Rambhojan Christine, Larifla Laurent, Clepier Josiane, Bouaziz-Amar Elodie, Velayoudom-Cephise Fritz-Line, Blanchet-Deverly Anne, Armand Christophe, Plumasseau Jean, Lacorte Jean-Marc, Foucan Lydia
Equipe de recherche sur le Risque Cardio métabolique, ECM/LAMIA EA4540, Université des Antilles, Guadeloupe, France.
Réseau GRANDIR, Guadeloupe, France.
Open Access Maced J Med Sci. 2016 Dec 15;4(4):596-602. doi: 10.3889/oamjms.2016.131. Epub 2016 Dec 8.
We aimed to study the relationships between circulating 25-hydroxyvitamin D [25(OH)D], insulin resistance and leptin-to-adiponectin (L/A) ratio in Guadeloupean children and adolescents and to analyse the changes in 25(OH)D levels after a 1-year lifestyle intervention program.
25(OH)D concentrations were measured via a chemiluminescence assay. Cardiometabolic risk factors, homoeostasis model assessment of insulin resistance (HOMA-IR), and adipokines were measured. The lifestyle intervention included dietary counselling, regular physical activity.
Among 117 girls and boys (11-15 years old, 31.6% obese), 40% had vitamin D deficiency (25(OH)D levels < 20 ng/mL). With linear regression models where 25(OH)D and HOMA-IR acted as independent variables and age, sex, BMI, L/A ratio as covariates, 25(OH)D was significantly associated with HOMA-IR alone (P = 0.036). HOMA-IR was also associated with BMI z-score ≥ 2, L/A ratio and an interaction term BMI z-score ≥ 2*L/A ratio (P < 0.001 for all). After one year, in 78 children/adolescent, mean serum 25(OH)D increased significantly from 21.4 ± 4.9 ng/mL at baseline to 23.2 ± 6.0 after 1 year; P = 0.003 whereas BMI z-score, HOMA-IR and L/A ratio decreased significantly (P = 0.003, P < 0.001 and P = 0.012; respectively).
The association between 25(OH)D and HOMA-IR, independently of obesity and the high prevalence of vitamin D deficiency should be considered in order to prevent the later incidence of T2DM. A healthy lifestyle including non-sedentary and outdoor activities could be a way for improving vitamin D status.
我们旨在研究瓜德罗普岛儿童和青少年中循环25-羟基维生素D[25(OH)D]、胰岛素抵抗与瘦素与脂联素比值（L/A）之间的关系，并分析为期1年的生活方式干预计划后25(OH)D水平的变化。
通过化学发光法测定25(OH)D浓度。测量心血管代谢危险因素、胰岛素抵抗的稳态模型评估（HOMA-IR）和脂肪因子。生活方式干预包括饮食咨询、定期体育活动。
在117名男孩和女孩（11-15岁，31.6%肥胖）中，40%存在维生素D缺乏（25(OH)D水平<20 ng/mL）。在以25(OH)D和HOMA-IR作为自变量、年龄、性别、BMI、L/A比值作为协变量的线性回归模型中，25(OH)D仅与HOMA-IR显著相关（P = 0.036）。HOMA-IR还与BMI z评分≥2、L/A比值以及交互项BMI z评分≥2*L/A比值相关（所有P<0.001）。一年后，78名儿童/青少年的血清25(OH)D平均水平从基线时的21.4±4.9 ng/mL显著升高至1年后的23.2±6.0 ng/mL；P = 0.003，而BMI z评分、HOMA-IR和L/A比值显著降低（分别为P = 0.003、P<0.001和P = 0.012）。
为预防2型糖尿病的后期发病，应考虑25(OH)D与HOMA-IR之间的关联，且该关联独立于肥胖和维生素D缺乏的高患病率。包括非久坐和户外活动在内的健康生活方式可能是改善维生素D状况的一种方法。
