Abstract
Background and Objective: Different metabolic phenotypes of obesity are related to cardiometabolic risk factors in children and adolescents. Vitamin D, as one important factor, could be related to different subgroups of metabolic obesity and might affect metabolic disorders. The purpose of this study was to evaluate the relationship between serum 25-hydroxyvitamin D concentration and subsets of metabolic phenotypes of obesity in children and adolescents.Methods: This nationwide cross-sectional study was conducted in the framework of the fifth survey of a national surveillance program, the CASPIAN study. Overall, 2,594 students aged 7–18 years were assessed for 25-hydroxyvitamin D status. Metabolic syndrome (MetS) was defined according to the ATP III criteria modified for the pediatric age group. Participants were classified into four metabolic phenotypes of obesity according to categories of the BMI and metabolic status: “metabolically healthy obese” (MHO), “metabolically non-healthy non-obese” (MNHNO), “metabolically non-healthy obese” (MNHO), and “metabolically healthy non-obese” (MHNO). Multinomial logistic regression analysis was performed for evaluating the association of 25-hydroxyvitamin D status with different metabolic phenotypes of obesity.Results: In this study, 85.2% of participants were classified as MHNO, 11.0 % as MHO, 2.5% as MNHNO, and 1.3% as MNHO. The frequency of hypovitaminosis D was more prevalent in MNHO (85.3%) than in other phenotypes (MHNO: 70%; MHO: 76.5%; MNHNO: 78.1%, respectively; p < 0.05). In the multivariate model, hypovitaminosis D significantly increased the odds of being MHO (OR: 1.46; 95% CI: 1.07–1.77) and MNHO (OR: 2.89; 1.05–8.31) compared to the healthy group. Likewise, in multivariate model, per each unit (ng/mL) increment in 25-hydroxyvitamin D concentration, the odds of MNHNO and MNHO decreased significantly by 7% (OR: 0.93; 0.91–0.96) and 6% (OR: 0.94; 0.91–0.98) respectively.Conclusion: Our results support the hypothesis that 25-hydroxyvitamin D concentration is associated with metabolic obesity phenotypes. Longitudinal studies are necessary to assess the clinical impacts of this finding.
Highlights
Obesity, especially among children and adolescents, is a major health challenge in developed and developing countries [1,2,3]
4,200 students were randomly selected for biochemical tests, from which 2,594 samples have been assessed for 25-hydroxyvitamin D status
There was a significant difference between boys and girls in terms of obesity phenotypes (p = 0.009); a higher percentage of boys and girls had metabolically healthy non-obese (MHNO) (83.5 and 87.4% respectively), and the lowest percentage was MNHO (1.7% in boys and 0.9% in girls)
Summary
Especially among children and adolescents, is a major health challenge in developed and developing countries [1,2,3] It is an important risk factor for the development of metabolic diseases, including diabetes mellitus (DM) and hypertension, as well as an increase in serum total cholesterol (TC) and triglycerides (TG) [4]. Despite this fact, some studies recognized non-obese individuals with metabolic abnormality— for instance, low high-density lipoprotein-cholesterol (HDLC), high TG and TC [5, 6]. The purpose of this study was to evaluate the relationship between serum 25-hydroxyvitamin D concentration and subsets of metabolic phenotypes of obesity in children and adolescents
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