Body Mass Index is a Strong Predictor of Vitamin D Deficiency in Multiethnic Obese Children

Abstract

CitationKannan S, Visintainer P, Ganguri HB, Conroy R, Gudala M, Wittcopp C. The main objective of this study is to determine predictors of vitamin D deficiency in obese children. Methods: Children aged 5-14 years with body mass index z-score (BMIZ)>95% were enrolled. Data included height, weight, ethnicity, season, dietary intake, serum 25-hydroxy vitamin D test: (25(OH)D), parathyroid hormone, calcium, insulin, glucose, high sensitivity C-reactive protein (CRP), lipids, aspartate aminotransferase (AST), alanine transaminase (ALT) and waist circumference. BMIZ calculation in children was categorized into ≥2.5 (high) and <2.5 (low). Serum 25(OH)D levels were dichotomized as <20 ng/mL (deficient) or ≥20 ng/mL (sufficient). Results: Ninety-one children completed the study. Mean BMIZ was 31.3±6.3 kg/m 2 . Mean 25(OH)D level was 21.2±7.6 ng/mL. A base logistic regression model showed odds of a deficient 25(OH)D was more than 3-times higher in children with a high BMIZ (OR: 3.35, 95% CI: 1.07-10.43). African-American children were more likely than Caucasian children to have low 25(OH)D (OR: 6.68, 95% CI: 1.31-36.13). Children enrolled in seasons other than winter were less likely to have a low 25(OH)D. Adjustment for nutrients and serum cardiovascular disease risk markers did not significantly alter the relationship between low 25(OH)D and BMIZ. Conclusions: The risk for vitamin D deficiency increases in children with severe obesity (BMIZ≥2.5 SD) and does not significantly change by season, ethnicity, nutrient intake, or cardiovascular disease risk parameters.

Tipping the Balance: Vitamin D Inadequacy in Children Impacts the Major Gut Bacterial Phyla

“…Our univariate analysis showed that vitamin D deficient children showed higher BMI compared to non-deficient (Table 1, Supplementary Figure S6), suggesting that overweight children are at significantly greater risk of vitamin D inadequacy. Additionally, the multivariate regression analysis demonstrated that BMI z scores were inversely related to vitamin D levels; these data were consistent with numerous studies demonstrating that BMI z scores are strong predictors of vitamin D levels, especially in children [114][115][116][117][118][119]. This reduction in the levels of serum 25(OH)D coinciding with an increase in BMI z scores may be due to volumetric dilution of vitamin D in the large adipose stores or excess sequestration of vitamin D in fat, leading to decreased bioavailability [115].…”

Current Evidence on Vitamin D Deficiency and Metabolic Syndrome in Obese Children: What Does the Evidence from Saudi Arabia Tell Us?

“…For example, increased use of TV, video or computers [ 37 , 38 , 39 ], less physical activity [ 33 , 38 , 39 , 40 , 41 , 42 , 43 ], low sun exposure [ 33 , 41 , 42 , 43 , 44 ], low levels of milk consumption [ 33 , 37 , 43 , 45 ] and high levels of soft drink consumption [ 45 ] can increase the risk of developing vitamin D deficiency in children aged 1–18 years. At age 6–16 years, children were vitamin D deficient in spring and winter [ 35 , 36 , 39 , 41 , 46 , 47 , 48 ] and girls were found to be more vitamin D deficient than boys [ 33 , 34 , 36 , 37 , 48 , 49 , 50 ]. Low vitamin D status is a significant concern in children aged 3–18 years from some racial/ethnic minorities and urban communities in USA, Central and Western Europe, Southern Asia and Eastern Africa [ 39 , 40 , 41 , 44 , 45 , 47 , 48 , 50 ].…”

“…At age 6–16 years, children were vitamin D deficient in spring and winter [ 35 , 36 , 39 , 41 , 46 , 47 , 48 ] and girls were found to be more vitamin D deficient than boys [ 33 , 34 , 36 , 37 , 48 , 49 , 50 ]. Low vitamin D status is a significant concern in children aged 3–18 years from some racial/ethnic minorities and urban communities in USA, Central and Western Europe, Southern Asia and Eastern Africa [ 39 , 40 , 41 , 44 , 45 , 47 , 48 , 50 ].…”

“…A growing body of epidemiological studies suggests an association between vitamin D deficiency and obesity in children and adolescents [ 12 , 14 , 15 , 38 , 41 , 44 , 47 , 48 ]. However, the causality of the association has been uncertain.…”

Obesity and Micronutrient Disbalance in Children

“…Результаты ряда эпидемиологических исследований предполагают связь между дефицитом VD и ожирением у детей и подростков [22][23]. Однако, несмотря на полученные данные, патогенетические механизмы их взаимного влияния остаются изученными не достаточно [24].…”