Department of Pediatrics/Division of Pediatric Endocrinology and Metabolism, The Children's Hospital, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Obesity (Silver Spring). 2011 Nov;19(11):2214-21. doi: 10.1038/oby.2011.110. Epub 2011 May 5.
Vitamin D deficiency may increase the risk for metabolic syndrome. We determined the relationship of serum 25-hydroxyvitamin D (25(OH)D) with metabolic syndrome components in obese adolescent females and assessed whether vitamin D treatment corrects metabolic disturbances. Eighty postmenarchal adolescents (53 African American (AA) and 27 Caucasian American (CA)) were evaluated with blood pressures and fasting measurements of serum 25(OH)D, lipid profile, C-reactive protein, alanine transaminases (ALTs) and aspartate transaminases followed by an oral glucose tolerance test. A subgroup (n = 14) of vitamin D deficient subjects were re-evaluated following vitamin D treatment. Among all subjects, 25(OH)D was inversely associated with fasting glucose (r = -0.28, P = 0.02) and positively associated with low-density lipoprotein (LDL) cholesterol (r = 0.31, P = 0.008), independent of race and BMI. In analyses by race, adjusted for BMI, 25(OH)D was inversely associated with fasting insulin in CA (r = -0.42, P = 0.03) but not AA (r = 0.11, P = 0.43) whereas 25(OH)D was positively associated with ALT in AA, but not CA (r = 0.29, P = 0.04 vs. r = -0.21, P = 0.32). Fasting glucose improved in vitamin D treated subgroup (from 89.07 ± 8.3 mg/dl to 84.34 ± 8.4 mg/dl, P = 0.05). A trend toward improvement in fasting glucose remained after exclusion of four subjects whose serum 25(OH)D(2) did not improve following treatment (P = 0.12). In conclusion, serum 25(OH)D was inversely associated with fasting glucose, and vitamin D treatment had beneficial effects on fasting glucose. Relationships of 25(OH)D with fasting insulin and ALT were ethnic specific. The positive relationship with LDL and ALT were suggestive of possible adverse influences of vitamin D.
维生素 D 缺乏可能会增加代谢综合征的风险。我们确定了血清 25-羟维生素 D(25(OH)D)与肥胖青春期女性代谢综合征成分的关系,并评估了维生素 D 治疗是否纠正代谢紊乱。对 80 名月经初潮后的青少年(53 名非裔美国人(AA)和 27 名白种人(CA))进行了血压和空腹血清 25(OH)D、血脂谱、C 反应蛋白、丙氨酸转氨酶(ALT)和天门冬氨酸转氨酶的测量,随后进行口服葡萄糖耐量试验。维生素 D 缺乏亚组(n = 14)在接受维生素 D 治疗后进行了重新评估。在所有受试者中,25(OH)D 与空腹血糖呈负相关(r = -0.28,P = 0.02),与低密度脂蛋白胆固醇呈正相关(r = 0.31,P = 0.008),与种族和 BMI 无关。在按种族进行的分析中,调整 BMI 后,25(OH)D 与 CA 空腹胰岛素呈负相关(r = -0.42,P = 0.03),但与 AA 无关(r = 0.11,P = 0.43),而 25(OH)D 与 AA 中的 ALT 呈正相关,但与 CA 无关(r = 0.29,P = 0.04 与 r = -0.21,P = 0.32)。维生素 D 治疗亚组的空腹血糖改善(从 89.07 ± 8.3mg/dl 降至 84.34 ± 8.4mg/dl,P = 0.05)。在排除 4 名血清 25(OH)D2 治疗后未改善的受试者后(P = 0.12),空腹血糖改善的趋势仍然存在。结论:血清 25(OH)D 与空腹血糖呈负相关,维生素 D 治疗对空腹血糖有有益作用。25(OH)D 与空腹胰岛素和 ALT 的关系具有种族特异性。与 LDL 和 ALT 的正相关提示维生素 D 可能有不良影响。