Low vitamin D is associated with hypertension in paediatric obesity.
The aim of this paper was to investigate the relationship between circulating 25-hydroxyvitamin D (25(OH)D) and cardio-metabolic risk factors in a large cohort of obese youth attending tertiary paediatric obesity services.
We conducted a retrospective cross-sectional study. Data were retrospectively collected from all new consultations of children and adolescents attending obesity outpatient clinics between 2008 and 2011 at the two major paediatric hospitals in Melbourne, Australia. Information collected included demographics, anthropometry, blood pressure, pubertal staging, body composition and fasting serum levels of 25(OH)D, glucose, insulin, cholesterol, triglyceride, high-density lipoprotein, liver function, calcium and phosphate.
25(OH)D data were available in 229 patients (age 3-18 years; 116 men; mean (standard deviation) body mass index ( BMI) Z-score 2.5 (0.5) ). One hundred four (45%) participants were 25(OH)D deficient (<50 nmol/L). Lower serum 25(OH)D levels were associated with higher BMI Z-score (P-trend = 0.001), total fat mass (P-trend = 0.009), systolic (P-trend = 0.03) and diastolic blood pressures(P-trend = 0.009). In multivariable-adjusted regression analysis, 25(OH)D was significantly lower in those with elevated blood pressure after adjustment for BMI(P-trend = 0.004) or total fat mass (P-trend = 0.01).
Overweight and obese youth attending specialist obesity services have a high prevalence of vitamin D deficiency. In this population, lower levels of vitamin D were seen in those with greater adiposity, and independent of this, in those who had higher blood pressure.
Kao KT
，Abidi N
，Ranasinha S
，Brown J
，Rodda C
，McCallum Z
，Zacharin M
，Simm PJ
，Magnussen CG
，Sabin MA
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25-hydroxyvitamin D is associated with adiposity and cardiometabolic risk factors in a predominantly vitamin D-deficient and overweight/obese but otherwise healthy cohort.
Vitamin D deficiency has reached epidemic proportions worldwide and has recently been linked to cardiometabolic risk factors including obesity, insulin resistance, hypertension, dyslipidemia, as well as type 2 diabetes and cardiovascular disease. The objective of this study was to examine the associations between circulating 25-hydrovitamin D (25(OH)D) levels and cardiometabolic risk factors using direct measures of adiposity, glucose intolerance, and insulin resistance, as well as lipids, blood pressure, and plasma markers of inflammation. We measured circulating 25(OH)D, physical activity (International Physical Activity Questionnaire- IPAQ), anthropometry (body mass index (BMI), waist-to-hip ratio (WHR), % body fat (dual energy X-ray absorptiometry)), metabolic parameters (fasting and 2-h plasma glucose levels during oral glucose tolerance test; insulin sensitivity (M, hyperinsulinaemic-euglycaemic clamp), and cardiovascular and inflammatory profiles (blood pressure (BP), pulse pressure (PP), mean arterial pressure (MAP), plasma lipid levels, white blood cell count (WBC), and plasma high-sensitivity C-reactive protein levels (hsCRP)) in 111 healthy, non-diabetic adults (66 males/45 females; age 31.1±9.2years; % body fat 36.0±10.2%). Mean 25(OH)D was 39.8±19.8 nmol/L with no difference between genders (p=0.4). On univariate analysis, 25(OH)D was associated with% body fat (r=-0.27; p=0.005), 2-h glucose (r=-0.21; p=0.03), PP (r=0.26; p=0.006), and insulin sensitivity (r=0.20, p=0.04), but not with age, BMI, WHR, fasting glucose, BP, MAP, lipids, or inflammatory markers (all p>0.05). After adjusting for age and sex, 25(OH)D remained associated with% body fat (β=-0.12%; p=0.003), 2-h glucose (β=-0.13mmol/L; p=0.02), PP (β=0.12mmHg; p=0.009), and insulin sensitivity (β=0.22mg/kg/min; p=0.03), and became associated with fasting glucose (β=-0.04mmol/L; p=0.04) and hsCRP (β=-0.51mg/L; p=0.04). After adjusting for age, sex, and % body fat, 25(OH)D was no longer associated with insulin sensitivity, 2-h glucose, or hsCRP, but remained associated with fasting glucose (β=-0.05mmol/L; p=0.03) and PP (β=0.10mmHg; p=0.03). 25(OH)D remained associated with fasting glucose (β=-0.06mmol/L; p=0.02) after hsCRP and physical activity were added to the model with % body fat, age, and sex. These cross-sectional data suggest that associations between vitamin D and cardiometabolic risk among healthy, non-diabetic adults are largely mediated by adiposity. Large-scale intervention and mechanistic studies are needed to further investigate whether vitamin D has an independent role in the prevention and/or management of cardiometabolic risk and disease.
Mousa A
，Naderpoor N
，de Courten MPJ
，Scragg R
，de Courten B
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Elevated systolic blood pressure of children in the United States is associated with low serum 25-hydroxyvitamin D concentrations related to body mass index: National Health and Examination Survey 2007-2010.
A negative association between serum 25-hydroxyvitamn D (25[OH]D) concentrations and blood pressure has been found in adults; whether a similar relationship exists in children remains unclear. We hypothesized that serum 25(OH)D concentrations of children would negatively correlate with blood pressure. Using a nationally representative sample of children aged 8 to 18years from the National Health and Nutrition Examination Survey 2007-2010 (n=2908), we compared serum 25(OH)D levels with diastolic and systolic blood pressure by vitamin D nutritional status categories. A high percentage of children were either vitamin D deficient (28.8%) or vitamin D insufficient (48.8%). Prehypertension was defined as blood pressure as ≥90th to <95th percentile and hypertension as ≥95th percentile by age, height, and sex national blood pressure percentile norms for children. Vitamin D-deficient children aged 8 to 13years had higher systolic blood pressure (104.8±0.7mm Hg) than did vitamin D-sufficient children (102.3±0.6mmHg; P<.05). Controlling for age, sex, race/ethnicity, and income, systolic blood pressure was inversely associated with serum 25(OH)D concentrations (P<.03), but not when also controlling for body mass index (P=.63). A higher percentage of vitamin D-deficient and vitamin D-insufficient children (1.7%) vs vitamin D-sufficient children (0.6%) had prehypertension or hypertension. In conclusion, the association of low serum 25(OH)D concentrations with elevated systolic blood pressure in children is likely related to body weight and markers of adiposity.
Moore CE
，Liu Y
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