Background: Vitamin D is a pleiotropic hormone the deficiency of which is related with extraskeletal manifestations such as insulin resistance and cardiovascular risk disease.
Objective and hypotheses: To investigate the levels of VitaminD in a sample of children with obesity and to evaluate the relationship between carbohydrate metabolism and metabolic syndrome (MS).
Method: In this prospective cross-sectional study, 189 children aged 514 years, with BMI>2SD, were evaluated from 1 January 2012 to 31 May 2015. Anthropometric data used: weight, height, BMI, abdominal circumference and blood pressure. Serum 25-hydroxyvit D, was measured. For lipid metabolism, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and triglyceride levels were determined. For glucose metabolism, fasting plasma glucose levels and insulin were measured after 12 h of fasting performing an oral glucose tolerance test. Serum 25-hydroxyvit D levels were considered: appropriate values >30 ng/dl, deficiency <29 ng/dl and insufficiency levels <20 ng/dl. Classification of MS was accordance with that of the International Diabetes Federation. A multiple regression analysis was performed.
Results: A total of 189 patients were included (48% male; 33.4% prepubertal), with a mean age 11.1 years (CI 9.812.5). 36 patients presented within MS (21%). We found higher incidence of deficiency and insufficiency VitD levels in pubertal children than in prepubertal (25 and 48% vs. 10 and 26% respectively) P<0.001. Prepubertal children (50%) presented HOMA>2.5 and pubertal children (73.4%) within HOMA> 3 was found (P<0.05). 78% of children with VitD insufficiency presented HOMA> 3 and only 22% had HOMA<3 (P=0.0001). 15% of patients with at least three criteria of MS (36/169), had levels of 25-hydroxyvit D >30 ng/dl. We found a negative correlation between HOMA and 25-hydroxyvit D among prepubertal and pubertal children (P=0.01).
Conclusion: Our data support that serum 25-hydroxyvit D level may be inversely associated with insulin resistance. Also patients within MS criteria have significantly lower levels of 25-hydroxyvit D.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology