Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.
Am J Clin Nutr. 2022 Jan 11;115(1):73-82. doi: 10.1093/ajcn/nqab319.
There remains a lack of evidence demonstrating a potential relationship between vitamin D and cardiometabolic risk among children.
We examined the effect of 3 different dosages of vitamin D on cardiometabolic risk factors among children at risk of deficiency.
Racially diverse schoolchildren aged 8-15 y were randomly assigned in a double-blind fashion to supplementation with 600, 1000, or 2000 IU vitamin D3/d for 6 mo. Changes in HDL cholesterol, triglycerides, LDL cholesterol, total cholesterol, and blood glucose over 6 mo and at 12 mo (6 mo post-supplementation) were assessed. Subgroup analyses were also performed by weight status and race.
Among 604 children, 40.9% were vitamin D-inadequate at baseline (<20 ng/mL; mean ± SD: 22.0 ± 6.8 ng/mL), 46.4% were overweight/obese, and 60.9% had ≥1 suboptimal blood lipids or glucose. Over 6 mo, serum 25-hydroxyvitamin D increased in all 3 dosage groups from baseline (mean ± SE change: 4.4 ± 0.6 ng/mL, 5.7 ± 0.7 ng/mL, and 10.7 ± 0.6 ng/mL for 600, 1000, and 2000 IU/d, respectively; P < 0.001). Whereas HDL cholesterol and triglycerides increased in the 600 IU group (P = 0.002 and P = 0.02, respectively), LDL cholesterol and total cholesterol decreased across dosage groups. At 6 mo post-supplementation, HDL cholesterol remained elevated in the 600 and 1000 IU groups ( P < 0.001 and P = 0.02, respectively) whereas triglycerides remained elevated in the 1000 and 2000 IU groups (P = 0.04 and P = 0.006, respectively). The suppression of LDL cholesterol and total cholesterol persisted in the 2000 IU group only (P = 0.04 and P < 0.001, respectively). There were no significant changes in blood glucose and similar responses were observed overall by weight status and racial groups across dosages.
Vitamin D supplementation demonstrated generally positive effects on HDL cholesterol, LDL cholesterol, and total cholesterol, especially at the lower dosage of 600 IU/d, with several significant changes persisting during the post-supplementation period. Increases in triglycerides across dosage groups may be due to natural changes during adolescence warranting further study.This trial was registered at clinicaltrials.gov as NCT01537809.
目前仍缺乏维生素 D 与儿童心血管代谢风险之间潜在关系的证据。
我们研究了 3 种不同剂量的维生素 D 对有缺乏风险的儿童心血管代谢风险因素的影响。
8-15 岁的不同种族的学龄儿童以双盲的方式随机分配，每天补充 600、1000 或 2000 IU 的维生素 D3，持续 6 个月。在 6 个月和 12 个月（6 个月的补充后）时评估高密度脂蛋白胆固醇、甘油三酯、低密度脂蛋白胆固醇、总胆固醇和血糖的变化。还按体重状况和种族进行了亚组分析。
在 604 名儿童中，40.9%的儿童在基线时维生素 D 不足（<20ng/ml；平均±SD：22.0±6.8ng/ml），46.4%超重/肥胖，60.9%有≥1 项血脂或血糖不达标。在所有 3 个剂量组中，血清 25-羟维生素 D 从基线开始增加（600 IU/d、1000 IU/d 和 2000 IU/d 组的平均±SE 变化分别为 4.4±0.6ng/ml、5.7±0.7ng/ml 和 10.7±0.6ng/ml；P<0.001）。虽然在 600 IU 组中高密度脂蛋白胆固醇和甘油三酯升高（P=0.002 和 P=0.02），但 LDL 胆固醇和总胆固醇在各剂量组中降低。在补充后 6 个月时，600 和 1000 IU 组的高密度脂蛋白胆固醇仍升高（P<0.001 和 P=0.02），而 1000 和 2000 IU 组的甘油三酯仍升高（P=0.04 和 P=0.006）。只有在 2000 IU 组中 LDL 胆固醇和总胆固醇的抑制作用持续存在（P=0.04 和 P<0.001）。血糖无显著变化，各剂量组按体重状况和种族分组，整体反应相似。
维生素 D 补充对高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和总胆固醇有普遍的积极影响，尤其是在较低剂量 600 IU/d 时，补充后期间有几项显著变化持续存在。各剂量组甘油三酯的增加可能是青春期自然变化所致，尚需进一步研究。本试验在 clinicaltrials.gov 上注册为 NCT01537809。
