Department of Pediatric Endocrinology and Diabetes, Konya Research Hospital, Konya, Turkey.
Obes Res Clin Pract. 2013 Jul-Aug;7(4):e275-83. doi: 10.1016/j.orcp.2012.01.004.
The aim of this study was to investigate the relationships between 25-hydroxy-vitamin D (25(OH)D) and insulin resistance in obese adolescents with non-alcoholic fatty liver disease (NAFLD).
Eighty-seven obese adolescents (45 girls and 42 boys, mean age: 12.7 ± 1.3 years, mean body mass index standard deviation score (BMI-SDS): 2.1 ± 0.3) and 30 lean subjects (15 girls and 15 boys, mean age: 12.3 ± 1.45 years, mean BMI-SDS: 0.5 ± 0.7) were enrolled for the study. The obese subjects were divided into two subgroups based on the presence or absence of fatty liver with high transaminases (NAFLD group and non-NAFLD group). Fasting blood samples were assayed for 25(OH)D, transaminases, glucose, and insulin levels. Insulin resistance was calculated by the homeostasis model assessment (HOMA-IR).
25(OH)D measurements were decreased in both obese groups (NAFLD and non-NAFLD) in comparison with the lean group (29.5 ± 18.4 vs. 41.0 ± 17.9 vs. 48.1 ± 22.2 ng/mL). However; the NAFLD group had significantly lower measurements of 25(OH)D than the non-NAFLD group (p < 0.001) and lean group (p < 0.001). 25(OH)D was negatively correlated with HOMA-IR (r = 0.158, p = 0.01) and with alanine aminotransferase (r = 0.794, p = 0.03) in the NAFLD obese group. There was no significant associations between fasting insulin, BMI-SDS and 25(OH)D in obese groups.
We suggest that low 25(OH)D occurs commonly in obese adolescents with NAFLD and we demonstrated an association between insufficient vitamin D status and low insulin sensitivity in obese adolescents with NAFLD.
本研究旨在探讨非酒精性脂肪性肝病(NAFLD)肥胖青少年中 25-羟维生素 D(25(OH)D)与胰岛素抵抗之间的关系。
本研究纳入了 87 名肥胖青少年(45 名女性和 42 名男性,平均年龄:12.7 ± 1.3 岁,平均体质指数标准差评分(BMI-SDS):2.1 ± 0.3)和 30 名正常体重青少年(15 名女性和 15 名男性,平均年龄:12.3 ± 1.45 岁,平均 BMI-SDS:0.5 ± 0.7)。根据是否存在高转氨酶的脂肪肝将肥胖组分为两个亚组(NAFLD 组和非 NAFLD 组)。采集空腹血样检测 25(OH)D、转氨酶、血糖和胰岛素水平。采用稳态模型评估(HOMA-IR)计算胰岛素抵抗。
与正常体重组相比,两组肥胖青少年(NAFLD 和非 NAFLD)的 25(OH)D 水平均降低(29.5 ± 18.4 vs. 41.0 ± 17.9 vs. 48.1 ± 22.2 ng/mL)。然而,NAFLD 组的 25(OH)D 水平明显低于非 NAFLD 组(p < 0.001)和正常体重组(p < 0.001)。NAFLD 肥胖组中,25(OH)D 与 HOMA-IR(r = 0.158,p = 0.01)和丙氨酸氨基转移酶(r = 0.794,p = 0.03)呈负相关。在肥胖组中,空腹胰岛素、BMI-SDS 与 25(OH)D 之间无显著相关性。
我们发现,NAFLD 肥胖青少年中普遍存在低 25(OH)D 血症,并且我们证明了维生素 D 状态不足与 NAFLD 肥胖青少年的胰岛素敏感性降低之间存在关联。