The role of vitamin D in calcium and bone metabolism is well established. Today, vitamin D deficiency is a pandemic and has been implicated in several diseases including Cardio Vascular morbidity and mortality and metabolic syndrome.
The association between vitamin D insufficiency and obesity has been extensively investigated in adults. The high rates of excessive body weight and obesity observed worldwide and vitamin D insufficiency are closely interrelated problems of today's medicine that indicate a pandemic and have deleterious health effects in large patient population

vitamin D deficiency seems to promote the development of a more proatherogenic cardiometabolic risk profile in the obese as well in persons with increased fat mass. Excessive body weight results in accumulation of adipose tissue, impaired adipocyte function, development of adipocyte hypertrophy, and an altered adipokine secretion profile. These changes result in migration and transformation of macrophages and in the development of adipose tissue inflammation.

Vitamin D insufficiency and excessive fat accumulation have mutually negative effects as a result of excessive metabolic processes, enzymatic disorders against a background of decreased activity of alpha-hydroxylase, the key enzyme in the biotransformation of calciferol in a fat-infiltrated liver, resulting in accumulation of inactive forms and decreased bioavailability of vitamin D. Vitamin D insufficiency also leads to elevated parathyroid hormone concentrations, decreased insulin sensitivity, activated lipogenesis, and an increase in fat mass.

Therefore, the influence of adipose tissue on the metabolism of vitamin D, on the one hand, and its pathogenic role in the obesity development mechanisms, on the other hand, are closely interrelated and represent mutually dependent processes.

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