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25-羟基维生素D不足可区分接受超重筛查的青春期前男孩心血管危险因素的累积情况。

25-Hydroxyvitamin D insufficiency discriminates cardiovascular risk factors accumulation in peri-pubertal boys undergoing overweight screening.

作者信息

Di Nisio Andrea, De Toni Luca, D'Addato Elvio, Pizzo Maria R, Sabatino Pasquale, Foresta Carlo

机构信息

Department of Medicine, Unit of Andrology and Human Reproductive Medicine, University of Padova, Via Giustiniani, 2, 35128, Padua, Italy.

U.O. Medicina P.O., Sapri (Salerno), Italy.

出版信息

Endocrine. 2016 Aug;53(2):530-7. doi: 10.1007/s12020-015-0725-4. Epub 2015 Sep 1.

Abstract

The aim of this study was to evaluate the possible association between cardiometabolic risk factors accumulation and vitamin D status in a cohort of Italian normal weight and overweight male children. 108 boys enrolled in an andrological health prevention project underwent physical examination, anthropometric measurements, and fasting blood sampling. Serum blood glucose, HDL-cholesterol, triglycerides, parathyroid hormone, and 25-hydroxyvitamin D (25(OH)D) were measured. Cardiovascular risk factors were defined according to the National Cholesterol Education Program Adult Treatment Panel III modified for age. Lean and overweight subjects differed in terms of waist circumference (P < 0.001), HDL-cholesterol (P = 0.001), triglycerides (P = 0.001), systolic blood pressure (P < 0.001) and diastolic blood pressure (P = 0.002). Both groups had similar mean 25(OH)D levels (P = 0.160) and were below the sufficiency threshold: indeed only 24 % of normal weight had 25(OH)D ≥30 ng/ml, and even less in the overweight/obese group (8 %, P = 0.03 vs. normal weight). A significant accumulation of risk factors in course of 25(OH)D insufficiency was detected in both the whole cohort and in the normal weight group (P = 0.003 and P = 0.04, respectively) with odd ratios of 1.31 (1.16-1.49 95%CI) and 1.41 (1.18-1.69 95%CI), respectively. In course of vitamin D deficiency, the odd ratios were 2.24 (1.34-3.77 95%CI, P = 0.003) in the whole cohort and 2.40 (1.27-4.82 95%CI, P = 0.03) in lean subjects. We reported a considerable occurrence of cardiovascular risk factors in course of hypovitaminosis D in overweight/obese boys and even in lean subjects, which normally would not have been further evaluated by considering the sole BMI-related parameters. In this regard, 25(OH)D levels appear as a potential discriminating parameter able to identify male children at higher health risk.

摘要

本研究旨在评估一组意大利正常体重和超重男童中心血管代谢危险因素聚集与维生素D状态之间的可能关联。108名参加男性生殖健康预防项目的男孩接受了体格检查、人体测量和空腹血样采集。检测了血清血糖、高密度脂蛋白胆固醇、甘油三酯、甲状旁腺激素和25-羟基维生素D(25(OH)D)。心血管危险因素根据针对年龄进行修改的美国国家胆固醇教育计划成人治疗小组第三次报告来定义。消瘦和超重受试者在腰围(P<0.001)、高密度脂蛋白胆固醇(P=0.001)、甘油三酯(P=0.001)、收缩压(P<0.001)和舒张压(P=0.002)方面存在差异。两组的平均25(OH)D水平相似(P=0.160),且均低于充足阈值:实际上,只有24%的正常体重者25(OH)D≥30 ng/ml,超重/肥胖组更低(8%,与正常体重组相比P=0.03)。在整个队列和正常体重组中均检测到在25(OH)D不足过程中危险因素有显著聚集(分别为P=0.003和P=0.04),优势比分别为1.31(1.16 - 1.49,95%CI)和1.41(1.18 - 1.69,95%CI)。在维生素D缺乏过程中,整个队列的优势比为2.24(1.34 - 3.77,95%CI,P=0.003),消瘦受试者为2.40(1.27 - 4.82,95%CI,P=0.03)。我们报告了超重/肥胖男孩甚至消瘦受试者在维生素D缺乏过程中心血管危险因素相当普遍存在,而仅考虑与BMI相关的参数时通常不会对其进行进一步评估。在这方面,25(OH)D水平似乎是一个能够识别健康风险较高男童的潜在鉴别参数。

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