Abstract
It has been shown that vitamin D is associated with obesity and the development of atherosclerosis. Less is known about this association among adolescents with obesity. To determine the association of vitamin D level and metabolic risk factors with carotid intima-media thickness (CIMT) among obese adolescents. We conducted a cross-sectional study among obese children aged 15 to 17 years in Yogyakarta, Indonesia. The association of vitamin D and other metabolic risk factors (triglyceride, low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C), and insulin resistance using homeostasis model assessment of insulin resistance (HOMA-IR)) with CIMT was explored by multivariable linear regression models. Out of 156 obese adolescents, 55.8% were boys. Compared to girls, boys had higher BMI z-score, waist circumference, and HDL-cholesterol. After adjustment for age, sex and second-hand smoke exposure, high HOMA-IR, total cholesterol, LDL-cholesterol and triglyceride levels were associated with higher odds of elevated CIMT. In analyses stratified by sex, a similar trend was observed in boys, while none of the risk factors were associated with CIMT in girls. We observed no association between vitamin D and CIMT. Hyperinsulinemia, higher total cholesterol and LDL cholesterol were associated with greater odds of elevated CIMT among obese adolescent boys.
Highlights
Atherosclerosis is a one of the important causes of cardiovascular and cerebrovascular diseases which lead to significant morbidity and mortality [1]
After adjustment for age, sex and second-hand smoke exposure, high homeostasis model assessment of insulin resistance (HOMA-IR), total cholesterol, LDL-cholesterol and triglyceride levels were associated with higher odds of elevated carotid intima-media thickness (CIMT)
In analyses stratified by sex, a similar trend was observed in boys, while none of the risk factors were associated with CIMT in girls
Summary
Atherosclerosis is a one of the important causes of cardiovascular and cerebrovascular diseases which lead to significant morbidity and mortality [1]. One of the autocrine functions of vitamin D is the modulation of inflammatory pathways which plays a role in cardiovascular diseases [8]. Vitamin D deficiency has been associated with the development of atherosclerotic and abnormality of arterial wall thickness mostly in adults [3, 9]. Sufficient level of vitamin D in adults leads to a reduction in circulating inflammatory and endothelial function biomarkers; vitamin D might have a potential role as an antiinflammatory therapy for the prevention and the treatment of cardiovascular disease [9]. There were few studies reporting the association between vitamin D deficiency with increased CIMT in children and adolescents with conflicting results [4, 13,14,15]. Less is known about this association among adolescents with obesity
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