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青少年维生素 D 缺乏:肥胖程度不同有区别吗?

Vitamin D deficiency in adolescents: is there a difference according to the degree of obesity?

机构信息

Departamento de Gastroenterología y Nutrición Pediátrica, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.

出版信息

Andes Pediatr. 2023 Jun;94(3):339-349. doi: 10.32641/andespediatr.v94i3.4395.

Abstract

OBJECTIVE

To analyze the frequency of vitamin D (VD) deficiency in adolescents with different degrees of obesity and its association with alterations in the metabolic profile.

PATIENTS AND METHOD

Cross-sectional, descriptive, and analytical study in 250 adolescents with different degrees of obesity, treated at the nutrition polyclinic of the Hospital Dr. Sotero del Río. Data on age, sex, weight, height, Tanner stage, 25-hydroxyvitamin D levels, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, basal insulin, and glycemia were collected. The following were used for statistical analysis: Student's test, chi-square, multiple linear regression analysis, and Pearson's correlation coefficient.

RESULTS

58% of the adolescents presented non-severe obesity and 42% severe obesity, the mean age was 12.4 ± 2.1 years, and 54% were male. 91% of the total sample presented VD deficiency, being more frequent among adolescents with severe obesity, reaching 95%. VD levels were significantly lower in winter. HOMA (homeostatic model assessment) values were higher among patients with severe obesity (6.3/4.2). Low HDL-c was more frequent in adolescents with severe obesity (78%/62%). An inverse correlation was found between VD and triglyceride levels (r = -0.20; p = 0.00) and total cholesterol (r = -0.15; p = 0.03).

CONCLUSION

The VD deficiency among obese adolescents is worrying, reaching more than 90% of the study sample. Our results highlight the importance of timely prevention, detection, and treatment of VD deficiency in obese adolescents to prevent bone health deterioration and cardiometabolic risk in adulthood.

摘要

目的

分析不同程度肥胖青少年维生素 D(VD)缺乏的频率及其与代谢谱改变的关系。

患者和方法

这是一项在不同程度肥胖的 250 名青少年中进行的横断面、描述性和分析性研究,这些青少年在 Sotero del Río 医院的营养门诊接受治疗。收集了年龄、性别、体重、身高、Tanner 分期、25-羟维生素 D 水平、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、甘油三酯、基础胰岛素和血糖等数据。用于统计分析的方法有:Student's 检验、卡方检验、多元线性回归分析和 Pearson 相关系数。

结果

58%的青少年患有非严重肥胖,42%的青少年患有严重肥胖,平均年龄为 12.4 ± 2.1 岁,54%为男性。总样本中有 91%存在 VD 缺乏,严重肥胖的青少年中更为常见,达到 95%。VD 水平在冬季显著降低。严重肥胖患者的 HOMA(稳态模型评估)值更高(6.3/4.2)。严重肥胖青少年中低 HDL-c 更为常见(78%/62%)。VD 与甘油三酯水平呈负相关(r = -0.20;p = 0.00),与总胆固醇水平呈负相关(r = -0.15;p = 0.03)。

结论

肥胖青少年的 VD 缺乏令人担忧,研究样本中超过 90%的青少年存在 VD 缺乏。我们的结果强调了及时预防、检测和治疗肥胖青少年 VD 缺乏的重要性,以防止骨健康恶化和成年后患心血管代谢风险。

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