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Qingrong Pan Department of Endocrinology, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China

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Shuxin Gao Department of General Practice, Cangzhou Central Hospital, Cangzhou, Hebei Province, China

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Xia Gao Department of Endocrinology, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China

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Ning Yang Department of Endocrinology, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China

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Zhi Yao Department of Endocrinology, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China

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Yanjin Hu Department of Endocrinology, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China

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Li Miao Department of Endocrinology, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China

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Zhe Chen Department of Endocrinology, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China

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Guang Wang Department of Endocrinology, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China

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speculated that the increase of Hcy was at least partially due to the decrease of renal function ( 15 ), because of the evidence that Hcy was negatively correlated with kidney function in general population ( 16 , 17 , 18 ). However, it is unknown whether

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Anna C van der Burgh Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands

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Samer R Khan Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands

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Sebastian J C M M Neggers Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands

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Ewout J Hoorn Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands

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Layal Chaker Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands

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Introduction Chronic kidney disease (CKD) is a highly prevalent condition ( 1 ) and is often characterized by a decline in kidney function over time. Generally, a higher prevalence of CKD is found in women, while men with CKD have a higher

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L E Zijlstra Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands

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D M van Velzen Department of Internal Medicine, Section of Endocrinology, Northwest Clinics, Alkmaar, The Netherlands

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S Simsek Department of Internal Medicine, Section of Endocrinology, Northwest Clinics, Alkmaar, The Netherlands

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S P Mooijaart Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands

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M van Buren Department of Nephrology, Leiden University Medical Center, Leiden, The Netherlands
Department of Internal Medicine, HagaHospital, The Hague, The Netherlands

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D J Stott Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK

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I Ford Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK

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J W Jukema Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands

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S Trompet Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands

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function to a lower estimated glomerular filtration rate (eGFR) and increased prevalence of CKD ( 10 , 11 , 12 ). Longitudinal studies have presented conflicting results, linking kidney function decline to low ( 13 ) or high thyroid function ( 14

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Cornelia Then Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, LMU München, Munich, Germany
Clinical Cooperation Group Diabetes, LMU München and Helmholtz Zentrum München, Munich, Germany

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Holger Then Freie Waldorfschule Augsburg, Augsburg, Germany

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Andreas Lechner Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, LMU München, Munich, Germany
Clinical Cooperation Group Diabetes, LMU München and Helmholtz Zentrum München, Munich, Germany
German Center for Diabetes Research (DZD), München-Neuherberg, Germany

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Cornelia Huth German Center for Diabetes Research (DZD), München-Neuherberg, Germany
Institute of Epidemiology, Helmholtz Zentrum München – German Research Center for Environmental Health (GmbH), Neuherberg, Germany

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Christa Meisinger Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München – German Research Center for Environmental Health (GmbH), Neuherberg, Germany
Chair of Epidemiology at UNIKAT Augsburg, Ludwig-Maximilians-Universität München, Munich, Germany

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Margit Heier Institute of Epidemiology, Helmholtz Zentrum München – German Research Center for Environmental Health (GmbH), Neuherberg, Germany
KORA Study Center, University Hospital Augsburg, Augsburg, Germany

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Annette Peters German Center for Diabetes Research (DZD), München-Neuherberg, Germany
Institute of Epidemiology, Helmholtz Zentrum München – German Research Center for Environmental Health (GmbH), Neuherberg, Germany
DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany

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Wolfgang Koenig DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany
Deutsches Herzzentrum München, Technische Universität München, Munich, Germany

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Wolfgang Rathmann Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Institute at Heinrich Heine University Düsseldorf, Düsseldorf, Germany

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Christian Herder German Center for Diabetes Research (DZD), München-Neuherberg, Germany
Institute of Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany

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Michael Roden German Center for Diabetes Research (DZD), München-Neuherberg, Germany
Institute of Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany

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Jürgen Scherberich Klinikum München-Harlaching, Teaching Hospital of the Ludwig-Maximilians-Universität, Munich, Germany

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Jochen Seissler Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, LMU München, Munich, Germany
Clinical Cooperation Group Diabetes, LMU München and Helmholtz Zentrum München, Munich, Germany

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clinical diagnosis, since obesity and other components of the metabolic syndrome, such as elevated fasting glucose and elevated blood pressure, are associated with glomerular hyperfiltration. The currently available kidney function markers (creatinine

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Adriana J van Ballegooijen Department of Health Sciences, Department of Epidemiology and Biostatistics, Department of Public Health, Department of General Practice, Department of Internal Medicine and Cardiovascular Research Institute Maastricht, Department of Internal Medicine, Faculty of Earth and Life Sciences, EMGO Institute for Health and Care Research, VU University Amsterdam, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands

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Marjolein Visser Department of Health Sciences, Department of Epidemiology and Biostatistics, Department of Public Health, Department of General Practice, Department of Internal Medicine and Cardiovascular Research Institute Maastricht, Department of Internal Medicine, Faculty of Earth and Life Sciences, EMGO Institute for Health and Care Research, VU University Amsterdam, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
Department of Health Sciences, Department of Epidemiology and Biostatistics, Department of Public Health, Department of General Practice, Department of Internal Medicine and Cardiovascular Research Institute Maastricht, Department of Internal Medicine, Faculty of Earth and Life Sciences, EMGO Institute for Health and Care Research, VU University Amsterdam, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands

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Marieke B Snijder Department of Health Sciences, Department of Epidemiology and Biostatistics, Department of Public Health, Department of General Practice, Department of Internal Medicine and Cardiovascular Research Institute Maastricht, Department of Internal Medicine, Faculty of Earth and Life Sciences, EMGO Institute for Health and Care Research, VU University Amsterdam, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands

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Jacqueline M Dekker Department of Health Sciences, Department of Epidemiology and Biostatistics, Department of Public Health, Department of General Practice, Department of Internal Medicine and Cardiovascular Research Institute Maastricht, Department of Internal Medicine, Faculty of Earth and Life Sciences, EMGO Institute for Health and Care Research, VU University Amsterdam, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands

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Giel Nijpels Department of Health Sciences, Department of Epidemiology and Biostatistics, Department of Public Health, Department of General Practice, Department of Internal Medicine and Cardiovascular Research Institute Maastricht, Department of Internal Medicine, Faculty of Earth and Life Sciences, EMGO Institute for Health and Care Research, VU University Amsterdam, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands

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Coen D A Stehouwer Department of Health Sciences, Department of Epidemiology and Biostatistics, Department of Public Health, Department of General Practice, Department of Internal Medicine and Cardiovascular Research Institute Maastricht, Department of Internal Medicine, Faculty of Earth and Life Sciences, EMGO Institute for Health and Care Research, VU University Amsterdam, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands

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Michaela Diamant Department of Health Sciences, Department of Epidemiology and Biostatistics, Department of Public Health, Department of General Practice, Department of Internal Medicine and Cardiovascular Research Institute Maastricht, Department of Internal Medicine, Faculty of Earth and Life Sciences, EMGO Institute for Health and Care Research, VU University Amsterdam, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands

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Ingeborg A Brouwer Department of Health Sciences, Department of Epidemiology and Biostatistics, Department of Public Health, Department of General Practice, Department of Internal Medicine and Cardiovascular Research Institute Maastricht, Department of Internal Medicine, Faculty of Earth and Life Sciences, EMGO Institute for Health and Care Research, VU University Amsterdam, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands

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)D and PTH in relation to kidney function is well-known, whereas the relationship with BNP is novel (11) . Observational data in patients with HF suggest that low 25(OH)D levels and high PTH levels are common and are both associated with higher BNP

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Merlin C Thomas Department of Diabetes, Central Clinical School, Monash University, Melbourne, VIC, Australia

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Brendon L Neuen The George Institute for Global Health, Sydney, NSW, Australia

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Stephen M Twigg The University of Sydney School of Medicine, Sydney, NSW, Australia
Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, NSW, Australia

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Mark E Cooper Department of Diabetes, Central Clinical School, Monash University, Melbourne, VIC, Australia

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Sunil V Badve The George Institute for Global Health, Sydney, NSW, Australia
Department of Renal Medicine, St George Hospital, Sydney, NSW, Australia
Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia

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effective means to protect kidney function in patients with T2D. Although SGLT2 inhibitors achieve urinary glucose wasting and were initially developed as glucose-lowering agents for the treatment of T2D, this represents only one of their potential

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Eliana Piantanida Department of Medicine and Surgery, University of Insubria, Varese, Italy

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Daniela Gallo Department of Medicine and Surgery, University of Insubria, Varese, Italy

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Giovanni Veronesi Department of Medicine and Surgery, University of Insubria, Varese, Italy
Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese, Italy

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Eugenia Dozio Department of Medicine and Surgery, University of Insubria, Varese, Italy

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Eugenia Trotti Department of Medicine and Surgery, University of Insubria, Varese, Italy

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Adriana Lai Department of Medicine and Surgery, University of Insubria, Varese, Italy

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Silvia Ippolito Department of Medicine and Surgery, University of Insubria, Varese, Italy

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Jessica Sabatino Department of Medicine and Surgery, University of Insubria, Varese, Italy

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Maria Laura Tanda Department of Medicine and Surgery, University of Insubria, Varese, Italy

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Antonio Toniolo Department of Biotechnology and Life Science, University of Insubria, Varese, Italy

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Marco Ferrario Department of Medicine and Surgery, University of Insubria, Varese, Italy
Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese, Italy

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Luigi Bartalena Department of Medicine and Surgery, University of Insubria, Varese, Italy

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Objective

The aim of this observational study was to clarify the link between vitamin D status and metabolic syndrome (MetS) in people with visceral obesity.

Design and methods

One hundred ninety-six consecutive patients (152 women; mean age 51 ± 13 years) with visceral obesity (mean body weight 103 ± 20 kg, mean waist circumference (WC) 119 ± 13 cm) were enrolled at the Obesity Outpatient Clinic of the University of Insubria in Varese. Anthropometric measurements were recorded. Laboratory tests, including vitamin D (25(OH)D)), fasting blood glucose (FBG), lipid profile, liver and kidney function tests were assessed. Vitamin D status was defined according to the European Society of Endocrinology guidelines, MetS to the 2009 harmonized definition.

Results

An inverse association emerged among 25(OH)D, body mass index (BMI) (P = 0.001) and WC (all P = 0.003). Serum 25(OH)D levels were inversely related to FBG and systolic blood pressure (SBP) (respectively, P = 0.01 and 0.02). Median serum 25(OH)D levels were 13.3 ng/mL (CI 95% 12; 15) in MetS and 16 ng/mL (CI 95% 14; 18) (P = 0.01) in non-MetS patients. Among patients with MetS, lower 25(OH)D concentrations were related to higher risk of hypertension (HT) (odds ratio (OR) 1.7, CI 95%, 0.7;4) and hyperglycemia (IFG)/type 2 diabetes (OR 5.5, CI 95% 2; 14).

Conclusion

Vitamin D status and MetS are inversely correlated in visceral obesity, particularly with regard to glucose homeostasis and BP. More extensive studies are required to investigate the potential for causality.

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Yinqiong Huang Department of Endocrinology, the Second Affiliated Hospital of Fujian Medical University, Quanzhou, China

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Zhaozhao Zhu Department of Endocrinology, the Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
Department of Endocrinology, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, China

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Zhiqin Huang Department of Endocrinology, the Second Affiliated Hospital of Fujian Medical University, Quanzhou, China

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Jingxiong Zhou Department of Endocrinology, the Second Affiliated Hospital of Fujian Medical University, Quanzhou, China

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.115 0.024 a a P < 0.05, b P < 0.01. Linear correlation analysis between serum TMAO and kidney function First, we analyzed the correlation between serum TMAO and kidney function in all subjects. Spearman correlation analysis

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Martine Cohen-Solal Department of Skeletal Diseases, INSERM U1132 & Université de Paris, Hôpital Lariboisière, Paris, France

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Thomas Funck-Brentano Department of Skeletal Diseases, INSERM U1132 & Université de Paris, Hôpital Lariboisière, Paris, France

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Pablo Ureña Torres AURA Nord, Saint Ouen, France
Department of Renal Physiology, Necker Hospital, Université de Paris, Paris, France

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cohort of 1426 participants followed for a mean of 4.7 years, including 199 with eGFR <60 mL/mn/1.73 m 2 , low TBS score was independently associated with increased fracture risk in adults with reduced kidney function ( 35 ). High

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Yutong Zou Division of Nephrology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, Sichuan, China

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Lijun Zhao Division of Nephrology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, Sichuan, China

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Junlin Zhang Division of Nephrology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, Sichuan, China

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Yiting Wang Division of Nephrology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, Sichuan, China

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Yucheng Wu Division of Nephrology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, Sichuan, China

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Honghong Ren Division of Nephrology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, Sichuan, China

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Tingli Wang Division of Nephrology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, Sichuan, China

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Rui Zhang Division of Nephrology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, Sichuan, China

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Jiali Wang Division of Nephrology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, Sichuan, China

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Yuancheng Zhao Division of Nephrology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, Sichuan, China

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Chunmei Qin Division of Nephrology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, Sichuan, China

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Huan Xu Division of Pathology, West China Hospital of Sichuan University, Chengdu, Sichuan, China

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Lin Li Division of Pathology, West China Hospital of Sichuan University, Chengdu, Sichuan, China

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Zhonglin Chai Department of Diabetes, Central Clinical School, Monash University, Melbourne, Australia

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Mark E Cooper Department of Diabetes, Central Clinical School, Monash University, Melbourne, Australia

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Nanwei Tong Division of Endocrinology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, Sichuan, China

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Fang Liu Division of Nephrology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, Sichuan, China

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accepted that hyperuricemia was considered to be a risk factor independent of other indicators for the development of incident chronic kidney disease (CKD) in type 2 diabetic mellitus (T2DM) patients with preserved kidney function ( 4 , 5 ). Furthermore

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