Nutrition Laboratory. School of Medicine, Universidad de Colima, Colima, México.
J Pediatr Endocrinol Metab. 2020 Apr 28;33(4):481-486. doi: 10.1515/jpem-2019-0510.
Background Obesity in children and adolescents has increased alarmingly, placing them at a higher risk for impaired glucose tolerance and type 2 diabetes. The prevalence of vitamin D deficiency has increased as well. Vitamin D is critical for glucose homeostasis and insulin secretion. Studies on adults have reported an inverse association between vitamin D levels and insulin resistance (IR), but the results in children are inconsistent. The aim of our study was to determine the association between IR and serum vitamin D levels in obese Mexican children and adolescents. Methods A cross-sectional study was performed on 227 children and adolescents between 6 and 19 years of age. Obesity was diagnosed through body mass index (BMI) for age, according to the World Health Organization (WHO) criteria (2007). 25-Hydroxyvitamin D (25[OH]D) was measured using an immunoassay technique and the homeostatic model assessment of insulin resistance (HOMA-IR) was calculated using the Matthews equation. Student's t-test was carried out. Results The mean serum 25(OH)D level was 35.80 ng/mL, and 55.1% of the subjects had levels classified as sufficient, 33.5% as insufficient, and 11.5% as deficient. The mean level of HOMA-IR was 3.16, and 70% of the subjects were diagnosed with IR. Fasting insulin levels and HOMA-IR were significantly different in adolescents with hypovitaminosis, compared with adolescents in the vitamin D sufficiency group (p = 0.01 and p = 0.03, respectively). Conclusions The insulin levels and HOMA-IR were higher in adolescents with hypovitaminosis. The girls presented higher levels of insulin and HOMA-IR than the boys.
儿童和青少年的肥胖问题令人震惊地增加,使他们更容易出现葡萄糖耐量受损和 2 型糖尿病。维生素 D 缺乏的患病率也有所增加。维生素 D 对葡萄糖稳态和胰岛素分泌至关重要。成人研究报告称,维生素 D 水平与胰岛素抵抗(IR)呈负相关,但儿童的结果不一致。我们的研究目的是确定肥胖墨西哥儿童和青少年的 IR 与血清维生素 D 水平之间的关系。
对 227 名 6 至 19 岁的儿童和青少年进行了横断面研究。根据世界卫生组织(WHO)标准(2007 年),通过年龄的体重指数(BMI)诊断肥胖。使用免疫测定技术测量 25-羟维生素 D(25[OH]D),并使用 Matthews 方程计算胰岛素抵抗的稳态模型评估(HOMA-IR)。进行了学生 t 检验。
血清 25(OH)D 水平的平均值为 35.80ng/mL,55.1%的受试者的水平被归类为充足,33.5%为不足,11.5%为缺乏。HOMA-IR 的平均水平为 3.16,70%的受试者被诊断为 IR。与维生素 D 充足组的青少年相比,维生素 D 缺乏症青少年的空腹胰岛素水平和 HOMA-IR 差异显著(p=0.01 和 p=0.03)。
维生素 D 缺乏症青少年的胰岛素水平和 HOMA-IR 较高。女孩的胰岛素和 HOMA-IR 水平高于男孩。