Pediatrics Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
Front Endocrinol (Lausanne). 2020 Jun 16;11:310. doi: 10.3389/fendo.2020.00310. eCollection 2020.
Different metabolic phenotypes of obesity are related to cardiometabolic risk factors in children and adolescents. Vitamin D, as one important factor, could be related to different subgroups of metabolic obesity and might affect metabolic disorders. The purpose of this study was to evaluate the relationship between serum 25-hydroxyvitamin D concentration and subsets of metabolic phenotypes of obesity in children and adolescents. This nationwide cross-sectional study was conducted in the framework of the fifth survey of a national surveillance program, the CASPIAN study. Overall, 2,594 students aged 7-18 years were assessed for 25-hydroxyvitamin D status. Metabolic syndrome (MetS) was defined according to the ATP III criteria modified for the pediatric age group. Participants were classified into four metabolic phenotypes of obesity according to categories of the BMI and metabolic status: "metabolically healthy obese" (MHO), "metabolically non-healthy non-obese" (MNHNO), "metabolically non-healthy obese" (MNHO), and "metabolically healthy non-obese" (MHNO). Multinomial logistic regression analysis was performed for evaluating the association of 25-hydroxyvitamin D status with different metabolic phenotypes of obesity. In this study, 85.2% of participants were classified as MHNO, 11.0 % as MHO, 2.5% as MNHNO, and 1.3% as MNHO. The frequency of hypovitaminosis D was more prevalent in MNHO (85.3%) than in other phenotypes (MHNO: 70%; MHO: 76.5%; MNHNO: 78.1%, respectively; < 0.05). In the multivariate model, hypovitaminosis D significantly increased the odds of being MHO (OR: 1.46; 95% CI: 1.07-1.77) and MNHO (OR: 2.89; 1.05-8.31) compared to the healthy group. Likewise, in multivariate model, per each unit (ng/mL) increment in 25-hydroxyvitamin D concentration, the odds of MNHNO and MNHO decreased significantly by 7% (OR: 0.93; 0.91-0.96) and 6% (OR: 0.94; 0.91-0.98) respectively. Our results support the hypothesis that 25-hydroxyvitamin D concentration is associated with metabolic obesity phenotypes. Longitudinal studies are necessary to assess the clinical impacts of this finding.
不同代谢表型的肥胖与儿童和青少年的心血管代谢危险因素有关。维生素 D 作为一个重要因素，可能与代谢性肥胖的不同亚群有关，并可能影响代谢紊乱。本研究旨在评估血清 25-羟维生素 D 浓度与儿童和青少年肥胖代谢表型亚群的关系。 这是一项全国性的横断面研究，在国家监测计划第五次调查的框架内进行，即 CASPIAN 研究。总体而言，对 2594 名 7-18 岁的学生进行了 25-羟维生素 D 状况评估。代谢综合征（MetS）根据适用于儿科年龄组的 ATP III 标准进行定义。根据 BMI 和代谢状态的类别，将参与者分为四种肥胖代谢表型：“代谢健康肥胖”（MHO）、“代谢不健康非肥胖”（MNHNO）、“代谢不健康肥胖”（MNHO）和“代谢健康非肥胖”（MHNO）。使用多项逻辑回归分析评估 25-羟维生素 D 状态与不同代谢肥胖表型的关系。 在这项研究中，85.2%的参与者被归类为 MHNO，11.0%为 MHO，2.5%为 MNHNO，1.3%为 MNHO。维生素 D 缺乏症的发生率在 MNHO 中更为常见（85.3%），而在其他表型中则较少（MHNO：70%；MHO：76.5%；MNHNO：78.1%；均<0.05）。在多变量模型中，维生素 D 缺乏症显著增加了 MHO（OR：1.46；95%CI：1.07-1.77）和 MNHO（OR：2.89；1.05-8.31）的患病几率，与健康组相比。同样，在多变量模型中，25-羟维生素 D 浓度每增加一个单位（ng/mL），MNHNO 和 MNHO 的患病几率分别显著降低 7%（OR：0.93；0.91-0.96）和 6%（OR：0.94；0.91-0.98）。 我们的研究结果支持了 25-羟维生素 D 浓度与代谢性肥胖表型有关的假设。需要进行纵向研究来评估这一发现的临床影响。
