Department of Pediatrics, Sapienza University of Rome, Viale Regina Elena, 324 00161 Rome, Italy.
Eur J Endocrinol. 2011 Oct;165(4):603-11. doi: 10.1530/EJE-11-0545. Epub 2011 Jul 13.
Evidence of the association between vitamin D and cardiovascular risk factors in the young is limited. We therefore assessed the relationships between circulating 25-hydroxyvitamin D(3) (25(OH)D(3)) and metabolic syndrome (MetS), its components, and early atherosclerotic changes in 452 (304 overweight/obese and 148 healthy, normal weight) Caucasian children.
We determined serum 25(OH)D(3) concentrations in relation to MetS, its components (central obesity, hypertension, low high-density lipoprotein (HDL)-cholesterol, hypertriglyceridemia, glucose impairment, and/or insulin resistance (IR)), and impairment of flow-mediated vasodilatation (FMD) and increased carotid intima-media thickness (cIMT) - two markers of subclinical atherosclerosis.
Higher 25(OH)D(3) was significantly associated with a reduced presence of MetS. Obesity, central obesity, hypertension, hypertriglyceridemia, low HDL-cholesterol, IR, and MetS were all associated with increased odds of having low 25(OH)D(3) levels, after adjustment for age, sex, and Tanner stage. After additional adjustment for SDS-body mass index, elevated blood pressure (BP) and MetS remained significantly associated with low vitamin D status. The adjusted odds ratio (95% confidence interval) for those in the lowest (<17 ng/ml) compared with the highest tertile (>27 ng/ml) of 25(OH)D(3) for hypertension was 1.72 (1.02-2.92), and for MetS, it was 2.30 (1.20-4.40). A similar pattern of association between 25(OH)D(3), high BP, and MetS was observed when models were adjusted for waist circumference. No correlation was found between 25(OH)D(3) concentrations and either FMD or cIMT.
Low 25(OH)D(3) levels in Caucasian children are inversely related to total adiposity, MetS, and hypertension.
有关维生素 D 与心血管危险因素之间关系的证据在年轻人中较为有限。因此,我们评估了循环 25-羟维生素 D(3)[25(OH)D(3)]与代谢综合征(MetS)、其组成部分以及 452 名(304 名超重/肥胖和 148 名健康、正常体重)白种人儿童早期动脉粥样硬化变化之间的关系。
我们测定了血清 25(OH)D(3)浓度与 MetS 及其组成部分(中心性肥胖、高血压、低高密度脂蛋白(HDL)-胆固醇、高三酰甘油血症、葡萄糖损害和/或胰岛素抵抗(IR))以及血流介导的血管扩张功能受损(FMD)和颈动脉内膜-中层厚度(cIMT)增加之间的关系。这两种标志物均与亚临床动脉粥样硬化有关。
较高的 25(OH)D(3)与 MetS 的发生呈负相关。在调整年龄、性别和 Tanner 分期后,肥胖、中心性肥胖、高血压、高三酰甘油血症、低 HDL-胆固醇、IR 和 MetS 均与较低的 25(OH)D(3)水平发生的几率增加有关。在进一步调整 SDS-体重指数后,高血压和 MetS 仍与维生素 D 状态低下显著相关。25(OH)D(3)水平最低(<17ng/ml)组与最高三分位(>27ng/ml)组相比,高血压的调整比值比(95%置信区间)为 1.72(1.02-2.92),MetS 的比值比为 2.30(1.20-4.40)。当模型根据腰围进行调整时,25(OH)D(3)与高血压和 MetS 之间的关联模式相似。25(OH)D(3)浓度与 FMD 或 cIMT 之间无相关性。
白种儿童中较低的 25(OH)D(3)水平与总体肥胖、MetS 和高血压呈负相关。