Greene-Finestone Linda S, Garriguet Didier, Brooks Stephen, Langlois Kellie, Whiting Susan J
Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario.
Health Analysis Division, Statistics Canada, Ottawa, Ontario.
Paediatr Child Health. 2017 Nov;22(8):438-444. doi: 10.1093/pch/pxx116. Epub 2017 Nov 10.
There is evidence that 25-hydroxyvitamin D levels are lower in overweight and obese youth. This study examined the relationship between weight status and 25-hydroxyvitamin D, while controlling for confounders, in Canadian youth.
Plasma 25-hydroxyvitamin D from subjects aged 6 to 17 years from the Canadian Health Measures Survey cycles 1 (2007 to 2009) and 2 (2009 to 2011) was used. Sex-specific multiple linear regression and logistic regressions examined the relationship of overweight and obesity (body mass index ≥ 85 percentile) with 25-hydroxyvitamin D levels and the odds of 25-hydroxyvitamin D <40 nmol/L and <50 nmol/L.
The prevalence of risk of vitamin D deficiency (25-hydroxyvitamin D < 30 nmol/L) was 6% (95% confidence interval [CI] 3.26% to 10.12%). Vitamin D inadequacy, estimated by levels <40 nmol/L, was 15% (95% CI 10.34% to 20.39%; 19% [95% CI 13.1 to 25.6] for teenagers). Seventy per cent (95% CI 63.59 to 75.17) had levels >50 nmol/L, consistent with achieving the Recommended Dietary Allowance. In adjusted analyses, overweight/obesity (1/3 of subjects) was independently associated with lower 25-hydroxyvitamin D for both sexes after adjustment for age, race, income, season, vitamin D supplementation and daily milk consumption. For 25-hydroxyvitamin D <40 nmol/L, the overweight/obese odds ratio for males was 2.63 (95% CI 1.34 to 5.18). For 25-hydroxyvitamin D <50 nmol/L, overweight/obese odds ratios were 2.19 (95% CI 1.46 to 3.28) for males and 1.39 (95% CI 1.05 to 1.84) for females.
This study confirms the inverse association between adiposity and serum concentrations of 25-hydroxyvitamin D in Canadian youth and the independent association of overweight/obesity to 25-hydroxyvitamin D level and vitamin D status after adjustment for other factors.
有证据表明超重和肥胖青少年的25-羟基维生素D水平较低。本研究在控制混杂因素的情况下，调查了加拿大青少年体重状况与25-羟基维生素D之间的关系。
使用了加拿大健康措施调查第1周期（2007年至2009年）和第2周期（2009年至2011年）中6至17岁受试者的血浆25-羟基维生素D。特定性别的多元线性回归和逻辑回归分析了超重和肥胖（体重指数≥第85百分位数）与25-羟基维生素D水平以及25-羟基维生素D<40 nmol/L和<50 nmol/L的几率之间的关系。
维生素D缺乏风险（25-羟基维生素D<30 nmol/L）的患病率为6%（95%置信区间[CI] 3.26%至10.12%）。以<40 nmol/L的水平估计，维生素D不足的比例为15%（95% CI 10.34%至20.39%；青少年为19%[95% CI 13.1至25.6]）。70%（95% CI 63.59至75.17）的人水平>50 nmol/L，符合推荐膳食摄入量。在调整分析中，在对年龄、种族、收入、季节、维生素D补充剂和每日牛奶摄入量进行调整后，超重/肥胖（受试者的三分之一）与两性较低的25-羟基维生素D独立相关。对于25-羟基维生素D<40 nmol/L，男性超重/肥胖的优势比为2.63（95% CI 1.34至5.18）。对于25-羟基维生素D<50 nmol/L，男性超重/肥胖的优势比为2.19（95% CI 1.46至3.28），女性为1.39（95% CI 1.05至1.84）。
本研究证实了加拿大青少年肥胖与血清25-羟基维生素D浓度之间的负相关，以及在调整其他因素后超重/肥胖与25-羟基维生素D水平和维生素D状态的独立关联。
