Gepato-gastroenterologik tadqiqotlar jurnali 2021, № 4
Subject of the article
ASSESSMENT OF THE RELATIONSHIP BETWEEN LIPID AND CARBOHYDRATE METABOLISM INDICATORS AND VITAMIN D STATUS IN CHILDREN WITH DIFFERENT BODY MASS INDEX (75-80)
Authors
Belykh N.A., Bulokhova E.
Institution
Ryazan State Medical University named after acad. I.P. Pavlov
Abstract
Overweight children represent a particularly vulnerable group for vitamin D deficiency. was to study the relationship between lipid and carbohydrate metabolism indicators and VD status in children, depending on the body mass index (BMI). A cross-sectional (one-step) study carried out on a sample of 154 children with different weight of 8-10 years old (girls - 74, boys - 80). There were identified three groups of research participants: group 1 - 44 obese, 2 group - 58 overweight, 3 group - 52 children with normal body weight. For all children, the serum 25(OH)D, parathyroid hormone (PTH), calcium (Ca), phosphorus (P), alanine aminotransferase (ALT), aspartate aminotransferase (AST), cholesterol (CS), triglycerides (TG), beta-lipoproteins (ß-LP), glucose, insulin determined, and Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) calculated. VD deficiency in obese children was found almost 2.3 times more often than in overweight (p = 0.002) and 2.8 times more often than in children with normal body weight (p = 0.001). Indicators of lipid and carbohydrate metabolism were within physiological limits. However, in obese children they significantly exceeded the indicator of healthy children (p <0.05). Children with VD deficiency (25(OH)D<20 ng/ml) had statistically significantly higher medians of serum PTH, TC, TG, ALT, AST, glucose, insulin, HOMA-IR and lower serum P and Ca compared with children with optimal VD status (p <0.05). The medians of serum ALT, AST, TC, ß-LP, TG, glucose, insulin and HOMA-IR in obese children with VD deficiency was statistically significantly higher compared in healthy children with VD deficiency and optimal VD status. VD deficiency is an important predictor of obesity complications and it exacerbates the risk of cardiometabolic disorders in children who are obese in the early school years.
Key words
Key words: children, obesity, vitamin D, vitamin D status, cardiometabolic disorders.
Literature
1. World Health Organization (WHO). Nutrition: Global Targets 2025. Geneva: WHO; 2018. http://www.who.int/nutrition/global-target-2025. Accessed 2 Mar 2021 2. Kansra A., Lakkunarajah S., Jay M. Childhood and Adolescent Obesity: A Review. Front. Pediatr. 2021; Vol. 8 (581461): 1-16. doi: 10.3389/fped.2020.581461 3. Chung S., Onuzuruike A, Magge S. Cardiometabolic risk in obese children. Ann N Y Acad Sci. 2018; Vol. 1411 (1): 166–183. doi: 10.1111/nyas.13602 4. Cesare M., Sorić M., Bovet P., et al. The epidemiological burden of obesity in childhood: a worldwide epidemic requiring urgent action. BMC Medicine. 2019; Vol. 17 (212): 1-21. https://doi.org/10.1186/s12916-019-1449-8 5. Zakharova I.N., Klimov L.Ya., Maltsev S.V., et al. Security of vitamin d and correction of its insufficiency in children of early age in the Russian Federation (fragment of the national program). Prakticheskaya medicina [Practical medicine]. 2017; Vol. 5 (106): 22-8. (In Russian) 6. Belykh N.A., Blokhova E.E. Obesity and micronutrient disbalance in children. Science of the young [Eruditio Juvenium]. 2019; Vol. 7 (3): 429-38. (In Russian) doi: 10.23888/HMJ201973429-438 7. Zakharova I.N., Tvorogova T.M., Gromova O.A., et al. Vitamin D Insufficiency in Adolescents: Results of Year-Round Screening in Moscow. Pediatricheskaya farmakologiya [Pediatric pharmacology]. 2015; Vol. 12 (5): 528-531. (In Russian). https://doi.org/10.15690/pf.v12i5.1453 8. Dreval' A.V., Kryukova I.V., Barsukov I.A., et al. Extra-osseous effects of vitamin D (a review). RMJ. 2017; Vol. 1: 53–6. (In Russian) 9. Filatova T.E., Nizov A.A., Davydov V.V. Experience of treatment of male hypertension with obesity, fasting hyperglycemia and deficiency of vitamin D. Rossijskij mediko-biologicheskij vestnik im. akademika I.P. Pavlova [I.P.Pavlov Russian Medical Biological Herald]. 2017; Vol. 25 (1): 69-75. (In Russian) doi: 10.23888/pavlovj2017169-75 10. Mirhosseini N., Rainsbury J., Kimball S. Vitamin D Supplementation, Serum 25(OH)D Concentrations and Cardiovascular Disease Risk Factors: A Systematic Review and Meta-Analysis. Front. Cardiovasc. Med. 2018; Vol. 5 (87): 1-35. doi: 10.3389/fcvm.2018.00087 11. Schroten N., Ruifrok W., Kleijn L., et al. Short-term vitamin D3 supplementation lowers plasma renin activity in patients with stable chronic heart failure: An open-label, blinded end point randomized prospective trial (VitD-CHF trial). Am Heart J. 2013; Vol. 166: 357-64. 12. Witte K., Byrom R., Gierula J., et al. Effects of vitamin D on cardiac function in patients with chronic HF: The VINDICATE study. J Am Coll Cardiol. 2016; Vol. 67 (22): 2593-603. 13. Ford J., MacLennan G., Avenell A., et al. Cardiovascular disease and vitamin D supplementation: trial analysis, systematic review, and meta-analysis. Am J Clin Nutr. 2014; Vol. 100 (3): 746–55. doi: 10.3945/ajcn.113.082602 14. Mao P., Zhang C., Tang L., et al. Effect of calcium or vitamin D supplementation on vascular outcomes: a metaanalysis of randomized controlled trials. Int J Cardiol. 2013; Vol. 169 (2): 106–11. doi: 10.1016/j.ijcard.2013.08.055 15. Kolesnikov A.N., Dubovaya A.V., Udovitchenko Yu.V. Participation of Vitamin D in Pathogenesis of Cardiovascular Diseases. Ros Vestn Perinatol i Pediatr. 2018; Vol. 63 (5): 43–50. (In Russian). doi: 10.21508/1027–4065–2018–63–5–43–50 16. WHO Regional Office for Europe: Copenhagen, Denmark. WHO European Childhood Obesity Surveillance Initiative. Protocol. 2016. [Accessed 2021 Mar 1]. Available from: http://www.euro.who.int/__data/assets/pdf_file/0018/333900/COSI-protocolen.pdf?ua=1. 17. WHO. AnthroPlus for Personal Computers Manual: Software for Assessing Growth of the World’s Children and Adolescents; WHO: Geneva, Switzerland, 2009. [Accessed 2020 Nov 1]. Available online: http://www.who.int/entity/growthref/tools/who_anthroplus_manual.pdf. 18. Peterkova V.A., Nagaeva E.V., Shiryaeva T.Yo. Assessment of the physical development of children and adolescents. Normative-methodical and reference materials. Monthly supplement to the journal "Information Bulletin of Health of the Samara Region". 2018; Vol. 194 (1): 1-75. (in Russian) 19. Union of Pediatricians of Russia. National program «Vitamin D deficiency in children and adolescents of the Russian Federation: modern approaches to correction». Moscow: Pediatr", 2018: 96 р. (in Russian) 20. Zil’berman L.I., Kuraeva T.L., Peterkova V.A., the expert board of the Russian Association of Endocrinologists. Federal clinical recommendations on diagnostics and treatment of type 2 diabetes mellitus in the children and adolescents. Problemy endokrinologii [Problems of Endocrinology]. 2014; Vol. 5: 57-68. (in Russian). doi: 10.14341/probl201460557-68 21. Migliaccio1 S., Nisio A., Mele C., et al. Obesity and hypovitaminosis D: causality or casualty? International Journal of Obesity Supplements. 2019; Vol. 9 (1): 20–31. https://doi.org/10.1038/s41367-019-0010-8 22. Beketova N.A., Pavlovskaya E.V., Kodentsova V.M., Vrzhesinskaya O.A., Kosheleva O.V., Sokolnikov A.A., Strokova T.V. Biomarkers of vitamin status in obese school children. Voprosy pitaniia [Problems of Nutrition]. 2019; 88 (4): 66–74. doi: 10.24411/0042-8833-2019-10043 (in Russian) 23. Skinner A., Perrin E., Moss L., et al. Cardiometabolic Risks and Severity of Obesity in Children and Young Adults. N. Engl. J. Med. 2015; Vol. 373 (14): 1307–1317. 24. Durá-Travé T., Gallinas-Victoriano F., Chueca-Guindulain M., et al. Prevalence of hypovitaminosis D and associated factors in obese Spanish children. Nutr. Diabetes. 2017; Vol. 7 (3): 248. doi: 10.1038/nutd.2016.50 25. Okbay Güneş A., Alikaşifoğlu M., Erginoz E., et al. The relationship between cardiometabolic risks and vitamin D levels with the degree of obesity. Turk Pediatri Ars. 2019; Vol.54 (4): 256–263. 26. Mellati A., Sharifi F., Faghihzadeh S., et al. Vitamin D status and its associations with components of metabolic syndrome in healthy children. J. Pediatr. Endocrinol. Metab. 2015; Vol. 28, (5-6): 641–48. doi: 10.1515/jpem-2013-0495 27. Ertugrul D., Yavuz B., Cil H., et al. STATIN-D Study: Comparison of the Influences of Rosuvastatin and Fluvastatin Treatment on the Levels of 25 Hydroxyvitamin D. Cardiovasc. Ther. 2011; Vol. 29, (2): 146–52. doi: 10.1111/j.1755-5922.2010.00141.x 28. Song Y., Wang L., Pittas A., et al. Blood 25-hydroxy vitamin D levels and incident type 2 diabetes: A metaanalysis of prospective studies. Diabetes Care. 2013; Vol. 36, (5): 1422–28. doi: 10.2337/dc12-0962 29. Durá-Travé T., Gallinas-Victoriano F., Peñafiel Freire D., et al. Hypovitaminosis D and Cardiometabolic Risk Factors in Adolescents with Severe Obesity. Children. 2020; Vol. 7, (2): 1-11. doi:10.3390/children7020010/