1659–1665. Available from:

Migliaccio S, Di Nisio A, Mele C, Scappaticcio L, Savastano S, et al. Obesity and hypovitaminosis D: causality or casualty? International Journal of Obesity Supplements [Internet]. 2019 Apr;9(1):20–31. Available from:

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.