Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China.
Department of Non-communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
BMJ Open Diabetes Res Care. 2020 Feb;8(1). doi: 10.1136/bmjdrc-2019-000846.
Vitamin D deficiency has recently evolved as a major public health issue worldwide. But the relationship between vitamin D and cardiovascular health in children remains unclear. Accordingly, we aimed to examine the associations between 25-hydroxyvitamin D (25(OH)D) concentrations and cardiometabolic risk factors, and to assess the possible effect modification of obesity on the associations in a Chinese pediatric population.
A cross-sectional sample of 6091 children aged 6-18 years was obtained using a cluster sampling method. The 25(OH)D concentrations, and metabolic risk factors, including waist to height ratio, blood pressure, blood lipids, fasting blood glucose (FBG), and insulin were measured. Adjusted ORs and multiplicative or additive interaction were calculated to assess the associations and effect modification, respectively.
Triglycerides, FBG, insulin, and homeostasis model assessment of insulin resistance were inversely associated with 25(OH)D concentrations (p<0.05) in both sexes. The OR of hyperglycemia among individuals with insufficient vitamin D was higher than those with adequate vitamin D after adjusting for covariates (OR: 1.47; 95% CI 1.26 to 1.70). Moreover, girls with insufficient vitamin D had significantly higher odds for hypertension and high total cholesterol than those with adequate vitamin D, which was not observed in boys. Thirty-two percent (95% CI 14% to 51%) of the increased odds of hyperglycemia can be explained by the interaction between insufficient vitamin D and obesity.
Vitamin D insufficiency is associated with increased odds of various cardiometabolic risk factors in Chinese children and has a synergistic effect on hyperglycemia with obesity.
维生素 D 缺乏症最近已成为全球主要的公共健康问题。但维生素 D 与儿童心血管健康之间的关系仍不清楚。因此，我们旨在研究 25-羟维生素 D（25（OH）D）浓度与心脏代谢危险因素之间的关系，并评估肥胖对中国儿科人群中这些关系的可能修饰作用。
采用聚类抽样法获得了 6091 名 6-18 岁儿童的横断面样本。测量了 25（OH）D 浓度以及代谢危险因素，包括腰高比、血压、血脂、空腹血糖（FBG）和胰岛素。计算了调整后的 OR 和乘法或加法交互作用，以评估关联和效应修饰。
在两性中，甘油三酯、FBG、胰岛素和胰岛素抵抗的稳态模型评估与 25（OH）D 浓度呈负相关（p<0.05）。调整协变量后，维生素 D 不足个体的高血糖 OR 高于维生素 D 充足个体（OR：1.47；95%CI 1.26 至 1.70）。此外，与维生素 D 充足的女孩相比，维生素 D 不足的女孩患高血压和高总胆固醇的几率明显更高，而男孩则没有这种情况。32%（95%CI 14%至 51%）的高血糖几率增加可以由维生素 D 不足和肥胖之间的交互作用来解释。
维生素 D 不足与中国儿童各种心脏代谢危险因素的几率增加有关，并与肥胖协同作用导致高血糖。
