Department of Pediatric Endocrinology, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey.
Department of Radiology, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey.
J Pediatr Endocrinol Metab. 2022 Jul 11;35(8):1051-1058. doi: 10.1515/jpem-2022-0250. Print 2022 Aug 26.
We aimed to evaluate the association between vitamin B12, folate, homocysteine levels, and carotid intima-media thickness (CIMT) among children with obesity in whom vitamin deficiencies are more frequent.
Herein, 100 children with obesity (58 girls) were included (age, 5-18 years). Height, weight, body mass index (BMI), waist circumference (WC), puberty stage, blood pressure, and biochemical values were collected from medical records; standard deviations (SDS) and percentiles were calculated. Obesity was defined as BMI SDS of >+2SDS. Vitamin B12 and folate levels of <300 pg/mL and <4.8 ng/mL, respectively, were considered deficient. A radiologist quantified measurements from the carotid artery.
Mean patient age was 12.52 ± 3.63 years. The mean weight SDS, BMI SDS, and WC/height were +3.37 ± 0.93, +2.93 ± 0.55, and 0.65 ± 0.05, respectively. In pubertal cases, insulin (p<0.001), the homeostatic model assessment for insulin resistance (HOMA-IR) (p=0.001) and homocysteine (p=0.002) levels were higher; vitamin B12 (p<0.001) and folate (p<0.001) levels were lower than those in prepubertal ones. WC and HOMA-IR correlated with CIMT; however, homocysteine levels were not correlated with CIMT.
In our study, pubertal cases had lower vitamin B12 and folate levels as well as higher homocysteine levels. Although no correlation was identified between homocysteine levels and CIMT, this condition may be related to our study group comprising children, who had a shorter duration of obesity than those in adults. As CIMT was higher in children/adolescents with increased WC, it is proposed that they need central obesity more frequently and carefully follow-up.
我们旨在评估维生素 B12、叶酸、同型半胱氨酸水平与肥胖儿童颈动脉内膜中层厚度（CIMT）之间的关系，这些儿童中维生素缺乏更为常见。
本研究纳入了 100 名肥胖儿童（58 名女孩）（年龄 5-18 岁）。从病历中收集身高、体重、体重指数（BMI）、腰围（WC）、青春期阶段、血压和生化值；计算标准差（SDS）和百分位数。BMI SDS ＞+2SDS 定义为肥胖。维生素 B12 和叶酸水平分别＜300pg/mL 和＜4.8ng/mL 被认为是缺乏的。一名放射科医生对颈动脉进行了定量测量。
患者平均年龄为 12.52±3.63 岁。平均体重 SDS、BMI SDS 和 WC/身高分别为+3.37±0.93、+2.93±0.55 和 0.65±0.05。在青春期病例中，胰岛素（p＜0.001）、胰岛素抵抗的稳态模型评估（HOMA-IR）（p=0.001）和同型半胱氨酸（p=0.002）水平较高；而维生素 B12（p＜0.001）和叶酸（p＜0.001）水平较低。WC 和 HOMA-IR 与 CIMT 相关；然而，同型半胱氨酸水平与 CIMT 不相关。
在我们的研究中，青春期病例的维生素 B12 和叶酸水平较低，同型半胱氨酸水平较高。尽管同型半胱氨酸水平与 CIMT 之间没有相关性，但这种情况可能与我们的研究组有关，该组儿童肥胖持续时间短于成年人。由于 WC 增加的儿童/青少年 CIMT 较高，建议他们更频繁地关注中心性肥胖并进行更仔细的随访。
