Abdominal obesity is an independent predictor of serum 25-hydroxyvitamin D deficiency in adults with cerebral palsy

Abstract

BackgroundIndividuals with cerebral palsy (CP) are at risk for nutritional insufficiency. The purpose of the study was to examine the vitamin D status of adults with CP, and to evaluate the association between vitamin D and functional level, age, race, and anthropometric indicators of adiposity.MethodsSerum vitamin D levels, BMI, waist circumference (WC), and functional level (measured by Gross Motor Function Classification System (GMFCS)) were examined in 112 adults with CP. Vitamin D status was assessed by serum 25-hydroxyvitamin D level (25(OH)D). The influence of motor impairment and adiposity on 25(OH)D were assessed using general linear modeling and logistic regression, with age, sex, race, and season as covariates.ResultsMean vitamin D was 28.1 ± 16.0 ng/ml. Only 45% of subjects had optimal levels of 25(OH)D, 21% were insufficient and 34% were deficient. Overweight or obesity was prevalent (52%), as was abdominal obesity in men (23.5% at 102 cm cutoff) and women (31.1% at 88 cm cutoff). There was a robust association between the indicator of visceral adiposity (WC) and 25(OH)D level (p <0.001), even after controlling for age, sex, race, season, and GMFCS. According to sex-specific WC cutoffs, the odds of being deficient in vitamin D increase by a factor of 3.5 (95% CI 1.12-11.0) for abdominal obesity. GMFCS was not associated with 25(OH)D.ConclusionsAdults with CP are at risk for low vitamin D levels and overweight/obesity. Waist circumference is a strong independent predictor for low vitamin D levels.

Cardiovascular disease and related risk factors in adults with cerebral palsy: a systematic review

“…Furthermore, in this study, presence of obesity based on both BMI and waist circumference was greater among participants who were in GMFCS levels III to V than those who were in GMFCS levels I to II. Approximately 52 percent of 112 adults with CP were overweight as discovered by Peterson et al . Of those, 23.5 percent were classified as obese.…”

“…In regard to risk factors of CVD, hypertension was noted within the literature pertaining to adults with CP. However, other risk factors of CVD such as overweight and obesity were addressed most frequently and may be of concern in this population . Of the limited evidence gathered from this review, inconsistent results and inconsistent use of outcome measures make it challenging to discern whether or not the prevalence of overweight/obesity is greater in adults with CP in comparison to the general population.…”

“…Many of the studies included data on risk factors of CVD, particularly overweight/obesity. Twelve studies reported percentages of individuals with CP that were either overweight or obese based on BMI within their respective sample size . One study reported sex differences for percent body fat in adults with CP and included percentages of those who were above clinical cut‐offs (i.e.…”

The Apparent Relation between Plasma 25-Hydroxyvitamin D and Insulin Resistance Is Largely Attributable to Central Adiposity in Overweight and Obese Adults

“…BMI is a widely used measurement of adiposity and is often used to account for the confounding effects of obesity on nutrientdisease relations (25). However, more sensitive measures of adiposity obtained via DXA, CT, or MRI have shown that central adiposity (i.e., visceral fat) is a strong predictor of vitamin D status independent of age, sex, race, season, dietary intake, BMI status, and even UVB exposure (24,26,43,48,49). These results show that a direct relation exists between body fat distribution and plasma 25(OH)D concentrations.…”

Determinants of muscle preservation in individuals with cerebral palsy across the lifespan: a narrative review of the literature

“…It can therefore be assumed that vitamin D deficiency is common in this population. Moreover, in a recent study with CP adults, more than 50% were either vitamin D insufficient or deficient, and abdominal adiposity was a strong independent predictor for low vitamin D levels …”