Hypovitaminosis D and Cardiometabolic Risk Factors in Adolescents with Severe Obesity

Abstract

Background/Objectives. Obesity is associated with cardiometabolic risk factors and with Vitamin D deficiency. The aim of this study was to examine the relationship between 25(OH)D concentrations and cardiometabolic risk factors in adolescents with severe obesity. Subjects/Methods. A cross-sectional clinical assessment (body mass index, fat mass index, fat-free mass index, waist-to-height ratio, and blood pressure) and metabolic study (triglycerides, total cholesterol, HDL-C, LDL-C, glucose, insulin, HOMA-IR, leptin, calcium, phosphorous, calcidiol, and PTH) were carried out in 236 adolescents diagnosed with severe obesity (BMI z-score > 3.0, 99th percentile), aged 10.2-15.8 years. The criteria of the US Endocrine Society were used for the definition of Vitamin D status. Results. Subjects with Vitamin D deficiency had significantly elevated values (p < 0.05) for BMI z-score, waist circumference, waist z-score, body fat percentage, fat mass index, systolic and diastolic blood pressure, total cholesterol, triglycerides, LDL-C, insulin, HOMA-IR, leptin, and PTH than subjects with normal Vitamin D status. There was a significant negative correlation (p < 0.05) of serum 25(OH)D levels with body fat percentage, FMI, systolic BP, total cholesterol, triglyceride, LDL-C, glucose, insulin, HOMA-IR, leptin, and PTH. Conclusions. Low Vitamin D levels in adolescents with severe obesity were significantly associated with some cardiometabolic risk factors, including body mass index, waist circumference, fat mass index, high blood pressure, impaired lipid profile, and insulin resistance.

The association between vitamin D status and cardiometabolic disorders in overweight and obese adolescents

“…There were significant correlations between 25(OH)D levels and the basal insulin level (r = -0.483; P < 0.001) and HOMA-IR (r = -0.454; P < 0.001) in overweight and obese adolescents, as determined by Spearman correlations. Our data confirm the results of studies by researchers in other countries concerning the correlations of serum 25(OH)D levels with insulin and HOMA-IR [39], but in our study, there was no correlation between 25(OH)D levels and blood glucose.…”

Vitamin D status and blood pressure in children and adolescents: a systematic review of observational studies

“…The included studies were published between 2007 [ 95 ] and 2020 [ 47 , 57 , 82 , 92 , 105 ]. The majority of the studies were conducted in the Americas (USA, n = 23 [ 15 , 33 , 34 , 36 , 37 , 40 , 43 , 65 , 66 , 69 , 75 , 79 – 81 , 84 , 86 , 91 , 92 , 95 , 100 , 103 , 107 ]; Latin America, n = 9 [ 53 – 56 , 74 , 83 , 96 – 98 ]; Canada, n = 1 [ 71 ]), followed by Asia ( n = 33) [ 14 , 28 – 32 , 35 , 38 , 39 , 44 , 48 – 50 , 57 – 59 , 61 – 64 , 67 , 68 , 70 , 72 , 73 , 76 – 78 , 88 , 90 , 105 , 106 , 109 ], Europe ( n = 14) [ 42 , 45 – 47 , 51 , 82 , 85 ...…”

“…Twelve studies [ 15 , 61 , 64 , 65 , 68 , 75 , 77 – 79 , 91 , 100 , 105 ] included nationally representative samples. Twenty studies included obese/overweight participants [ 16 , 33 , 34 , 37 , 38 , 41 , 47 , 49 , 62 , 69 , 71 , 84 , 88 , 89 , 95 , 96 , 98 , 103 , 104 , 107 ]; one study [ 43 ] included children with multiple, modifiable atherosclerosis-promoting risk factors; one [ 79 ] was conducted on youth with type 1 diabetes. Only one study [ 93 ] recruited children and adolescents with primary hypertension, and only one [ 35 ] included healthy children with vitamin D deficiency.…”

“…Among the 36 studies [ 27 – 34 , 38 – 41 , 43 , 44 , 47 , 49 , 51 , 52 , 59 , 63 , 66 , 69 , 71 – 73 , 77 , 81 , 88 , 89 , 92 , 93 , 95 , 96 , 98 , 104 , 108 , 109 ] that did not adjust for potential confounders, ten [ 28 , 29 , 31 , 47 , 73 , 89 , 92 , 95 , 98 , 109 ] found a significant inverse association between vitamin D and SBP (of which three [ 29 , 31 , 109 ] in boys only), while the majority ( n = 25) [ 30 , 32 – 34 , 38 – 41 , 43 , 44 , 49 , 51 , 52 , 59 , 63 , 66 , 69 , 71 , 72 , 77 , 78 , 88 , 93 , 104 , 108 ] did not report such findings. Regarding the relationship between vitamin D and DBP, twelve [ 28 – 32…”

“…Regarding the relationship between vitamin D and DBP, twelve [ 28 – 32 , 47 , 73 , 77 , 98 , 104 , 108 , 109 ] found a significant inverse association (of which two [ 31 , 109 ] in boys only), whereas most of the studies ( n = 21) [ 33 , 34 , 38 – 41 , 44 , 49 , 51 , 52 , 59 , 63 , 66 , 69 , 71 , 72 , 81 , 88 , 89 , 92 , 93 ] did not. Regarding hypertension, three studies [ 47 , 98 , 104 ] found higher prevalence with poorer vitamin D status. In contrast, two studies [ 49 , 96 ] did not report any relationship between vitamin D and hypertension status.…”