25-Hydroxyvitamin D insufficiency discriminates cardiovascular risk factors accumulation in peri-pubertal boys undergoing overweight screening
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The aim of this study was to evaluate the possible association between cardiometabolic risk factors accumulation and vitamin D status in a cohort of Italian normal weight and overweight male children. 108 boys enrolled in an andrological health prevention project underwent physical examination, anthropometric measurements, and fasting blood sampling. Serum blood glucose, HDL-cholesterol, triglycerides, parathyroid hormone, and 25-hydroxyvitamin D (25(OH)D) were measured. Cardiovascular risk factors were defined according to the National Cholesterol Education Program Adult Treatment Panel III modified for age. Lean and overweight subjects differed in terms of waist circumference (P < 0.001), HDL-cholesterol (P = 0.001), triglycerides (P = 0.001), systolic blood pressure (P < 0.001) and diastolic blood pressure (P = 0.002). Both groups had similar mean 25(OH)D levels (P = 0.160) and were below the sufficiency threshold: indeed only 24 % of normal weight had 25(OH)D ≥30 ng/ml, and even less in the overweight/obese group (8 %, P = 0.03 vs. normal weight). A significant accumulation of risk factors in course of 25(OH)D insufficiency was detected in both the whole cohort and in the normal weight group (P = 0.003 and P = 0.04, respectively) with odd ratios of 1.31 (1.16–1.49 95%CI) and 1.41 (1.18–1.69 95%CI), respectively. In course of vitamin D deficiency, the odd ratios were 2.24 (1.34–3.77 95%CI, P = 0.003) in the whole cohort and 2.40 (1.27–4.82 95%CI, P = 0.03) in lean subjects. We reported a considerable occurrence of cardiovascular risk factors in course of hypovitaminosis D in overweight/obese boys and even in lean subjects, which normally would not have been further evaluated by considering the sole BMI-related parameters. In this regard, 25(OH)D levels appear as a potential discriminating parameter able to identify male children at higher health risk.
KeywordsVitamin D Children Obesity Adolescents Cardiovascular risk Metabolic syndrome
ADN, LDT, and CF wrote the manuscript, EDA, PS collected the data, MRP performed laboratory assessment, ADN analyzed the data.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest and financial relationships with any organizations that might have an interest in the submitted work. No external funding has been secured for this study.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
- 2.Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Dietary reference intakes for calcium, magnesium, phosphorus, vitamin D, and fluoride (Food and Nutrition Board, Institute of Medicine National Academy Press, Washington, DC, 1997)Google Scholar
- 4.M.F. Holick, N.C. Binkley, H.A. Bischoff-Ferrari, C.M. Gordon, D.A. Hanley, R.P. Heaney, M.H. Murad, C.M. Weaver, Endocrine society: evaluation, treatment, and prevention of vitamin D deficiency: an endocrine society clinical practice guideline. J. Clin. Endocrinol. Metab. 96(7), 1911–1930 (2011). doi: 10.1210/jc.2011-0385 CrossRefPubMedGoogle Scholar
- 7.Institute of Medicine (US) Standing Committee (IOM), Dietary reference intakes for calcium and vitamin D (National Academies Press, Washington, DC, 2011)Google Scholar
- 11.A.C. Ross, J.E. Manson, S.A. Abrams, J.F. Aloia, P.M. Brannon, S.K. Clinton, R.A. Durazo-Arvizu, J.C. Gallagher, R.L. Gallo, G. Jones, C.S. Kovacs, S.T. Mayne, C.J. Rosen, S.A. Shapses, The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J. Clin. Endocrinol. Metab. 96, 53–58 (2011). doi: 10.1210/jc.2010-2704 CrossRefPubMedGoogle Scholar
- 13.D. Martins, M. Wolf, D. Pan, A. Zadshir, N. Tareen, R. Thadhani, A. Felsenfeld, B. Levine, R. Mehrotra, K. Norris, Prevalence of cardiovascular risk factors and the serum levels of 25- hydroxyvitamin D in the United States: data from the Third National Health and Nutrition Examination Survey. Arch. Intern. Med. 167, 1159–1165 (2007). doi: 10.1001/archinte.167.11.1159 CrossRefPubMedGoogle Scholar
- 18.L. De Toni, V. De Filippis, S. Tescari, M. Ferigo, A. Ferlin, V. Scattolini, A. Avogaro, R. Vettor, C. Foresta, Uncarboxylated Osteocalcin stimulates 25-hydroxy-vitamin D production in Leydig cell line through a GPRC6A-dependent pathway. Endocrinology 155(11), 4266–4274 (2014). doi: 10.1210/en.2014-1283 CrossRefPubMedGoogle Scholar
- 19.V. Ganji, X. Zhang, N. Shaikh, V. Tangpricha, Serum 25-hydroxyvitamin D concentrations are associated with prevalence of metabolic syndrome and various cardiometabolic risk factors in US children and adolescents based on assay-adjusted serum 25-hydroxyvitamin D data from NHANES 2001–2006. Am. J. Clin. Nutr. 94, 225–233 (2011). doi: 10.3945/ajcn.111.013516 CrossRefPubMedGoogle Scholar
- 22.C.L. Ogden, R.J. Kuczmarski, K.M. Flegal, Z. Mei, S. Guo, R. Wei, L.M. Grummer-Strawn, L.R. Curtin, A.F. Roche, C.L. Johnson, Centers for disease control and prevention 2000 growth charts for the United States: improvements to the 1977 National Center for Health Statistics version. Pediatrics 109, 45–60 (2002). doi: 10.1542/peds.109.1.45 CrossRefPubMedGoogle Scholar
- 27.S. Cook, M. Weitzman, P. Auinger, M. Nguyen, W.H. Dietz, Prevalence of a metabolic syndrome phenotype in adolescents: findings from the third National Health and Nutrition Examination Survey, 1988–1994. Arch. Pediatr. Adolesc. Med. 157(8), 821–827 (2003). doi: 10.1001/archpedi.157.8.821 CrossRefPubMedGoogle Scholar
- 30.A. Colao, G. Muscogiuri, M. Rubino, L. Vuolo, C. Pivonello, P. Sabatino, M. Pizzo, G. Campanile, R. Fittipaldi, G. Lombardi, C. Di Somma, Hypovitaminosis D in adolescents living in the land of sun is correlated with incorrect life style: a survey study in Campania region. Endocrine 49(2), 521–527 (2015). doi: 10.1007/s12020-014-0483-8 CrossRefPubMedGoogle Scholar
- 32.J. Valtueña, L. Gracia-Marco, G. Vicente-Rodríguez, M. González-Gross, I. Huybrechts, J.P. Rey-López, T. Mouratidou, I. Sioen, M.I. Mesana, A.E. Martínez, K. Widhalm, L.A. Moreno, HELENA Study Group. Vitamin D status and physical activity interact to improve bone mass in adolescents. The HELENA Study. Osteoporos. Int. 23(8), 2227–2237 (2012)CrossRefPubMedGoogle Scholar
- 37.W.D. Johnson, J.J.M. Kroon, F.L. Greenway, C. Bouchard, D. Ryan, P.T. Katzmarzyk, Prevalence of risk factors for metabolic syndrome in adolescents: national Health and Nutrition Examination Survey (NHANES), 2001–2006. Arch. Pediatr. Adolesc. Med. 163, 371–377 (2009). doi: 10.1001/archpediatrics.2009.3 CrossRefPubMedGoogle Scholar
- 38.A.R. Folsom, A. Alonso, J.R. Misialek, E.D. Michos, E. Selvin, J.H. Eckfeldt, J. Coresh, J.S. Pankow, P.L. Lutsey, Parathyroid hormone concentration and risk of cardiovascular diseases: the Atherosclerosis Risk in Communities (ARIC) study. Am. Heart J. 168(3), 296–302 (2014). doi: 10.1016/j.ahj.2014.04.017 CrossRefPubMedPubMedCentralGoogle Scholar
- 39.S. Gutiérrez Medina, T. Gavela-Pérez, M.N. Domínguez-Garrido, E. Gutiérrez-Moreno, A. Rovira, C. Garcés, L. Soriano-Guillén, The influence of puberty on vitamin D status in obese children and the possible relation between vitamin D deficiency and insulin resistance. J. Pediatr. Endocrinol. Metab. 28(1–2), 105–110 (2015). doi: 10.1515/jpem-2014-0033 PubMedGoogle Scholar
- 40.D.M. Harrington, A.E. Staiano, S.T. Broyles, A.K. Gupta, P.T. Katzmarzyk, BMI percentiles for the identification of abdominal obesity and metabolic risk in children and adolescents: evidence in support of the CDC 95th percentile. Eur. J. Clin. Nutr. 67(2), 218–222 (2013). doi: 10.1038/ejcn.2012.203 CrossRefPubMedGoogle Scholar
- 42.Y. Dong, I.S. Stallmann-Jorgensen, N.K. Pollock, R.A. Harris, D. Keeton, Y. Huang, K. Li, R. Bassali, D.H. Guo, J. Thomas, G.L. Pierce, J. White, M.F. Holick, H. Zhu, A 16-week randomized clinical trial of 2000 international units daily vitamin d-3 supplementation in black youth: 25-hydroxyvitamin d, adiposity, and arterial stiffness. J. Clin. Endocrinol. Metab. 95(10), 4584–4591 (2010). doi: 10.1210/jc.2010-0606 CrossRefPubMedGoogle Scholar