Ann Pediatr Endocrinol Metab.  2022 Jun;27(2):113-120. 10.6065/apem.2142158.079.

The association between vitamin D deficiency and metabolic syndrome in Ukrainian adolescents with overweight and obesity

Affiliations
  • 1Department of Pediatrics № 2, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
  • 2Department of Children’s Diseases with Pediatric Surgery, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine

Abstract

Purpose
This work aims to determine the association between vitamin D deficiency and metabolic syndrome in overweight and obese adolescents from Ukraine.
Methods
Anthropometric measurements were taken and general and biochemical examinations were performed on 136 obese and overweight adolescents and 60 adolescents with normal body weight. The vitamin D status was determined using 25-hydroxyvitamin D (25(OH)D) (calcidiol) levels in blood serum. To establish the factors influencing vitamin D status, the subjects were asked to answer a questionnaire and 2007 International Diabetes Federation diagnostic criteria were used to determine the incidence of metabolic syndrome. All research results were processed statistically.
Results
A calcidiol sufficiency level was found in 3.9% of obese adolescents and 6.7% of overweight adolescents. Metabolic syndrome was found in 64.4% of obese adolescents with vitamin D deficiency, and in 26.2% of overweight adolescents. Factors associated with an increased risk of developing vitamin D deficiency in adolescents with metabolic syndrome included male sex (p=0.042), low income per family member (p=0.040), daily milk consumption of up to 1 cup per day (p=0.001), physical activity (p=0.001), duration of outdoor stays (p=0.001), and passive rest in front of a computer or television (p=0.001). Adolescents with metabolic syndrome were found predominance of body mass index (p<0.001), waist circumference (p<0.001), fasting blood glucose level (Р<0.001), and decreased calcidiol level (p=0.022). Among metabolic syndrome components, vitamin D deficiency was strongly associated with waist circumference and increased fasting blood glucose (p<0.05).
Conclusion
Vitamin D deficiency is prevalent in overweight and obese adolescents from Ukraine. Vitamin D deficiency is associated with metabolic syndrome criteria in overweight and obese adolescents.

Keyword

Vitamin D; Adolescents; Overweight; Obesity; Metabolic syndrome

Reference

References

1. Holik MF. The vitamin D deficiency pandemic: Approaches for diagnosis, treatment and prevention. Rev Endocr Metab Disord. 2017; 18:153–65.
2. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011; 96:1911–30.
3. Drapkina O, Shepel R. Pleiotropic effects of vitamin D. Ration Pharmacother Cardiol. 2016; 12:227–32.
4. Wacker M, Holick M. Vitamin D - effects on skeletal and extraskeletal health and the need for supplementation. Nutrients. 2013; 5:111–48.
5. Holick MF. Vitamin D: evolutionary, physiological and health perspectives. Curr Drug Targets. 2011; 12:4–18.
6. Koundourakis NE, Margioris AN. Vitamin D and physical activity. In : Gowder SJT, editor. A critical evaluation of vitamin D - basic overview. London: InTechOpen;2017. p. 3–46.
7. Oberg J, Jorde R, Almas B, Emaus N, Grimnes G. Vitamin D deficiency and lifestyle risk factors in a Norwegian adolescent population. Scand J Public Health. 2014; 42:593–602.
8. Shulhai AMA, Pavlyshyn HA, Shulhai OM. Peculiarities of the prevalence and risk factors for vitamin D deficiency in overweight and obese adolescents in Ukraine. Arch Balk Med Union. 2019; 54:57–63.
9. Chlebna-Sokol D, Konstantynowicz J, Abramowicz P, Kulik-Rechberger B, Niedziela M, Obuchowicz A, et al. Evidence of a significant vitamin D deficiency among 9-13-year-old Polish children: results of a multicentre study. Eur J Nutr. 2019; 58:2029–36.
10. Hintzpeter B, Scheidt-Nave C, Muller MJ, Schenk L, Mensink GB. Higher prevalence of vitamin D deficiency is associated with immigrant background among children and adolescents in Germany. J Nutr. 2008; 138:1482–90.
11. Haimi M, Kremer R. Vitamin D deficiency/insufficiency from childhood to adulthood: Insights from a sunny country. World J Clin Pediatr. 2017; 6:1–9.
12. Al-Hamad D, Raman V. Metabolic syndrome in children and adolescents. Transl Pediatr. 2017; 6:397–407.
13. Agudelo GM, Bedoya G, Estrada A, Patino FA, Munoz AM, Velasquez CM. Variations in the prevalence of metabolic syndrome in adolescents according to different criteria used for diagnosis: which definition should be chosen for this age group? Metab Syndr Relat Disord. 2014; 12:202–9.
14. Friend A, Craig L, Turner S. The prevalence of metabolic syndrome in children: a systematic review of the literature. Metab Syndr Relat Disord. 2013; 11:71–80.
15. Gregory JW. Prevention of obesity and metabolic syndrome in children. Front Endocrinol (Lausanne). 2019; 10:669.
16. Mottillo S, Filion KB, Genest J, Lawrence J, Pilote L, Poirier P, et al. The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis. J Am Coll Cardiol. 2010; 56:1113–32.
17. Ahmadi N, Sadr SM, Mohammadi MR, Mirzaei M, Mehrparvar AH, Yassini Ardekani SM, et al. Prevalence of abdominal obesity and metabolic syndrome in children and adolescents: a community based cross-sectional study. Iran J Public Health. 2020; 49:360–8.
18. Rho H, Lee S, Lee H, Shim K, Chun H, Byun A, et al. The association between serum vitamin D level and metabolic syndrome in elderly people: based on the Korean National Health and Nutrition Examination Survey 2012. Korean J Fam Pract. 2016; 6:315–21.
19. Papandreou D, Hamid ZT. The role of vitamin D in diabetes and cardiovascular disease: an updated review of the literature. Dis Markers. 2015; 2015:580474.
20. Mehta V, Agarwal S. Does vitamin D deficiency lead to hypertension? Cureus. 2017; 9:e1038.
21. Mozos I, Marginean O. Links between Vitamin D deficiency and cardiovascular diseases. Biomed Res Int. 2015; 2015:109275.
22. Pludowski P, Karczmarewicz E, Bayer M, Carter G, Chlebna-Sokol D, Czech-Kowalska J, et al. Practical guidelines for the supplementation of vitamin D and the treatment of deficits in Central Europe - recommended vitamin D intakes in the general population and groups at risk of vitamin D deficiency. Endokrynol Pol. 2013; 64:319–27.
23. Zimmet P, Alberti KG, Kaufman F, Tajima N, Silink M, Arslanian S, et al. The metabolic syndrome in children and adolescents - an IDF consensus report. Pediatr Diabetes. 2007; 8:299–306.
24. v. Childhood overweight and obesity [Internet]. Switzerland (Geneva): World Health Organization;c2021. [cited 2021 Jul 28]. Available from: https://www.who.int/toolkits/growth-reference-data-for-5to19-years/indicators/bmi-for-age.
25. Rafraf M, Hasanabad SK, Jafarabadi MA. Vitamin D status and its relationship with metabolic syndrome risk factors among adolescent girls in Boukan, Iran. Public Health Nutr. 2014; 17:803–9.
26. Carlsson M, Wanby P, Brudin L, Lexne E, Mathold K, Nobin R, et al. Older Swedish adults with high self-perceived health show optimal 25-hydroxyvitamin d levels whereas vitamin D status is low in patients with high disease burden. Nutrients. 2016; 8:717.
27. Kim M, Na W, Sohn C. Correlation between vitamin D and cardiovascular disease predictors in overweight and obese Koreans. J Clin Biochem Nutr. 2013; 52:167–71.
28. Pacifico L, Anania C, Osborn JF, Ferraro F, Bonci E, Olivero E, et al. Low 25(OH)D3 levels are associated with total adiposity, metabolic syndrome, and hypertension in Caucasian children and adolescents. Eur J Endocrinol. 2011; 165:603–11.
29. Paschou SA, Kosmopoulos M, Nikas IP, Spartalis M, Kassi E, Goulis DG, et al. The impact of obesity on the association between vitamin D deficiency and cardiovascular disease. Nutrients. 2019; 11:2458.
30. Pavlyshyn HA, Shulhai AMA. The association between vitamin D status and cardiometabolic disorders in overweight and obese adolescents. Ukr Biochem J. 2021; 93:72–81.
31. Strange RC, Shipman KE, Ramachandran S. Metabolic syndrome: a review of the role of vitamin D in mediating susceptibility and outcome. World J Diabetes. 2015; 6:896–911.
32. Vogt S, Baumert J, Peters A, Thorand B, Scragg R. Waist circumference modifies the association between serum 25(OH)D and systolic blood pressure: results from NHANES 2001-2006. J Hypertens. 2016; 34:637–45.
33. Verrusio W, Andreozzi P, Renzi A, Musumeci M, Gueli N, Cacciafesta M. Association between serum vitamin D and metabolic syndrome in middle-aged and older adults and role of supplementation therapy with vitamin D. Ann Ist Super Sanita. 2017; 53:54–9.
34. Wang CM, Chang CS, Chang YF, Wu SJ, Chiu CJ, Hou MT, et al. Inverse relationship between metabolic syndrome and 25-hydroxyvitamin D concentration in elderly people without vitamin D deficiency. Sci Rep. 2018; 8:17052.
35. Mutt SJ, Hyppönen E, Saarnio J, Järvelin MR, Herzig KH. Vitamin D and adipose tissue-more than storage. Front Physiol. 2014; 5:228.
36. Dominguez E, Penafiel A, Pedrazaa A, Martínez Leo E. Molecular mechanisms from insulin-mimetic effect of vitamin D: treatment alternative in type 2 diabetes mellitus. Food Funct. 2021; 12:6682–90.
37. Kelishadi R, Farajzadegan Z, Bahreynian M. Association between vitamin D status and lipid profile in children and adolescents: a systematic review and meta-analysis. Int J Food Sci Nutr. 2014; 65:404–10.
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