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Teen obesity strongly associated with vitamin D deficiency – April 2012

Serum 25-hydroxyvitamin D (25-OH-D) in obese adolescents.

Endokrynol Pol. 2011;62(6):506-11.
Garanty-Bogacka B, Syrenicz M, Goral J, Krupa B, Syrenicz J, Walczak M, Syrenicz A.
Independent Laboratory of Propaedeutics of Children’s Diseases, Pomeranian Medical University, Szczecin, Poland. propedeutyka1 at wp.pl

BACKGROUND:
There is increasing evidence that vitamin D deficiency is common and has been associated with several non-bone related outcomes, including insulin resistance, type 2 diabetes and cardiovascular disease. The influences of gender, puberty, and adiposity on serum hydroxyvitamin D (25-OH-D) levels and the relationship between 25-OH-D and insulin resistance in obese children were studied.

MATERIAL AND METHODS:
Age, gender, pubertal stage, weight status (standard deviation score of body mass index: BMI-SDS, percentage body fat, waist circumference), 25-OH-D levels, and insulin resistance index calculated by homeostasis model assessment (HOMA-IR) were evaluated in 64 obese adolescents. Multivariable linear regression was used to determine factors associated with decreased serum 25-OH-D levels and to study the relationship between 25-OH-D and HOMA-IR.

RESULTS:
Median serum 25-OH-D level was 10.1 ng/mL (25.2 nmol/L).

  • 14% of patients were vitamin D-sufficient (25-OH-D ? 20 ng/mL),
  • 36% had intermediate values (11-19 ng/mL), and
  • 50% were deficient (25-OH-D ? 10 ng/mL).

In the multivariable model, older age, puberty, higher value of percentage of body fat, and the presence of acanthosis nigricans (AN) were all negatively associated with 25-OH-D. Lower 25-OH-D levels were also associated with higher blood glucose, insulin and HOMA-IR after adjustment for puberty and SDS-BMI. Summer positively correlated with 25-OH-D level.

CONCLUSION:
Our study confirms that obesity is a risk factor for vitamin D deficiency. Hypovitaminosis D, common in obese adolescents at risk for type 2 diabetes (older age, puberty, acanthosis nigricans) is associated with worse insulin resistance.

PMID: 22144216

Table extracted from PDF file at the bottom of this page

The lower the value of p, the more probable the association.
p = 0 is extremely probable

untitled
Endokrynologia Polska/Polish Journal of Endocrinology 2011; 62 (6)
Table III. Clinical and biochemical characteristics of subjects based on vitamin D status
Tabela III. Kliniczna i biochemiczna charakterystyka grupy badanej w zaleznosci od stezenia witaminy D w surowicy
Sufficient > 20 ng/mL
Insufficient < 20 ng/mL
Deficient < 10 ng/ml
p value
n (%)
9 (14)
23 (36)
32 (50)
Age, years (mean ± SD)
13.3 ± 2.5
14.8 ± 1.6
16.2 ± 2.3
0.025
Studied in winter, n (%)
1 (4)
9 (36)
16 (60)
0.078
Male/female, n (%)
7(21) / 2(7)
10(30) / 13(42)
16(49) /16(51)
0.450
Body mass, kg (mean ± SD)
67.5 ± 15.4
81.4 ± 15.6
87.8 ± 20.6
0.017
BMI-SDS (mean ± SD)
2.9 ± 0.6
3.5 ± 1.3
4.1 ± 1.7
0.086
Percentage of fat (mean ± SD)
29.3 ± 4.2
32.6 ± 4.3
36.9 ± 4.1
0.000
Waist-SDS [cm] (mean ± SD)
2.7 ± 1.0
3.4 ± 1.3
4.7 ± 1.7
0.001
Acanthosis nigricans, n (%)
1 (3)
5 (15)
27 (82)
0.000
SBP [mm Hg] (mean ± SD)
114.8 ± 8.2
119.4 ± 10.3
127.7 ± 8.9
0.000
DBP [mm Hg] (mean ± SD)
70.4 ± 8.3
74.4 ± 10.0
84.5 ± 8.9
0.000
25-OH-D [ng/mL] (mean ± SD)
24.1 ± 1.9
14.1 ± 2.9
6.8 ± 1.7
0.000
Glucose [mmol/L] (mean ± SD)
5.1 ± 0.2
5.3 ± 0.4
5.3 ± 0.4
0.286
Insulin [uU/mL] (mean ± SD)
13.5 ± 5.4
13.8 ± 5.5
25.7 ± 9.9
0.000
HOMA-IR median (min, max)
3.0 ± 1.3
3.1 ± 1.4
5.9 ± 2.2
0.000
HbA1c (%) (mean ± SD)
5.3 ± 0.2
5.4 ± 0.3
5.7 ± 0.3
0.000
T-chol [mg/dL] (mean ± SD)
159.2 ± 38.5
168.7 ± 24.5
183.2 ± 21.0
0.019
HDL-chol [mg/dL] (mean ± SD)
50.8 ± 9.1
54.2 ± 9.2
41.2 ± 9.2
0.000
LDL-chol [mg/dL] (mean ± SD)
87.6 ± 37.2
95.7 ± 45.4
113.0 ± 27.2
0.027
TG, mg/dL [mg/mL] (mean ± SD)
71.4 ± 38.7
93.7 ± 45.4
162.4 ± 43.0
0.003
(Table III).
Table III displays differences in clinical characteristics and results of biochemical investigations by vitamin D status.
The risk of vitamin D deficiency/insufficiency was greater in winter (25/26) than in summer (30/38; p = 0.078). Sex was not associated with vitamin D sta­tus, although boys had higher mean serum 25-OH-D levels compared to girls (13.3 ± 7.2 vs. 10.4 ± 5.4 ng/mL; p = 0.07; data not shown). Pubertal stage (2-5 accord­ing to Tanner's scale) was not associated with vitamin D status (p = 0.126; data not shown).
Both vitamin D deficiency and insufficiency were associated with higher body mass, (but not with BMI-SDS), higher content of fat tissue, greater waist cir­cumference (waist-SDS), and the presence of acanthosis nigricans, which was found in 97% of vitamin D deficient / insufficient patients. Adolescents with vitamin D defi-
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See also VitaminDWiki

See also VitaminDWiki - Body Mass Index

Attached files

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