Araştırma Makalesi
Vitamin D Levels in Obese Children: Evaluation of the Association Between Insulin Levels and Dyslipidemia
Öz
Obesity and vitamin D deficiency are both important important healthcare problems in childhood. The purpose of this study was to evaluate the association between body mass index, vitamin D status, insulin and triglyceride levels. 83 pediatric patients who were followed up for obesity in the Pediatric Metabolism Outpatient Clinic and received only healthy nutritional support were included in the project. Demographic data was obtained, height-weight measurements were performed and body mass index and percentile values were calculated. Serum 25 hydroxy-vitamin D, insulin, hemoglobin A1C, cholesterol and triglyceride levels of the patients were evaluated. The mean age of the pediatric patients included in the study was 10.73 ± 3.32 years. It was found that in 42.6% of the patients 25 hydroxy-vitamin D levels were below 10 ng / mL and in 47.1% of them vitamin D levels were between 20-30 ng/mL. Twelve % (n = 10) of the pediatric patients were evaluated as overweight and 88 % (n = 73) were obese. There was no statistically significant difference in serum 25 hydroxy-vitamin D, insulin, hemoglobin A1C, cholesterol and triglyceride levels between these two groups. On the other hand, negative correlations were found between body weight and 25 hydroxy-vitamin D levels and between body weight and insulin and triglyceride levels. Similar to this, a negative correlation was seen between 25 hydroxy-vitamin D and insulin levels and 25 hydroxy-vitamin D and triglyceride levels. This study reveals the relationship between body mass index values and vitamin D status of children in our region; vitamin D levels were inadequate in obese children and vitamin D levels decreased with increasing body weight. In addition, a negative correlation was found between vitamin D and insulin and triglyceride levels.
Anahtar Kelimeler
Kaynakça
- 1. Schonfeld-Warden N, Warden CH. Pediatric obesity. Pediatr Clin North Am 1997; 44:339-361.
- 2. Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, Mullany EC, Biryukov S, Abbafati C, Abera SF, Abraham JP, Abu-Rmeileh NM, Achoki T, AlBuhairan FS, Alemu ZA, Alfonso R, Ali MK, Ali R, Guzman NA, Ammar W, Anwari P, Banerjee A, Barquera S, Basu S, Bennett DA, Bhutta Z, Blore J, Cabral N, Nonato IC, Chang JC, Chowdhury R, Courville KJ, Criqui MH, Cundiff DK, Dabhadkar KC, Dandona L, Davis A, Dayama A, Dharmaratne SD, Ding EL, Durrani AM, Esteghamati A, Farzadfar F, Fay DF, Feigin VL, Flaxman A, Forouzanfar MH, Goto A, Green MA, Gupta R, Hafezi-Nejad N, Hankey GJ, Harewood HC, Havmoeller R, Hay S, Hernandez L, Husseini A, Idrisov BT, Ikeda N, Islami F, Jahangir E, Jassal SK, Jee SH, Jeffreys M, Jonas JB, Kabagambe EK, Khalifa SE, Kengne AP, Khader YS, Khang YH, Kim D, Kimokoti RW, Kinge JM, Kokubo Y, Kosen S, Kwan G, Lai T, Leinsalu M, Li Y, Liang X, Liu S, Logroscino G, Lotufo PA, Lu Y, Ma J, Mainoo NK, Mensah GA, Merriman TR, Mokdad AH, Moschandreas J, Naghavi M, Naheed A, Nand D, Narayan KM, Nelson EL, Neuhouser ML, Nisar MI, Ohkubo T, Oti SO, Pedroza A, Prabhakaran D, Roy N, Sampson U, Seo H, Sepanlou SG, Shibuya K, Shiri R, Shiue I, Singh GM, Singh JA, Skirbekk V, Stapelberg NJ, Sturua L, Sykes BL, Tobias M, Tran BX, Trasande L, Toyoshima H, van de Vijver S, Vasankari TJ, Veerman JL, Velasquez-Melendez G, Vlassov VV, Vollset SE, Vos T, Wang C, Wang X, Weiderpass E, Werdecker A, Wright JL, Yang YC, Yatsuya H, Yoon J, Yoon SJ, Zhao Y, Zhou M, Zhu S, Lopez AD, Murray CJ, Gakidou E. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2014 ;384(9945):766-781.
- 3. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA 2014;311(8):806-814.
- 4. Thompson RD, Obarzanek E, Franko DL, Barton AB, Morrison J, Biro FM, Daniels RS, Striegel-Moore RH. Childhood overweight and cardiovascular disease risk factors: The National Heart, Lung, and Blood Institute Growth and Health Study. J Pediatr 2007;150(1):18–25.
- 5. Trandafir LM, Temneanu OR. Pre and post-natal risk and determination of factors for child obesity. J Med Life 2016;9(4):386–391.
- 6. Kahn SE, Hull RL, Utzschneider KM. Mechanisms linking obesity to insulin resistance and type 2 diabetes. Nature 2006;444(7121):840–846.
- 7. Norris AL, Steinberger J, Steffen LM, Metzig AM, Schwarzenberg SJ, Kelly AS. Circulating oxidized LDL and inflammation in extreme pediatric obesity. Obesity (Silver Spring) 2011;19:1415–1419.
- 8. Rosen CJ. Vitamin D insufficiency. N Engl J Med 2011;364(3):248–254.
- 9. Öğüş E, Sürer H, Kılınç AS, Fidancı V, Yılmaz G, Dindar N, Karakaş A. D Vitamini Düzeylerinin Aylara, Cinsiyete ve Yaşa Göre Değerlendirilmesi. Ankara Med J 2015;15(1):1-5.
- 10. Çimen MBY, Bölgen Çimen Ö. Obezite ve D Vitamini. Mersin Univ Saglık Bilim Derg 2016;9(2):102-112.
- 11. Turer CB, Lin H, Flores G. Prevalence of vitamin D deficiency among overweight and obese US children. Pediatrics 2013;131:152–161.
- 12. Cole JT, Bellizzi CM, Flegal KM, Dietz HW. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000;320(7244):1240.
- 13. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2011;96(7):1911–30.
- 14. Yao Y, Zhu L, He L, Duan Y, Liang W, Nie Z, Jin Y, Wu X, Fang Y. A meta-analysis of the relationship between vitamin D deficiency and obesity. Int J Clin Exp Med 2015;8(9):14977-14984.
- 15. Walsh SJ, Bowls S, Evans AL. Vitamin D in Obesity. Curr Opin Endocrinol Diabetes Obes 2017;24:389–394.
- 16. Bell NH, Epstein S, Greene A, Shary J, Oexmann MJ, Shaw S. Evidence for alteration of the vitamin Dendocrine system in obese subjects. J Clin Invest 1985;76:370-373.
- 17. Mosekilde L. Vitamin D and the elderly. Clin Endocrinol (Oxf) 2005;62(3):265-281.
- 18. Hypponen E, Power C. Vitamin D status and glucose homeostasis in the 1958 British birth cohort: the role of obesity. Diabetes Care 2006;29(10): 2244-2246.
- 19. Bischof MG, Heinze G, Vierhapper H. Vitamin D status and its relation to age and body mass index. Horm Res 2006;66(5):211-215.
- 20. Kayaniyil S, Vieth R, Retnakaran R, Knight JA, Qi Y, Gerstein HC, Perkins BA, Harris SB, Zinman B, Hanley AJ. Association of vitamin D with insulin resistance and beta-cell dysfunction in subjects at risk for type 2 diabetes. Diabetes Care 2010;33(6):1379-1381.
- 21. Reyman M, Verrijn Stuart AA, van Summeren M, Rakhshandehroo M, Nuboer R, de Boer FK, van den Ham HJ, Kalkhoven E, Prakken B, Schipper HS. Int J Obes (Lond) 2014;38(1):46-52.
- 22. Maestro B, Campion J, Davila N, Calle C. Stimulation by 1,25-dihydroxyvitamin D3 of insulin receptor expression and insulin responsiveness for glucose transport in U-937 human promonocytic cells. Endocr J 2000;47(4):383-391.
- 23. Scragg R, Sowers M, Bell C: Third National Health and Nutrition Examination Survey. Serum 25-hydroxyvitamin D, diabetes, and ethnicity in the Third National Health and Nutrition Examination Survey. Diabetes Care 2004;27(12):2813-2818.
- 24. Lu L, Yu Z, Pan A, Hu FB, Franco OH, Li H, Li X, Yang X, Chen Y, Lin X. Plasma 25-hydroxyvitamin D concentration and metabolic syndrome among middle-aged and elderly Chinese individuals. Diabetes Care 2009;32(7):1278-1283.
- 25. Zhao G, Ford ES, Li C. Associations of serum concentrations of 25-hydroxyvitamin D and parathyroid hormone with surrogate markers of insulin resistance among U.S. adults without physician-diagnosed diabetes: NHANES, 2003-2006. Diabetes Care 2010;33(2):344-347.
- 26. Liu E, Meigs JB, Pittas AG, McKeown NM, Economos CD, Booth SL, Jacques PF. Plasma 25-hydroxyvitamin d is associated with markers of the insulin resistant phenotype in nondiabetic adults. J Nutr 2009;139(2):329-334.
- 27. Chiu KC, Chu A, Go VL, Saad MF. Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction. Am J Clin Nutr 2004;79(5):820-825.
- 28. Jablonski KL, Chonchol M, Pierce GL, Walker AE, Seals DR. 25-Hydroxyvitamin D deficiency is associated with inflammation-linked vascular endothelial dysfunction in middle-aged and older adults. Hypertension 2011;57(1):63-69.
- 29. De Pergola G, Nitti A, Bartolomeo N, Gesuita A, Giagulli VA, Triggiani V, Guastamacchia E, Silvestris F. Possible role of hyperinsulinemia and insulin resistance in lower vitamin D levels in overweight and obese patients. Biomed Res Int 2013;2013:921348.
- 30. Nwosu BU, Maranda L, Cullen K, Ciccarelli C, Lee MM. Vitamin D status is associated with early markers of cardiovascular disease in prepubertal children. J Pediatr Endocrinol Metab 2013;26(11-12):1067-1075.
- 31. Birken CS, Lebovic G, Anderson LN, McCrindle BW, Mamdani M, Kandasamy S, Khovratovich M, Parkin PC, Maguire JL. Association between Vitamin D and Circulating Lipids in Early Childhood. PLoS One 2015;10(7):e0131938.
- 32. Lee M, Ebert JR, Kadakia MP, Zhang J, Czerwinski SA. Inverse associations between cardiometabolic risk factors and 25-hydroxyvitamin D in obese American children and adolescents. Am J Hum Biol 2016;28(5):736-742.
Obez çocuklarda D vitamini düzeyleri: İnsülin düzeyi ve dislipidemi ile ilişkisinin değerlendirilmesi
Öz
Çocukluk çağında obezite ve D vitamini eksikliği günümüzde giderek artan önemli sağlık sorunlarındandır. Bu çalışmada, obez hastaların vitamin D düzeyleri ile beden kütle indeksi arasındaki ilişkiyi incelemek amaçlanmıştır. Çalışmaya Çocuk Metabolizma polikliniğinde obezite nedeniyle takip edilen ve sağlıklı beslenme desteği alan 83 çocuk hasta dahil edilmiştir. Hastaların demografik bilgileri, boy-kilo ölçümleri alınmış, beden kütle indeksi ve persentil değerleri hesaplanmıştır. Hastaların serum 25 hidroksi vitamin D, insülin, hemoglobin A1C, kolesterol ve trigliserit düzeyleri değerlendirilmiştir. Çalışmaya alınan çocuk hastaların yaş ortalaması 10.73±3.32 yıldır. Hastaların 25 hidroksi vitamin D düzeylerinin, % 42.6 sının 10 ng/mL’nin altında, %47.1’ inin 20-30 ng/mL arasında olduğu bulunmuştur. Çocuk hastaların %12’si (n=10) fazla kilolu, % 88’i (n=73) obez olarak değerlendirilmiş ve fazla kilolu ve obez olarak değerlendirilen çocukların serum 25 hidroksi vitamin D, insülin, hemoglobin A1C, kolesterol ve trigliserit düzeyleri arasında istatistiksel olarak anlamlı bir fark saptanmamıştır. Buna karşılık vücut ağırlığı ile 25 hidroksi vitamin D düzeyleri arasında negatif yönde, vücut ağırlığı ile insülin ve trigliserit düzeyleri arasında ise pozitif yönde bir ilişki tespit edilmiştir. Benzer biçimde, 25 hidroksi vitamin D ile insülin düzeyleri ve trigliserit düzeyleri arasında ise negatif yönde bir ilişki bulunmuştur. Bu çalışma bölgemizdeki çocukların beden kütle indeksi değerleri ve D Vitamini ilişkisini ortaya koymakta olup, obez çocuklarda vitamin D düzeylerinin yetersiz düzeyde olduğu, vücut ağırlığı artışı ile vitamin D düzeyinin azaldığı görülmüştür. Ayrıca vitamin D ile insülin ve trigliserit düzeyleri arasında negatif yönde bir ilişki bulunmuştur.
Anahtar Kelimeler
Kaynakça
- 1. Schonfeld-Warden N, Warden CH. Pediatric obesity. Pediatr Clin North Am 1997; 44:339-361.
- 2. Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, Mullany EC, Biryukov S, Abbafati C, Abera SF, Abraham JP, Abu-Rmeileh NM, Achoki T, AlBuhairan FS, Alemu ZA, Alfonso R, Ali MK, Ali R, Guzman NA, Ammar W, Anwari P, Banerjee A, Barquera S, Basu S, Bennett DA, Bhutta Z, Blore J, Cabral N, Nonato IC, Chang JC, Chowdhury R, Courville KJ, Criqui MH, Cundiff DK, Dabhadkar KC, Dandona L, Davis A, Dayama A, Dharmaratne SD, Ding EL, Durrani AM, Esteghamati A, Farzadfar F, Fay DF, Feigin VL, Flaxman A, Forouzanfar MH, Goto A, Green MA, Gupta R, Hafezi-Nejad N, Hankey GJ, Harewood HC, Havmoeller R, Hay S, Hernandez L, Husseini A, Idrisov BT, Ikeda N, Islami F, Jahangir E, Jassal SK, Jee SH, Jeffreys M, Jonas JB, Kabagambe EK, Khalifa SE, Kengne AP, Khader YS, Khang YH, Kim D, Kimokoti RW, Kinge JM, Kokubo Y, Kosen S, Kwan G, Lai T, Leinsalu M, Li Y, Liang X, Liu S, Logroscino G, Lotufo PA, Lu Y, Ma J, Mainoo NK, Mensah GA, Merriman TR, Mokdad AH, Moschandreas J, Naghavi M, Naheed A, Nand D, Narayan KM, Nelson EL, Neuhouser ML, Nisar MI, Ohkubo T, Oti SO, Pedroza A, Prabhakaran D, Roy N, Sampson U, Seo H, Sepanlou SG, Shibuya K, Shiri R, Shiue I, Singh GM, Singh JA, Skirbekk V, Stapelberg NJ, Sturua L, Sykes BL, Tobias M, Tran BX, Trasande L, Toyoshima H, van de Vijver S, Vasankari TJ, Veerman JL, Velasquez-Melendez G, Vlassov VV, Vollset SE, Vos T, Wang C, Wang X, Weiderpass E, Werdecker A, Wright JL, Yang YC, Yatsuya H, Yoon J, Yoon SJ, Zhao Y, Zhou M, Zhu S, Lopez AD, Murray CJ, Gakidou E. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2014 ;384(9945):766-781.
- 3. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA 2014;311(8):806-814.
- 4. Thompson RD, Obarzanek E, Franko DL, Barton AB, Morrison J, Biro FM, Daniels RS, Striegel-Moore RH. Childhood overweight and cardiovascular disease risk factors: The National Heart, Lung, and Blood Institute Growth and Health Study. J Pediatr 2007;150(1):18–25.
- 5. Trandafir LM, Temneanu OR. Pre and post-natal risk and determination of factors for child obesity. J Med Life 2016;9(4):386–391.
- 6. Kahn SE, Hull RL, Utzschneider KM. Mechanisms linking obesity to insulin resistance and type 2 diabetes. Nature 2006;444(7121):840–846.
- 7. Norris AL, Steinberger J, Steffen LM, Metzig AM, Schwarzenberg SJ, Kelly AS. Circulating oxidized LDL and inflammation in extreme pediatric obesity. Obesity (Silver Spring) 2011;19:1415–1419.
- 8. Rosen CJ. Vitamin D insufficiency. N Engl J Med 2011;364(3):248–254.
- 9. Öğüş E, Sürer H, Kılınç AS, Fidancı V, Yılmaz G, Dindar N, Karakaş A. D Vitamini Düzeylerinin Aylara, Cinsiyete ve Yaşa Göre Değerlendirilmesi. Ankara Med J 2015;15(1):1-5.
- 10. Çimen MBY, Bölgen Çimen Ö. Obezite ve D Vitamini. Mersin Univ Saglık Bilim Derg 2016;9(2):102-112.
- 11. Turer CB, Lin H, Flores G. Prevalence of vitamin D deficiency among overweight and obese US children. Pediatrics 2013;131:152–161.
- 12. Cole JT, Bellizzi CM, Flegal KM, Dietz HW. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000;320(7244):1240.
- 13. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2011;96(7):1911–30.
- 14. Yao Y, Zhu L, He L, Duan Y, Liang W, Nie Z, Jin Y, Wu X, Fang Y. A meta-analysis of the relationship between vitamin D deficiency and obesity. Int J Clin Exp Med 2015;8(9):14977-14984.
- 15. Walsh SJ, Bowls S, Evans AL. Vitamin D in Obesity. Curr Opin Endocrinol Diabetes Obes 2017;24:389–394.
- 16. Bell NH, Epstein S, Greene A, Shary J, Oexmann MJ, Shaw S. Evidence for alteration of the vitamin Dendocrine system in obese subjects. J Clin Invest 1985;76:370-373.
- 17. Mosekilde L. Vitamin D and the elderly. Clin Endocrinol (Oxf) 2005;62(3):265-281.
- 18. Hypponen E, Power C. Vitamin D status and glucose homeostasis in the 1958 British birth cohort: the role of obesity. Diabetes Care 2006;29(10): 2244-2246.
- 19. Bischof MG, Heinze G, Vierhapper H. Vitamin D status and its relation to age and body mass index. Horm Res 2006;66(5):211-215.
- 20. Kayaniyil S, Vieth R, Retnakaran R, Knight JA, Qi Y, Gerstein HC, Perkins BA, Harris SB, Zinman B, Hanley AJ. Association of vitamin D with insulin resistance and beta-cell dysfunction in subjects at risk for type 2 diabetes. Diabetes Care 2010;33(6):1379-1381.
- 21. Reyman M, Verrijn Stuart AA, van Summeren M, Rakhshandehroo M, Nuboer R, de Boer FK, van den Ham HJ, Kalkhoven E, Prakken B, Schipper HS. Int J Obes (Lond) 2014;38(1):46-52.
- 22. Maestro B, Campion J, Davila N, Calle C. Stimulation by 1,25-dihydroxyvitamin D3 of insulin receptor expression and insulin responsiveness for glucose transport in U-937 human promonocytic cells. Endocr J 2000;47(4):383-391.
- 23. Scragg R, Sowers M, Bell C: Third National Health and Nutrition Examination Survey. Serum 25-hydroxyvitamin D, diabetes, and ethnicity in the Third National Health and Nutrition Examination Survey. Diabetes Care 2004;27(12):2813-2818.
- 24. Lu L, Yu Z, Pan A, Hu FB, Franco OH, Li H, Li X, Yang X, Chen Y, Lin X. Plasma 25-hydroxyvitamin D concentration and metabolic syndrome among middle-aged and elderly Chinese individuals. Diabetes Care 2009;32(7):1278-1283.
- 25. Zhao G, Ford ES, Li C. Associations of serum concentrations of 25-hydroxyvitamin D and parathyroid hormone with surrogate markers of insulin resistance among U.S. adults without physician-diagnosed diabetes: NHANES, 2003-2006. Diabetes Care 2010;33(2):344-347.
- 26. Liu E, Meigs JB, Pittas AG, McKeown NM, Economos CD, Booth SL, Jacques PF. Plasma 25-hydroxyvitamin d is associated with markers of the insulin resistant phenotype in nondiabetic adults. J Nutr 2009;139(2):329-334.
- 27. Chiu KC, Chu A, Go VL, Saad MF. Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction. Am J Clin Nutr 2004;79(5):820-825.
- 28. Jablonski KL, Chonchol M, Pierce GL, Walker AE, Seals DR. 25-Hydroxyvitamin D deficiency is associated with inflammation-linked vascular endothelial dysfunction in middle-aged and older adults. Hypertension 2011;57(1):63-69.
- 29. De Pergola G, Nitti A, Bartolomeo N, Gesuita A, Giagulli VA, Triggiani V, Guastamacchia E, Silvestris F. Possible role of hyperinsulinemia and insulin resistance in lower vitamin D levels in overweight and obese patients. Biomed Res Int 2013;2013:921348.
- 30. Nwosu BU, Maranda L, Cullen K, Ciccarelli C, Lee MM. Vitamin D status is associated with early markers of cardiovascular disease in prepubertal children. J Pediatr Endocrinol Metab 2013;26(11-12):1067-1075.
- 31. Birken CS, Lebovic G, Anderson LN, McCrindle BW, Mamdani M, Kandasamy S, Khovratovich M, Parkin PC, Maguire JL. Association between Vitamin D and Circulating Lipids in Early Childhood. PLoS One 2015;10(7):e0131938.
- 32. Lee M, Ebert JR, Kadakia MP, Zhang J, Czerwinski SA. Inverse associations between cardiometabolic risk factors and 25-hydroxyvitamin D in obese American children and adolescents. Am J Hum Biol 2016;28(5):736-742.
Toplam 32 adet kaynakça vardır.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | ORİJİNAL MAKALELER / ORIGINAL ARTICLES |
| Yazarlar | |
| Yayımlanma Tarihi | 9 Kasım 2020 |
| Yayımlandığı Sayı | Yıl 2020 Cilt: 42 Sayı: 6 |