Preview

Current Pediatrics

Advanced search

COMPONENTS OF THE METABOLIC SYNDROME IN CHILDREN AND ADOLESCENTS WITH DIFFERENT LEVELS OF VITAMIN D: A CROSS-SECTIONAL STUDY

https://doi.org/10.15690/vsp.v16i3.1731

Abstract

Background. Vitamin D is a significant risk factor for atherogenic disorders. It is of interest to study the relationship between vitamin D deficiency and the components of the metabolic syndrome, insulin resistance and markers of chronic inflammation in different age groups.

Objective.  Our aim was to study association of the components  of the metabolic syndrome and pro-atherogenic  metabolic disorders with vitamin D levels in children and adolescents.

Methods. In a cross-sectional (one-stage) study, the serum 25(OH)D level in children and adolescents was determined. The relationship between the 25(ОН)D level and the presence of the metabolic syndrome was assessed in quartile groups.

Results. The study included 319 children and adolescents (49% — girls) aged 10–15 years. In the quartile I in terms of the 25(ОН)D level, higher (as compared with the quartile IV) mean level values of insulin (11.5 ± 6.3 and 7.3 ± 4.0 mmol/L, p <0.001), HOMA index (2.4 ± 0.8 and 1.6 ± 0.7, p <0.001), body mass index (22.6 ± 4.3 and 19.3 ± 3.9 kg/m2, p = 0.012), waist circumference (68 ± 11 and 61 ± 12 cm, p = 0.034), blood concentration of C-reactive protein (2.3 ± 1 and 0.9 ± 0.7 mg/ml, p <0.001), diastolic blood pressure (70 ± 7 and 65 ± 6 mm Hg, р = 0.028), uric acid (0.29 ± 0.06 and 0.21 ± 0.06 mmol/L, р = 0.021), glucose (4.8 ± 0.6 and 4.6 ± 0.6 mmol/L, p = 0.011), triglycerides (0.86 ± 0.37 and 0.72 ± 0.31 mmol/L, р = 0.017), and lower mean level values of highdensity lipoprotein cholesterol (1.38 ± 0.36 and 1.58 ± 0.31 mmol/L, p = 0.011) were noted. Multivariate regression analysis showed an independent  relationship between the 25(ОН)D level, C-reactive  protein level (β = -0.55,  p <0.001),  and HOMA index (β = -0.96, p < 0.001).

Conclusion. A low vitamin D level in the blood serum in children is associated with the components of the metabolic syndrome.

About the Authors

Svetlana I. Malyavskaya
Northern State Medical University
Russian Federation

Arkhangelsk



Аndrej V. Lebedev
Northern State Medical University
Russian Federation

Arkhangelsk



Galina N. Kostrova
Northern State Medical University
Russian Federation

Arkhangelsk



References

1. McCrindle BW, Urbina EM, Dennison BA, Jacobson MS, Steinberger J, Rocchini AP, Hayman LL, Daniels SR. Scientific Statement From the American Heart. Association Atherosclerosis, Hypertension and Obesity in Youth Committee, Council of Cardiovascular Disease in the Young, With the Council on Cardiovascular Nursing. Circulation. 2007;115:1948–1967.

2. Профилактика сердечно-сосудистых заболеваний в детском и подростковом возрасте. Российские рекомендации // Российский кардиологический журнал. — 2012. — № 6 (Приложение 1). — С. 1–40. [Profilaktika serdechno-sosudistyh zabolevanij v detskom i podrostkovom vozraste. Rossijskie rekomendacii // Rossijskij kardiologicheskij zhurnal. 2012;6 (Prilozhenie 1):1–40. (In Russ.)]

3. Zimmet P, Alberti KG, Kaufman F, Tajima N, Silink M, Arslanian S, Wong G, Bennett P, Shaw J, Caprio S. IDF Consensus Group. The metabolic syndrome in children and adolescents — an IDF consensus report. Pediatr Diabetes. 2007;8(5):299–306.

4. Gami AS, Witt BJ, Howard OE. Metabolic syndrome and risk of incident cardiovascular events and death. Asystematic review and metaanalysis of longitudinal studies. J Am Coll Cardiol. 2007;49:403–414.

5. Benetos A, Thomas F, Pannier B, Bean K, Jego B, Guize L. Allcause and cardiovascular mortality using the different definitions of metabolic syndrome. Am J Cardiol. 2008;102:188–191.

6. Hu G, Qiao Q, Tuomilehto J, Balkau B, Borch-Johnsen K, Pyorala K. For the DECODE Study Group. Prevalence of the metabolic syndrome and its relation to all-cause and cardiovascular mortality in nondiabetic European men and women. Arch Intern Med. 2004;164:1066–1076.

7. Малявская С.И., Лебедев А.В. Актуальность выявления метаболических фенотипов ожирения в детском и подростковом возрасте // Альманах клинической медицины. — 2015. — Т. 42. — С. 72–79. DOI: http://dx.doi.org/10.18786/2072-0505-2015-42-38-45. [Maljavskaja SI, Lebedev AV. Aktual’nost’ vyjavlenija metabolicheskih fenotipov ozhirenija v detskom i podrostkovom vozraste // Al’manah klinicheskoj mediciny. 2015;42:72–79. (In Russ.)]

8. Holick MF. Vitamin D Deficiency. N Engl J Med. 2007;357:266–281.

9. Sung CC, Liao MT, Lu KC, Wu CC. Role of vitamin D in insulin resistance. J Biomed Biotechnol. 2012;2012:634195.

10. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM. Endocrine Society. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011;Jul,96(7):1911–30. doi: 10.1210/jc.2011-0385.

11. Atkins D, Best D, Briss PA, Eccles M, Falck-Ytter Y, Flottorp S, Guyatt GH, Harbour RT, Haugh MC, Henry D, Hill S, Jaeschke R, Leng G, Liberati A, Magrini N, Mason J, Middleton P, Mrukowicz J, O’Connell D, Oxman AD, Phillips B, Schunemann HJ, Edejer TT, Varonen H, Vist GE, Williams Jr JW, Zaza S. Grading quality of evidence and strength of recommendations. BMJ. 2004; 328:1490.

12. Sugden JA, Davies JI, Witham MD, Morris AD, Struthers AD. Vitamin D improves endothelial function in patients with type 2 diabetes mellitus and low vitamin D levels. Diabetes Med. 2008;25:320–325.

13. Libby P, Ridker PM, Hansson GK. Inflammation in atherosclerosis: from pathophysiology to practice. J Am Coll Cardiol. 2009; 54:2129–2138.

14. Shi H, Norman AW, Okamura WH, Sen A, Zemel MB. 1-Alpha, 25-Dihydroxyvitamin D3 modulates human adipocyte metabolism via nongenomic action. FASEB J. 2001 Dec;15(14):2751–3.

15. Chiu KC, Chu A, Go VL, Saad MF. Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction. Am J Clin Nutr. 2004 May;79(5):820–5.

16. Li YC, Qiao G, Uskokovic M, Xiang W, Zheng W, Kong J. Vitamin D: a neg-ative endocrine regulator of the renin-angiotensin system and blood pressure. J Steroid Biochem Mol Biol. 2004 May; 89–90(1–5):387–92.

17. Haussler MR, Haussler CA, Bartik L, Whitfield GK, Hsieh JC, Slater S, Jurutka PW. Vitamin D receptor: molecular signaling and actions of nutritional ligands in disease prevention. Nutr Rev. 2008 Oct;66(10 Suppl 2):S98–112. doi: 10.1111/j.1753-4887.2008.00093.x.Review.

18. Holick MF, Chen TC. Vitamin D deficiency: a worldwide problem with health consequences. Am J Clin Nutr. 2008;87:1080S–1086S.

19. Захарова И.Н., Дмитриева Ю.А., Васильева С.В., Евсеева Е.А. Что нужно знать педиатру о витамине D: новые данные о его роли в организме // Педиатрия. Журнал им. Г.Н. Сперанского. — 2014. — Т. 3. — № 93 — С. 111–117. [Zaharova IN, Dmitrieva JuA, Vasil’eva SV, Evseeva EA. Chto nuzhno znat’ pediatru o vitamin D: novye dannye o ego roli v organizme // Pediatrija. Zhurnal im. G.N. Speranskogo. 2014;3(93):111–117. (In Russ.)]

20. Abuannai M, O’Keefe JH. Vitamin D and cardiovascular health. Primary Care Cardiovasc J. 2011;4:59–62.

21. Малявская С.И., Лебедев А.В. Метаболический портрет детей с ожирением // Российский вестник перинатологии и педиатрии. — 2015. — Т. 6. — № 60 — С. 73–81. [Maljavskaja SI, Lebedev AV. Metabolicheskij portret detej s ozhireniem // Rossijskij vestnik perinatologii i pediatrii. 2015;6(60):73–81. (In Russ.)]

22. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000;320:1240.

23. Зильберман Л.И., Кураева Т.Л., Петеркова В.А., экспертный совет Российской ассоциации эндокринологов. Федеральные клинические рекомендации по диагностике и лечению сахарного диабета 2-го типа у детей и подростков // Проблемы эндокринологии. — 2014. — Т. 5. — С. 57–68. doi: 10.14341/ probl201460557-68. [Zil’berman LI, Kuraeva TL, Peterkova VA, jekspertnyj sovet Rossijskoj associacii jendokrinologov. Federal’nye klinicheskie rekomendacii po diagnostike i lecheniju saharnogo diabeta 2-go tipa u detej i podrostkov // Problemy jendokrinologii. 2014;5:57–68. (In Russ.)]

24. Pearson TA, Mensah GA, Alexander RW, Anderson JL, Cannon RO III, Criqui M, Fadl YY, Fortmann SP, Hong Y, Myers GL, Rifai N, Smith SC Jr, Taubert K, Tracy RP, Vinicor F. Centers for Disease Control and Prevention; American Heart Association. Markers of inflammation and cardiovascular disease: application to clinical and public health practice: a statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation. 2003; 107:499–511.

25. Forouhi NG, Ye Z, Rickard AP, Khaw KT, Luben R, Langenberg C, Wareham NJ. Circulating 25-hydroxyvitamin D concentration and the risk of type 2 diabetes: results from the European Prospective Investigation into Cancer (EPIC)-Norfolk cohort and updated meta-analysis of prospective studies. Diabetologia. 2012; 55(8):2173–2182.

26. Lee JH, O’Keefe JH, Bell D, Hensrud DD, Holick MF. Vitamin D deficiency: an important, common, and easily treatable cardiovascular risk factor? J Am Coll Cardiol. 2008;52:1949–1956.

27. Chou MY, Hartvigsen K, Hansen LF, Fogelstrand L, Shaw PX, Boullier A, Binder CJ, Witztum JL. Oxidation-specific epitopes are important targets of innate immunity. J Intern Med. 2008; 263:479–88.

28. Riachy R, Vandewalle B, Conte JK, Kerr Conte J, Moerman E, Sacchetti P, Lukowiak B, Gmyr V, Bouckenooghe T, Dubois M, Pattou F. 1,25-dihydroxyvitamin D3 protects RINm5F and human islet cells against cytokine-induced apoptosis: implication of the antiapoptotic protein A20. Endocrinology. 2002;143(12): 4809–4819.

29. Ye WZ, Reis AF, Dubois-Laforgue D, Bellanne-Chantelot C, Timsit J, Velho G. Vitamin D receptor gene polymorphisms are associated with obesity in type 2 diabetic subjects with early age of onset. European Journal of Endocrinology. 2001;145(2):181–186.

30. Lavie CJ, Milani RV, Verma A, O’Keefe JH. C-reactive protein and cardiovascular disease: is it ready for primetime? Am J Med Sci. 2009;338:486–492.

31. Alvarez JA, Ashraf A. Role of vitamin d in insulin secretion and insulin sensitivity for glucose homeostasis. Int J Endocrinol. 2010;2010:351385.

32. Cho HJ, Kang HC, Choi SA, Ju YC, Lee HS, Park HJ. The possible role of Ca2+ on the activation of microsomal triglyceride transfer protein in rat hepatocytes. Biol Pharm Bull. 2005 Aug; 28(8):1418–23.

33. Steingrimsdottir L, Gunnarsson O, Indridason OS, Franzson L, Sigurdsson G. Relationship between serum parathyroid hormone levels, vitamin D sufficiency, and calcium intake. JAMA. 2005 Nov 9;294(18):2336–41.

34. Carpenter TO, Herreros F, Zhang JH, Ellis BK, Simpson C, Torrealba-Fox E, Kim GJ, Savoye M, Held NA, Cole DE. Demographic, dietary, and biochemical determinants of vitamin D status in innercity children. Am J Clin Nutr. 2012;95:137–146.

35. Малявская С.И., Захарова И.Н., Кострова Г.Н., Лебедев А.В., Голышева Е.В., Суранова И.В., Майкова И.Д., Евсеева Е.А. Обеспеченность витамином D населения различных возрастных групп, проживающих в городе Архангельске // Вопросы современной педиатрии. — 2015. — Т. 6. — № 14. — С. 681–685. DOI: http://dx.doi.org/10.15690/vsp.v14i6.1476. [Maljavskaja SI, Zaharova IN, Kostrova GN, Lebedev AV, Golysheva EV, Suranova IV, Majkova ID, Evseeva EA. Obespechennost’ vitaminom D naselenija razlichnyh vozrastnyh grupp, prozhivajushhih v gorode Arhangel’ske // Voprosy sovremennoj pediatrii. 2015;6(14): 681–685. (In Russ.)]


Review

For citations:


Malyavskaya S.I., Lebedev А.V., Kostrova G.N. COMPONENTS OF THE METABOLIC SYNDROME IN CHILDREN AND ADOLESCENTS WITH DIFFERENT LEVELS OF VITAMIN D: A CROSS-SECTIONAL STUDY. Current Pediatrics. 2017;16(3):213-219. https://doi.org/10.15690/vsp.v16i3.1731

Views: 1581


ISSN 1682-5527 (Print)
ISSN 1682-5535 (Online)