J Endocrinol Metab

Journal of Endocrinology and Metabolism, ISSN 1923-2861 print, 1923-287X online, Open Access

Article copyright, the authors; Journal compilation copyright, J Endocrinol Metab and Elmer Press Inc

Journal website https://www.jofem.org

Original Article

Volume 11, Number 5, October 2021, pages 115-122

Evaluation of Visceral Adiposity Index and Vitamin D Status in Colon Cancer: Is Visceral Obesity the Missing Link?

**Table 1.** Baseline Characteristics of Study Groups
Variables	Patients group (n = 60)	Control group (n = 40)	Corrected P value
All values were provided as mean ± standard deviation (SD) or ratio. BMI: body mass index; FBS: fasting blood sugar; LDL-C: low-density lipoprotein cholesterol; HDL-C: high-density lipoprotein cholesterol; VAI: visceral adiposity index.
Age (years)	56.97 ± 5.58	56.78 ± 7.22	0.882
Gender, n (%)
Male	42 (70%)	26 (65%)	0.378
Female	18 (30%)	14 (35%)
Height (m)	1.69 ± 0.078	1.69 ± 0.0795	0.645
Weight (kg)	91.50 ± 16.9	89.7 ± 12.54	0.566
BMI (kg/m²)	32.15 ± 5.072	31.3 ± 3.764	0.849
Waist (cm)	112.42 ± 18.22	109.83 ± 16.0	0.467
FBS (mg/dL)	100.9 ± 9.78	98.5 ± 8.57	0.207
Total cholesterol (mg/dL)	241.97 ± 54.19	226.65 ± 38.34	0.125
LDL-C (mg/L)	148.95 ± 73.16	136.32 ± 59.51	0.188
HDL-C (mg/L)	44.2 ± 7.8	49.25 ± 8.45	0.003
Triglycerides (mg/dL)	244.08 ± 51.1	205.38 ± 39.062	0.006
VAI	3.92 ± 1.492	3.265 ± 1.099	0.019
25(OH) vitamin D	19.39 ± 9.297	24.1 ± 8.425	0.011
Vitamin D deficiency	32 (53.3%)	13 (32.5%)	0.032

Table 1. Baseline Characteristics of Study Groups

Variables

Patients group (n = 60)

Control group (n = 40)

Corrected P value

All values were provided as mean ± standard deviation (SD) or ratio. BMI: body mass index; FBS: fasting blood sugar; LDL-C: low-density lipoprotein cholesterol; HDL-C: high-density lipoprotein cholesterol; VAI: visceral adiposity index.

Age (years)

56.97 ± 5.58

56.78 ± 7.22

0.882

Gender, n (%)

Male

42 (70%)

26 (65%)

0.378

Female

18 (30%)

14 (35%)

Height (m)

1.69 ± 0.078

1.69 ± 0.0795

0.645

Weight (kg)

91.50 ± 16.9

89.7 ± 12.54

0.566

BMI (kg/m²)

32.15 ± 5.072

31.3 ± 3.764

0.849

Waist (cm)

112.42 ± 18.22

109.83 ± 16.0

0.467

FBS (mg/dL)

100.9 ± 9.78

98.5 ± 8.57

0.207

Total cholesterol (mg/dL)

241.97 ± 54.19

226.65 ± 38.34

0.125

LDL-C (mg/L)

148.95 ± 73.16

136.32 ± 59.51

0.188

HDL-C (mg/L)

44.2 ± 7.8

49.25 ± 8.45

0.003

Triglycerides (mg/dL)

244.08 ± 51.1

205.38 ± 39.062

0.006

VAI

3.92 ± 1.492

3.265 ± 1.099

0.019

25(OH) vitamin D

19.39 ± 9.297

24.1 ± 8.425

0.011

Vitamin D deficiency

32 (53.3%)

13 (32.5%)

0.032

**Table 2.** Significant Variables After Adjustment for Other Factors
Variables	Patients group (n = 60)	Control group (n = 40)	P value
All values were provided as mean ± standard error. Model 1: adjusted for age, BMI, and sex. Model 2: adjusted for age. Model 3: adjusted for BMI. Model 4: adjusted for sex. HDL-C: high-density lipoprotein cholesterol; TG: triglyceride; VAI: visceral adiposity index; 25(OH)D: 25-OH vitamin D; BMI: body mass index.
Model 1
HDL-C (mg/L)	44.2 ± 1.047	49.25 ± 1.282	0.012
TG (mg/dL)	243.939 ± 8.616	205.591 ± 10.552	0.002
VAI	3.925 ± 0.172	3.261 ± 0.21	0.009
25(OH)D	19.38 ± 1.154	24.14 ± 1.413	0.019
Model 2
HDL-C (mg/L)	44.19 ± 1.043	49.263 ± 1.28	0.008
TG (mg/dL)	244.088 ± 8.83	205.367 ± 10.82	0.025
VAI	3.925 ± 0.17	3.262 ± 0.21	0.031
25(OH)D	19.39 ± 1.16	24.128 ± 1.42	0.040
Model 3
HDL-C (mg/L)	44.353 ± 1.014	49.021 ± 1.242	0.002
TG (mg/dL)	242.912 ± 8.603	207.131 ± 10.546	0.001
VAI	3.879 ± 0.158	3.331 ± 0.193	0.001
25(OH)D	19.455 ± 1.159	24.031 ± 1.421	0.026
Model 4
HDL-C (mg/L)	44.232 ± 1.04	49.202 ± 1.28	0.008
TG (mg/dL)	243.204 ± 8.418	206.694 ± 10.313	0.001
VAI	3.928 ± 0.174	3.256 ± 0.214	0.040
25(OH)D	19.354 ± 1.158	24.182 ± 1.418	0.052

Table 2. Significant Variables After Adjustment for Other Factors

Variables

Patients group (n = 60)

Control group (n = 40)

P value

All values were provided as mean ± standard error. Model 1: adjusted for age, BMI, and sex. Model 2: adjusted for age. Model 3: adjusted for BMI. Model 4: adjusted for sex. HDL-C: high-density lipoprotein cholesterol; TG: triglyceride; VAI: visceral adiposity index; 25(OH)D: 25-OH vitamin D; BMI: body mass index.

Model 1

HDL-C (mg/L)

44.2 ± 1.047

49.25 ± 1.282

0.012

TG (mg/dL)

243.939 ± 8.616

205.591 ± 10.552

0.002

VAI

3.925 ± 0.172

3.261 ± 0.21

0.009

25(OH)D

19.38 ± 1.154

24.14 ± 1.413

0.019

Model 2

HDL-C (mg/L)

44.19 ± 1.043

49.263 ± 1.28

0.008

TG (mg/dL)

244.088 ± 8.83

205.367 ± 10.82

0.025

VAI

3.925 ± 0.17

3.262 ± 0.21

0.031

25(OH)D

19.39 ± 1.16

24.128 ± 1.42

0.040

Model 3

HDL-C (mg/L)

44.353 ± 1.014

49.021 ± 1.242

0.002

TG (mg/dL)

242.912 ± 8.603

207.131 ± 10.546

0.001

VAI

3.879 ± 0.158

3.331 ± 0.193

0.001

25(OH)D

19.455 ± 1.159

24.031 ± 1.421

0.026

Model 4

HDL-C (mg/L)

44.232 ± 1.04

49.202 ± 1.28

0.008

TG (mg/dL)

243.204 ± 8.418

206.694 ± 10.313

0.001

VAI

3.928 ± 0.174

3.256 ± 0.214

0.040

25(OH)D

19.354 ± 1.158

24.182 ± 1.418

0.052

**Table 3.** Comparison Between Non-Deficient Vitamin D Levels Versus Deficient Vitamin D Patients in Colon Cancer Group
Variables	Non-deficient vitamin D (25 (OH) D > 20.00) (n = 32)	Deficient vitamin D (25 (OH) D < 20.00) (n = 28)	P value
All values were provided as mean ± standard deviation (SD) or ratio. 25(OH) D: 25-OH vitamin D; BMI: body mass index; HDL-C: high-density lipoprotein cholesterol; LDL: low-density lipoprotein cholesterol; VAI: visceral adiposity index; FBS: fasting blood sugar.
Age (years)	57.93 ± 4.37	56.13 ± 6.41	0.215
Gender
Male	22 (68.8%)	20 (71.4%)	0.5
Female	10 (31.2%)	8 (28.6%)
BMI (kg/m²)	32.12 ± 4.869	32.18 ± 5.32	0.968
Height (m)	1.68 ± 0.0633	1.689 ± 0.09	0.671
Weight (kg)	90.89 ± 15.53	92.03 ± 18.25	0.797
Waist (cm)	109.71 ± 15.9	114.78 ± 19.96	0.286
Total cholesterol (mg/L)	242.82 ± 52.6	241.22 ± 56.36	0.91
LDL-C (mg/L)	150.64 ± 48.27	147.47 ± 54.18	0.813
HDL-C (mg/dL)	45.36 ± 9.6	43.19 ± 5.78	0.303
Triglycerides (mg/dL)	234.11 ± 75.59	252.81 ± 71.0	0.327
VAI	3.475 ± 0.989	4.31 ± 1.75	0.029
FBS (mg/dL)	101.79 ± 9.82	100.156 ± 9.85	0.525

Table 3. Comparison Between Non-Deficient Vitamin D Levels Versus Deficient Vitamin D Patients in Colon Cancer Group

Variables

Non-deficient vitamin D (25 (OH) D > 20.00) (n = 32)

Deficient vitamin D (25 (OH) D < 20.00) (n = 28)

P value

All values were provided as mean ± standard deviation (SD) or ratio. 25(OH) D: 25-OH vitamin D; BMI: body mass index; HDL-C: high-density lipoprotein cholesterol; LDL: low-density lipoprotein cholesterol; VAI: visceral adiposity index; FBS: fasting blood sugar.

Age (years)

57.93 ± 4.37

56.13 ± 6.41

0.215

Gender

Male

22 (68.8%)

20 (71.4%)

0.5

Female

10 (31.2%)

8 (28.6%)

BMI (kg/m²)

32.12 ± 4.869

32.18 ± 5.32

0.968

Height (m)

1.68 ± 0.0633

1.689 ± 0.09

0.671

Weight (kg)

90.89 ± 15.53

92.03 ± 18.25

0.797

Waist (cm)

109.71 ± 15.9

114.78 ± 19.96

0.286

Total cholesterol (mg/L)

242.82 ± 52.6

241.22 ± 56.36

0.91

LDL-C (mg/L)

150.64 ± 48.27

147.47 ± 54.18

0.813

HDL-C (mg/dL)

45.36 ± 9.6

43.19 ± 5.78

0.303

Triglycerides (mg/dL)

234.11 ± 75.59

252.81 ± 71.0

0.327

VAI

3.475 ± 0.989

4.31 ± 1.75

0.029

FBS (mg/dL)

101.79 ± 9.82

100.156 ± 9.85

0.525

**Table 4.** Tumor Characteristics in Patients’ Group (N = 60)
Variables	N (%)
LVI: lymphovascular invasion; PNI: perineural invasion.
TNM stage
I	10 (16.7 %)
II	13 (21.7%)
III	23 (38.3%)
IV	14 (23.3%)
Nodal staging
N0	19 (31.65%)
N1	22 (36.7%)
N2	19 (31.65%)
Pathology type
Adenocarcinoma	41 (68.3%)
Mucoid type	12 (20%)
Signet ring type	7 (11.7%)
LVI/PNI
Negative	14 (61.7%)
Positive	37 (23.3%)
Unknown	9 (15%)
Site of tumor
Right	23 (38.3%)
Left	22 (36.7%)
Transverse	11 (6.7%)
Sigmoid	4 (18.3%)

Table 4. Tumor Characteristics in Patients’ Group (N = 60)

Variables

N (%)

LVI: lymphovascular invasion; PNI: perineural invasion.

TNM stage

10 (16.7 %)

13 (21.7%)

III

23 (38.3%)

14 (23.3%)

Nodal staging

19 (31.65%)

22 (36.7%)

19 (31.65%)

Pathology type

Adenocarcinoma

41 (68.3%)

Mucoid type

12 (20%)

Signet ring type

7 (11.7%)

LVI/PNI

Negative

14 (61.7%)

Positive

37 (23.3%)

Unknown

9 (15%)

Site of tumor

Right

23 (38.3%)

Left

22 (36.7%)

Transverse

11 (6.7%)

Sigmoid

4 (18.3%)

**Table 5.** Comparison of Tumor Characteristics in Relation to 25-OH Vitamin D Level, BMI and VAI
Variables	Vitamin D level	BMI	VAI
BMI: body mass index; VAI: visceral adiposity index; LVI: lymphovascular invasion; PNI: perineural invasion.
TNM stage
I-II	23.17 ± 9.12	30.91 ± 3.7	3.29 ± 1.09
III	18.13 ± 8.85	34.1 ± 6.23	4.27 ± 1.3
IV	15.25 ± 8.51	30.96 ± 4.01	4.36 ± 2.01
P value	0.027	0.058	0.031
Nodal staging
N0	21.684 ± 10.199	30.61 ± 3.33	3.43 ± 1.1
N1	19.522 ± 10.2	33.88 ± 5.47	4.37 ± 1.67
N2	16.947 ± 6.79	31.69 ± 5.65	3.89 ± 1.59
P value	0.295	0.106	0.131
Pathology type
Adenocarcinoma	19.37 ± 9.385	31.8350 ± 4.91	3.778 ± 1.352
Mucoid type	17.67 ± 8.731	33.0264 ± 6.89	4.547 ± 1.983
Signet ring type	22.428 ± 10.31	32.5078 ± 1.7	3.693 ± 1.236
P value	0.568	0.765	0.27
LVI/PNI
Negative	15.5 ± 9.4	32.88 ± 4.196	3.81 ± 1.381
Positive	20.5 ± 8.981	32.49 ± 5.731	4.01 ± 1.613
Unknown	20.89 ± 9.8	29.61 ± 2.127	3.73 ± 1.233
P value	0.203	0.260	0.842
Site of tumor
Right	20.695 ± 10.41	32.89 ± 5.18	4.14 ± 1.46
Left	19.18 ± 9.032	32.6 ± 5.69	3.89 ± 1.46
Transverses	19.41 ± 8.24	30.09 ± 3.71	3.55 ± 1.87
Sigmoid	13.0 ± 6.32	31.11 ± 3.81	3.91 ± 0.849
P value	0.512	0.46	0.761

Table 5. Comparison of Tumor Characteristics in Relation to 25-OH Vitamin D Level, BMI and VAI

Variables

Vitamin D level

BMI

VAI

Normal vs. abnormal

BMI: body mass index; VAI: visceral adiposity index; LVI: lymphovascular invasion; PNI: perineural invasion.

TNM stage

I-II

23.17 ± 9.12

30.91 ± 3.7

3.29 ± 1.09

III

18.13 ± 8.85

34.1 ± 6.23

4.27 ± 1.3

15.25 ± 8.51

30.96 ± 4.01

4.36 ± 2.01

P value

0.027

0.058

0.031

Nodal staging

21.684 ± 10.199

30.61 ± 3.33

3.43 ± 1.1

19.522 ± 10.2

33.88 ± 5.47

4.37 ± 1.67

16.947 ± 6.79

31.69 ± 5.65

3.89 ± 1.59

P value

0.295

0.106

0.131

Pathology type

Adenocarcinoma

19.37 ± 9.385

31.8350 ± 4.91

3.778 ± 1.352

Mucoid type

17.67 ± 8.731

33.0264 ± 6.89

4.547 ± 1.983

Signet ring type

22.428 ± 10.31

32.5078 ± 1.7

3.693 ± 1.236

P value

0.568

0.765

0.27

LVI/PNI

Negative

15.5 ± 9.4

32.88 ± 4.196

3.81 ± 1.381

Positive

20.5 ± 8.981

32.49 ± 5.731

4.01 ± 1.613

Unknown

20.89 ± 9.8

29.61 ± 2.127

3.73 ± 1.233

P value

0.203

0.260

0.842

Site of tumor

Right

20.695 ± 10.41

32.89 ± 5.18

4.14 ± 1.46

Left

19.18 ± 9.032

32.6 ± 5.69

3.89 ± 1.46

Transverses

19.41 ± 8.24

30.09 ± 3.71

3.55 ± 1.87

Sigmoid

13.0 ± 6.32

31.11 ± 3.81

3.91 ± 0.849

P value

0.512

0.46

0.761