Vitamin D Yetersizliği ve Obezite

Bu derleme makalesinde, Vitamin D (Vit D)-obezite ilişkisinin mekanizmasına güncel bilgiler ışığında açıklık getirilmeye çalışılmıştır. Bu ilişki, yağ doku hücrelerinde (adipozit) Vit D reseptörlerinin varlığının gösterilmesi ile başlamıştır. Yağ doku leptin, adiponektin ve resistin gibi hormonları ve TNFα, IL-1β ve IL-6 ve CRP gibi birçok inflamatuar sitokin salgılar. Vit D mezodermal hücrelerin adipozitlere farklılaşması, çoğalması ve olgunlaşması sırasında aracı birçok adipogenik faktörü (adipokin) düzenler. Adipokinler, iştah ve doyma hissi, glikoz ve lipid metabolizması, kan basıncının düzenlenmesi, yangı ve bağışıklık fonksiyonlarını etkiler. Adipozitlerde antiinflamatuar yollar Vit D ile uyarılır. Vit D, yağ dokuda IkB’nin fosforilasyonunu ve NFkB’nin çekirdeğe translokasyonunu inhibe ederek iltihaplanmayı engeller. Obezitede Vit D yağ dokuda aşırı depolanır, deride vitaminin yapımı azalır ve kanda düzeyi düşer. Vit D yetersizliği adipozitlerde lipogenezi uyararak ve Ca akışını sağlayarak dokunun yağlanmasını hızlandırır. Sonuçta yağ doku iltihaplanır ve obezite gelişir. Viseral yağ doku IL, TNF-α, MCP-1 ve resistin gibi inflamatuar adipokinleri salgılayarak hipertansiyon, insulin direnci, diyabet ve Vit D’nin metabolik anormalliklerine yol açar. 

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