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肥胖儿童和青少年的维生素 D 缺乏和不足及其与胰岛素抵抗的关系。

Vitamin d deficiency and insufficiency in obese children and adolescents and its relationship with insulin resistance.

机构信息

Department of Pediatrics, Medical Faculty, Bezmialem Vakif University, Fatih 3409, Istanbul, Turkey.

出版信息

Int J Endocrinol. 2013;2013:631845. doi: 10.1155/2013/631845. Epub 2013 Mar 27.

Abstract

Objectives. We aimed to determine the relationship between insulin resistance and serum 25-hydroxyvitamin D (25-OHD) levels in obese children and their nonobese peers. Materials and Methods. Included in the study group were 188 obese children (aged 9-15 years), and 68 age- and gender-matched healthy children of normal weight as control group. Anthropomorphic data were collected on patients and fasting serum glucose, insulin, serum lipids, alanine aminotransaminase (ALT) and 25-OHD were measured. The homeostatic model assessment of insulin resistance (HOMA-IR) was calculated in both groups. Results. The levels of 25-OHD in the obese group were significantly lower than those of the nonobese (P = 0.002). HOMA-IR, triglycerides, low-density lipoprotein, and ALT levels in the obese group were significantly higher than values of control group (P < 0.001 and P = 0.002, resp.). In the obese group, vitamin D deficiency, insufficiency, and sufficiency (25-OHD < 10 ng/dl, < 20, >10 ng/dl; > 20 ng/dl, resp.) were not correlated with HOMA-IR (r : -0.008, P = 0.935). HOMA-IR was negatively correlated with BMI, BMI SDS, and BMI%, and triglycerides, low-density lipoprotein, and ALT levels (P < 0.001). Conclusion. The insulin resistance of the obese subjects who were vitamin D deficient and insufficient did not statistically differ from those with vitamin D sufficiency. Low 25-hydroxyvitamin D levels were not related with higher insulin resistance in obese children and adolescents. In obese subjects, insulin resistance was affected more from BMI, BMI SDS, and BMI% than from 25-hydroxyvitamin D levels.

摘要

目的。本研究旨在探讨肥胖儿童与非肥胖儿童胰岛素抵抗与血清 25-羟维生素 D(25-OHD)水平的关系。

材料和方法。研究组纳入 188 例肥胖儿童(9-15 岁),对照组为 68 例年龄和性别匹配的正常体重健康儿童。记录患者的人体测量学数据,检测空腹血糖、胰岛素、血脂、丙氨酸氨基转移酶(ALT)和血清 25-OHD 水平。计算两组的稳态模型评估胰岛素抵抗指数(HOMA-IR)。

结果。肥胖组的 25-OHD 水平明显低于非肥胖组(P = 0.002)。肥胖组的 HOMA-IR、甘油三酯、低密度脂蛋白和 ALT 水平明显高于对照组(P < 0.001 和 P = 0.002)。在肥胖组中,维生素 D 缺乏、不足和充足(25-OHD < 10ng/dl、< 20ng/dl、> 10ng/dl;> 20ng/dl)与 HOMA-IR 无相关性(r:-0.008,P = 0.935)。HOMA-IR 与 BMI、BMI SDS 和 BMI%及甘油三酯、低密度脂蛋白和 ALT 水平呈负相关(P < 0.001)。

结论。维生素 D 缺乏和不足的肥胖患者的胰岛素抵抗与维生素 D 充足的患者无统计学差异。低 25-羟维生素 D 水平与肥胖儿童和青少年更高的胰岛素抵抗无关。在肥胖患者中,胰岛素抵抗受 BMI、BMI SDS 和 BMI%的影响大于 25-羟维生素 D 水平。

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