Gao Yi-Xiong, Zhang Jian, Man Qingqing, Li Yuqian, Jia Shanshan
National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Peking, China.
J Pediatr Endocrinol Metab. 2021 Nov 9;35(1):55-63. doi: 10.1515/jpem-2021-0581. Print 2022 Jan 27.
Vitamin D promotes both lipolysis and lipogenesis, and some pediatric studies showed inconsistent associations between vitamin D and metabolic syndrome (MetS). This cross-sectional study aimed to examine the association between vitamin D levels and MetS components among metropolitan adolescents.
A total of 4,149 adolescents aged 10-18 years were recruited from 23 metropolises in China. The MetS conditions were assessed according to the International Diabetes Federation consensus definition, and the serum 25-hydroxy vitamin D (25(OH)D) concentrations were analyzed. The association between MetS components and serum 25(OH)D levels was analyzed by the logistic regression model. Restricted cubic spline was applied to the model nonlinear association.
Prevalence of vitamin D deficiency was 74.9%, and 41.2% of study participants had at least one MetS component. After adjustment, the significant trend for a lower waist-to-height ratio was not observed in study participants with higher serum 25(OH)D quartile (p=0.57), but a significant nonlinear association between abdominal obesity and serum 25(OH)D levels was found (p=0.04): the highest risk of abdominal obesity occurred at 14.1 ng/mL of serum 25(OH)D. The association of serum 25(OH)D was significantly inverse with MetS (OR: 0.95; 95% CI: 0.92-0.98), but not with raised triglycerides (OR: 0.99; 95% CI: 0.96-1.01), raised blood pressure (OR: 0.99; 95% CI: 0.97-1.01) and impaired fasting glycemia (OR: 1.03; 95% CI: 1.01-1.04).
The net effect of vitamin D on lipid metabolism may be concentration-dependent, and the actual effect of vitamin D on MetS process may be complex among metropolitan adolescents, though serum 25(OH)D is inversely associated with MetS.
维生素D既能促进脂肪分解又能促进脂肪生成,一些儿科研究显示维生素D与代谢综合征(MetS)之间的关联并不一致。这项横断面研究旨在探讨大城市青少年中维生素D水平与MetS各组分之间的关联。
从中国23个大城市招募了总共4149名10至18岁的青少年。根据国际糖尿病联盟的共识定义评估MetS情况,并分析血清25-羟基维生素D(25(OH)D)浓度。通过逻辑回归模型分析MetS各组分与血清25(OH)D水平之间的关联。将受限立方样条应用于模型非线性关联分析。
维生素D缺乏的患病率为74.9%,41.2%的研究参与者至少有一项MetS组分。调整后,在血清25(OH)D四分位数较高的研究参与者中未观察到腰高比降低的显著趋势(p = 0.57),但发现腹部肥胖与血清25(OH)D水平之间存在显著的非线性关联(p = 0.04):血清25(OH)D为14.1 ng/mL时腹部肥胖风险最高。血清25(OH)D与MetS呈显著负相关(OR:0.95;95%CI:0.92 - 0.98),但与甘油三酯升高(OR:0.99;95%CI:0.96 - 1.01)、血压升高(OR:0.99;95%CI:0.97 - 1.01)和空腹血糖受损(OR:1.03;95%CI:1.01 - 1.04)无关。
维生素D对脂质代谢的净效应可能是浓度依赖性的,尽管血清25(OH)D与MetS呈负相关,但在大城市青少年中维生素D对MetS进程的实际影响可能很复杂。