Vitamin D Insufficiency Associated With Insulin Resistance Independent of Obesity in Children

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Vitamin D insufficiency was higher only in obese girls compared with in children who were either overweight or normal weight.
Vitamin D insufficiency was higher only in obese girls compared with in children who were either overweight or normal weight.

Children who are obese and have insulin resistance (IR) may be more likely to have vitamin D deficiency/insufficiency compared with children who are not obese and do not have insulin resistance, according to a study published in Diabetes.

Researchers conducted a cross-sectional epidemiological study of a representative sample of Greek school-aged children aged from 9 to 13 years (n= 2277) to examine the association between vitamin D levels and both obesity and IR.

Study results showed that boys compared with girls had higher body mass index (P =.004) and serum 23(OH)D concentrations (P <.001), and a lower Homeostasis Model Assessment of Insulin Resistance score.

Overall prevalence rates of overweight and obesity were 31.0% and 11.4%, respectively; however, boys were found to have a higher prevalence of obesity (13.8%) compared with girls (9.2%; P <.05). IR had an overall prevalence in the cohort of 29%, with a higher prevalence in girls (34.9%) compared with boys (23%; P < .001).

Vitamin D insufficiency was higher only in obese girls compared with in children who were either overweight or normal weight (P =.024). Regarding vitamin D status in the total sample, the prevalence rates of insufficiency and deficiency were 52.2% and 5.2%, respectively. When compared with boys, girls were found to have higher prevalence rates of vitamin D insufficiency and deficiency (56.7% vs 47.6% [P <.001] and 7.1% vs 3.3% [P <.001], respectively)].

In addition, there was a significant difference in vitamin D deficiency prevalence between children with IR and those without IR (7.1% vs 4.4%; P =.010). Both obese and nonobese children with IR, compared with children who were not obese with a normal insulin response, had a higher prevalence of vitamin D insufficiency (66% and 59.2% vs 49.8%; P <.05). The logistic regression analysis suggested that children with IR were 1.48 times more likely to be vitamin D insufficient compared with children with normal insulin status (95% CI, 1.2-1.84), but it did not show a significant association between obesity and vitamin D deficiency or insufficiency.

Researchers concluded that there was a high prevalence of vitamin D insufficiency observed in schoolchildren, specifically among children with IR and who were obese. The data suggest there may be a strong association between vitamin D insufficiency and IR that is independent of obesity. Clinicians should closely monitor the vitamin D levels in children who are obese and those with IR, as these children are at a significantly higher risk of having vitamin D deficiency and insufficiency and may require more aggressive vitamin D management.

Reference

Moschonis G, Androutsos O, Hulshof T, Dracopoulou M, Chrousos GP, Manios Y. Vitamin D insufficiency is associated with insulin resistance independently of obesity in primary schoolchildren. The Healthy Growth Study [published online April 2, 2018]. Pediatr Diabetes. doi: 10.1111/pedi.12678

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