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巴西青少年维生素 D 不足与肥胖和代谢紊乱的关系。

Association of vitamin D insufficiency with adiposity and metabolic disorders in Brazilian adolescents.

机构信息

1 Department of Nutrition, Federal University of Juiz de Fora, Rua Antonio Altaf 150/201, Cascatinha 36033-330, Juiz de Fora, Minas Gerais, Brazil.

2 Department of Nutrition and Health, Federal University of Viçosa, Viçosa, MG, Brazil.

出版信息

Public Health Nutr. 2014 Apr;17(4):787-94. doi: 10.1017/S1368980013001225. Epub 2013 May 9.

Abstract

OBJECTIVE

The present study aimed to evaluate the frequency of deficiency/insufficiency of vitamin D in adolescents and its relationship to overweight and metabolic disorders.

DESIGN

Cross-sectional study. Nutritional status was assessed by BMI according to WHO recommendations. Dietary intake was evaluated using a 3 d dietary record. The biochemical evaluation comprised measurements of serum lipids, lipoproteins, glucose, insulin, calcidiol (25(OH)D) and parathyroid hormone. Insulin resistance was calculated using the homeostasis model assessment. Body composition and blood pressure were assessed.

SETTING

Fifteen schools (eight public and seven private) in the central city of Juiz de Fora, Brazil.

SUBJECTS

The analysis included a study population of 160 adolescents (seventy-seven eutrophic and eighty-three overweight) aged 15 to 17 years.

RESULTS

Vitamin D deficiency and insufficiency was observed in 1.25 and 70.6 % of adolescents, respectively. Serum 25(OH)D levels were statistically lower in adolescents with weight excess, abdominal obesity, hypercholesterolaemia, higher levels of parathyroid hormone, insulin resistance, hyperinsulinaemia and hypertension (P < 0.05). Lower BMI and waist circumference were observed in the third (highest) tertile of vitamin D intake for all adolescents. The high prevalence of vitamin D insufficiency is primarily nutritional and reflects a low vitamin D intake.

CONCLUSIONS

Our results support the negative association among serum 25(OH)D levels and vitamin D intake with non-skeletal outcomes in Brazilian adolescents. Vitamin D fortification of foods and/or the use of vitamin D supplements need to be considered to raise vitamin D intake in the adolescent population, even in a sunny country like Brazil.

摘要

目的

本研究旨在评估青少年维生素 D 缺乏/不足的频率及其与超重和代谢紊乱的关系。

设计

横断面研究。根据世界卫生组织的建议,通过 BMI 评估营养状况。使用 3 天饮食记录评估饮食摄入。生化评估包括血清脂质、脂蛋白、血糖、胰岛素、钙二醇(25(OH)D)和甲状旁腺激素的测量。使用稳态模型评估计算胰岛素抵抗。评估身体成分和血压。

地点

巴西中部茹伊斯-迪福拉市的十五所学校(八所公立和七所私立)。

受试者

分析包括 160 名 15 至 17 岁的青少年(77 名营养良好和 83 名超重)的研究人群。

结果

分别有 1.25%和 70.6%的青少年存在维生素 D 缺乏和不足。超重、腹部肥胖、高胆固醇血症、甲状旁腺激素水平较高、胰岛素抵抗、高胰岛素血症和高血压的青少年血清 25(OH)D 水平较低(P < 0.05)。所有青少年的维生素 D 摄入量的第三(最高)三分位时,BMI 和腰围较低。维生素 D 不足的高患病率主要是营养性的,反映了维生素 D 摄入量低。

结论

我们的结果支持巴西青少年血清 25(OH)D 水平与非骨骼结局之间的负相关。需要考虑对食物进行维生素 D 强化或使用维生素 D 补充剂来提高青少年人群的维生素 D 摄入量,即使在像巴西这样阳光充足的国家也是如此。

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