Vitamin d deficiency and insufficiency in obese children and adolescents and its relationship with insulin resistance

Emel Torun, Erdem Gönüllü, Ilker Tolga Ozgen, Ergül Cindemir, Faruk Oktem, Emel Torun, Erdem Gönüllü, Ilker Tolga Ozgen, Ergül Cindemir, Faruk Oktem

Abstract

Objectives. We aimed to determine the relationship between insulin resistance and serum 25-hydroxyvitamin D (25-OHD) levels in obese children and their nonobese peers. Materials and Methods. Included in the study group were 188 obese children (aged 9-15 years), and 68 age- and gender-matched healthy children of normal weight as control group. Anthropomorphic data were collected on patients and fasting serum glucose, insulin, serum lipids, alanine aminotransaminase (ALT) and 25-OHD were measured. The homeostatic model assessment of insulin resistance (HOMA-IR) was calculated in both groups. Results. The levels of 25-OHD in the obese group were significantly lower than those of the nonobese (P = 0.002). HOMA-IR, triglycerides, low-density lipoprotein, and ALT levels in the obese group were significantly higher than values of control group (P < 0.001 and P = 0.002, resp.). In the obese group, vitamin D deficiency, insufficiency, and sufficiency (25-OHD < 10 ng/dl, < 20, >10 ng/dl; > 20 ng/dl, resp.) were not correlated with HOMA-IR (r : -0.008, P = 0.935). HOMA-IR was negatively correlated with BMI, BMI SDS, and BMI%, and triglycerides, low-density lipoprotein, and ALT levels (P < 0.001). Conclusion. The insulin resistance of the obese subjects who were vitamin D deficient and insufficient did not statistically differ from those with vitamin D sufficiency. Low 25-hydroxyvitamin D levels were not related with higher insulin resistance in obese children and adolescents. In obese subjects, insulin resistance was affected more from BMI, BMI SDS, and BMI% than from 25-hydroxyvitamin D levels.

References

    1. Holick MF, Chen TC. Vitamin D deficiency: a worldwide problem with health consequences. American Journal of Clinical Nutrition. 2008;87(4):1080–1086.
    1. Holick MF. Resurrection of vitamin D deficiency and rickets. Journal of Clinical Investigation. 2006;116(8):2062–2072.
    1. Hess AF. Collected Writings. Vol. 1. Springfield, III, USA: Charles C Thomas; 1936.
    1. Hess AF, Unger LJ. The cure of infantile rickets by sunlight. The Journal of the American Medical Association. 1921;77, article 39
    1. Holick MF. Medical progress: vitamin D deficiency. The New England Journal of Medicine. 2007;357(3):266–281.
    1. Chapuy MC, Schott AM, Garnero P, Hans D, Delmas PD, Meunier PJ. Healthy elderly French women living at home have secondary hyperparathyroidism and high bone turnover in winter. Journal of Clinical Endocrinology and Metabolism. 1996;81(3):1129–1133.
    1. Lapatsanis D, Moulas A, Cholevas V, Soukakos P, Papadopoulou ZL, Challa A. Vitamin D: a necessity for children and adolescents in Greece. Calcified Tissue International. 2005;77(6):348–355.
    1. Guillemant J, Taupin P, Le HT, et al. Vitamin D status during puberty in French healthy male adolescents. Osteoporosis International. 1999;10(3):222–225.
    1. Moussavi M, Heidarpour R, Aminorroaya A, Pournaghshband Z, Amini M. Prevalence of vitamin D deficiency in Isfahani high school students in 2004. Hormone Research. 2005;64(3):144–148.
    1. Olmez D, Bober E, Buyukgebiz A, Cimrin D. The frequency of vitamin D insufficiency in healthy female adolescents. Acta Paediatrica, International Journal of Paediatrics. 2006;95(10):1266–1269.
    1. Hatun S, Islam O, Cizmecioglu F, et al. Subclinical vitamin D deficiency is increased in adolescent girls who wear concealing clothing. Journal of Nutrition. 2005;135(2):218–222.
    1. Kadowaki S, Norman AW. Time course study of insulin secretion after 1,25-dihydroxyvitamin D3 administration. Endocrinology. 1985;117(5):1765–1771.
    1. Lee S, Clark SA, Gill RK, Christakos S. 1,25-Dihydroxyvitamin D3 and pancreatic β-cell function: vitamin D receptors, gene expression, and insulin secretion. Endocrinology. 1994;134(4):1602–1610.
    1. Scragg R, Holdaway I, Singh V, Metcalf P, Baker J, Dryson E. Serum 25-hydroxyvitamin D3 levels decreased in impaired glucose tolerance and diabetes mellitus. Diabetes Research and Clinical Practice. 2010;121(1-2):297–300.
    1. Holick MF. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. The American Journal of Clinical Nutrition. 2004;80(6):1678–1688.
    1. Reis AF, Hauache OM, Velho G. Vitamin D endocrine system and the genetic susceptibility to diabetes, obesity and vascular disease: a review of evidence. Diabetes and Metabolism. 2005;31(4):318–325.
    1. Goran MI, Ball GDC, Cruz ML. Cardiovascular endocrinology 2: obesity and risk of type 2 diabetes and cardiovascular disease in children and adolescents. Journal of Clinical Endocrinology and Metabolism. 2003;88(4):1417–1427.
    1. Smotkin-Tangorra M, Purushothaman R, Gupta A, Nejati G, Anhalt H, Ten S. Prevalence of vitamin D insufficiency in obese children and adolescents. Journal of Pediatric Endocrinology and Metabolism. 2007;20(7):817–823.
    1. Forouhi NG, Luan J, Cooper A, Boucher BJ, Wareham NJ. Baseline serum 25-hydroxy vitamin d is predictive of future glycemic status and insulin resistance the medical research council ely prospective study 1990–2000. Diabetes. 2008;57(10):2619–2625.
    1. Rajakumar K, de las Heras J, Lee S, Holick MF, Arslanian SA. 25- Hydroxyvitamin D concentrations and in vivo insulin sensitivity and β- cell function relative to insulin sensitivity in black and white youth. Diabetes Care. 2012;35(3):627–633.
    1. Bundak R, Furman A, Gunoz H, Darendeliler F, Bas F, Neyzi O. Body mass index references for Turkish children. Acta Paediatrica. 2006;95(2):194–198.
    1. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. British Medical Journal. 2000;320(7244):1240–1243.
    1. Matthews DR, Hosker JP, Rudenski AS. Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28(7):412–419.
    1. Valerio G, Licenziati MR, Iannuzzi A, et al. Insulin resistance and impaired glucose tolerance in obese children and adolescents from Southern Italy. Nutrition, Metabolism and Cardiovascular Diseases. 2006;16(4):279–284.
    1. Ahmed SF, Franey C, McDewitt H, et al. Recent trends and clinical features of childhood vitamin D deficiency presenting to a children’s hospital in Glasgow. Archives of Disease in Childhood. 2011;96(7):694–625.
    1. Cizmecioğlu FM, Etiler N, Görmüş U, Hamzaoğlu O, Hatun S. Hypovitaminosis D in obese and overweight schoolchildren. Journal of Clinical Research in Pediatric Endocrinology. 2008;1(2):89–96.
    1. Olson ML, Maalouf NM, Oden JD, White PC, Hutchison MR. Vitamin D deficiency in obese children and its relationship to glucose homeostasis. The Journal of Clinical Endocrinology & Metabolism. 2012;97(1):279–285.
    1. Beydoun MA, Boueiz A, Shroff MR, Beydoun HA, Wang Y, Zonderman AB. Associations among 25-hydroxyvitamin D, diet quality, and metabolic disturbance differ by adiposity in adults in the United States. Journal of Clinical Endocrinology and Metabolism. 2010;95(8):3814–3827.
    1. Hatun S, Ozkan B, Bereket A. Vitamin D deficiency and prevention: Turkish experience. Acta Paediatrica. 2011;100(9):1195–1199.
    1. Bourlon PM, Faure-Dussert A, Billaudel B. The de novo synthesis of numerous proteins is decreased during vitamin D3 deficiency and is gradually restored by 1,25-dihydroxyvitamin D3 repletion in the islets of Langerhans of rats. Journal of Endocrinology. 1999;162(1):101–109.
    1. Billaudel B, Barakat L, Faure-Dussert A. Vitamin D3 deficiency and alterations of glucose metabolism in rat endocrine pancreas. Diabetes and Metabolism. 1998;24(4):344–350.
    1. Kajikawa M, Ishida H, Fujimoto S, et al. An insulinotropic effect of vitamin D analog with increasing intracellular Ca2+ concentration in pancreatic β-cells through nongenomic signal transduction. Endocrinology. 1999;140(10):4706–4712.
    1. Bourlon PM, Billaudel B, Faure-Dussert A. Influence of vitamin D3 deficiency and 1,25 dihydroxyvitamin D3 on de novo insulin biosynthesis in the islets of the rat endocrine pancreas. Journal of Endocrinology. 1999;160(1):87–95.
    1. Rajakumar K, Fernstrom JD, Holick MF, Janosky JE, Greenspan SL. Vitamin D status and response to vitamin D3 in obese vs. Non-obese African American children. Obesity. 2008;16(1):90–95.
    1. Reinehr T, de Sousa G, Alexy U, Kersting M, Andler W. Vitamin D status and parathyroid hormone in obese children before and after weight loss. European Journal of Endocrinology. 2007;157(2):225–232.
    1. Kelly A, Brooks LJ, Dougherty S, Carlow DC, Zemel BS. A cross-sectional study of vitamin D and insulin resistance in children. Archives of Disease in Childhood. 2011;96(5):447–452.
    1. Alemzadeh R, Kichler J, Babar G, Calhoun M. Hypovitaminosis D in obese children and adolescents: relationship with adiposity, insulin sensitivity, ethnicity, and season. Metabolism. 2008;57(2):183–191.
    1. Garanty-Bogacka B, Syrenicz M, Goral J, et al. Serum 25-hydroxyvitamin D, (25-OH-D) in obese adolescents. Endokrynologia Polska. 2011;62(6):506–511.

Source: PubMed

Sponsorer och medarbetare

Medicinska tillstånd

Läkemedelsinterventioner

3
Prenumerera