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维生素 D 不足/缺乏与巴西儿童的胰岛素抵抗有关,而与体脂分布无关。

Vitamin D insufficiency/deficiency is associated with insulin resistance in Brazilian children, regardless of body fat distribution.

机构信息

1Department of Nutrition and Health,Federal University of Viçosa,Biological Sciences Center,Viçosa,CEP 36570-900,MG,Brazil.

2Department of Nutrition,Federal University of Minas Gerais,Belo Horizonte,MG,Brazil.

出版信息

Public Health Nutr. 2017 Nov;20(16):2878-2886. doi: 10.1017/S136898001700194X. Epub 2017 Aug 22.

Abstract

OBJECTIVE

To assess the prevalence of vitamin D insufficiency and deficiency and its association with cardiometabolic risk factors, controlled by adiposity, in a representative sample of prepubescent children.

DESIGN

Cross-sectional population-based study. Body composition was evaluated by dual-energy X-ray absorptiometry. Anthropometric measures and blood pressure were performed. Laboratory analyses were performed to determine the levels of vitamin D (25-hydroxyitamin D; 25(OH)D), glucose, insulin, serum lipids and intact parathyroid hormone. Dietary intake was assessed by three 24 h recalls.

SETTING

Viçosa, Minas Gerais, Brazil, 2015.

SUBJECTS

Representative sample of 378 children aged 8 and 9 years from urban schools.

RESULTS

Inadequate serum concentrations of 25(OH)D were diagnosed in more than half of the children and none of them met the recommended vitamin D intake. After adjusting for confounding factors in the multiple regression analysis, lower prevalence of insulin resistance and hypertriacylglycerolaemia was found in children with serum 25(OH)D levels ≥75 nmol/l (prevalence ratio=0·25; 95 % CI 0·08, 0·85) and ≥50 nmol/l (prevalence ratio=0·61; 95 % CI 0·37, 0·99), respectively. However, after adjusting for different indicators of adiposity, insulin resistance remained independently associated and the association with hypertriacylglycerolaemia was lost after adjusting for central adiposity. The prevalence of vitamin D insufficiency/deficiency was associated with the number of cardiometabolic alterations in children.

CONCLUSIONS

The study results showed that prevalence of vitamin D insufficiency/deficiency was high among the children and insulin resistance was the main cardiometabolic alteration associated with this condition, even in a tropical climate country such as Brazil.

摘要

目的

评估维生素 D 不足和缺乏的流行情况及其与肥胖控制下的代谢危险因素的相关性,在青春期前儿童的代表性样本中进行。

设计

横断面人群基础研究。采用双能 X 射线吸收法评估身体成分。进行人体测量和血压测量。进行实验室分析以确定维生素 D(25-羟维生素 D;25(OH)D)、血糖、胰岛素、血清脂质和完整甲状旁腺激素的水平。通过三份 24 小时回顾评估饮食摄入量。

地点

巴西米纳斯吉拉斯州维索萨,2015 年。

受试者

来自城市学校的 378 名 8 至 9 岁的儿童的代表性样本。

结果

超过一半的儿童血清 25(OH)D 浓度不足,且他们均未达到推荐的维生素 D 摄入量。在多元回归分析中调整混杂因素后,血清 25(OH)D 水平≥75nmol/l(患病率比=0·25;95 % CI 0·08, 0·85)和≥50nmol/l(患病率比=0·61;95 % CI 0·37, 0·99)的儿童中,胰岛素抵抗和高三酰甘油血症的发生率较低。然而,在调整不同的肥胖指标后,胰岛素抵抗仍然与该疾病独立相关,且在调整中心性肥胖后,与高三酰甘油血症的相关性消失。维生素 D 不足/缺乏的流行与儿童中心血管代谢异常的数量有关。

结论

研究结果表明,巴西等热带气候国家的儿童维生素 D 不足/缺乏的流行率较高,胰岛素抵抗是与这种情况相关的主要心血管代谢异常。

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