vitamin d deficiency in obese children an its relationship to glucose homeostasis
DESCRIPTION
Vitamin D Deficiency in Obese Children an Its Relationship to Glucose Homeostasis. Olson, M.L., et al. J Clin Endocrinol Metab, 97, 279-285, 2012. Researchers. 5.967 Impact Factor Internal Medicine Pediatric Endocrinology. Background. Obesity has tripled in U.S. children since 1980 - PowerPoint PPT PresentationTRANSCRIPT
OLSON, M.L . , ET AL
Vitamin D Deficiency in Obese Children an Its Relationship to
Glucose Homeostasis
J Clin Endocrinol Metab, 97, 279-285, 2012
Researchers
5.967 Impact FactorInternal MedicinePediatric Endocrinology
Background
Obesity has tripled in U.S. children since 1980 19% of 6-19yr olds are obese
The rise in obesity has paralleled increases in childhood hypertension, hyperlipidemia, and Type 2 Diabetes.
Childhood obesity is associated with increase prevalence of cardiovascular events and Type 2 Diabetes in adulthood.
Supporting Evidence
Hypovitaminosis D in obese children and adolescents: relationship with adiposity, insulin sensitivity, ethnicity, and season Metabolism 57:183-91
Prevalence of vitamin D insufficiency in obese children and adolescents J Clin Endocrinol Metab 92:2017-29
Study Objective
To compare prevalence of vitamin D deficiency in obese versus non-overweight children.
Examine relationships between: Dietary habits and serum 25(OH)D levels Abnormal glucose metabolism and obesity in children
Cross-sectional observational study- no intervention was implemented
Subjects
411 obese and 89 non-overweight children (aged 6-16 years) residing in North Texas Grouping based on BMI percentile-for-age: Obese= >95th
percentile, non= <85th percentile Adequate sample size, but could have included more non-
overweight to better compare Convenience sample of non-overweight subjects from
Endocrinology Center for Hyperthyroidism No known relationship between thyroid and vitamin D status
Same exclusion criteria for both groups Meds: anticonvulsant, glucocorticoid, and/or vitamin D
supplement Health Status: Hepatic dz, renal dz, malabsorptive disorder,
bone metabolism disorder, hypothalamic dz, genetic predisposition to obesity
Accounted for multiple subject characteristics
AgeBMIGenderEthnicitySeasonDietary practices
Calculating Pediatric BMI
Test Procedures
Used common, standard procedures determined to be reliable and valid: Serum 25(OH)D Diabetes Risk Factors (validated by Amer Diabetes Assoc)
OGTT Fasting plasma glucose and insulin HgbA1C HOMA-IR (insulin resistance and beta-cell function)
All measurements taken in same way in both groups
Result evaluation based to gender, race, and season in both groups
Study Design- valid
Used standardized, accurate measures of glucose metabolism and vitamin D status
Included variety of subjects: different genders, races, ages
Matched non-overweight subjects to obese based on age, race, and season more accurate comparison
Relevant Outcomes
Obese had less seasonal variation in vitamin D status (p<0.03)
Breakfast skipping and high soda intakes were associated with lower vitamin D status (p<0.001)
When adjusted for age and BMI, vitamin D status negatively correlated with HOMA-IR and OGTT (p=0.001 and p=0.04) Lower vitamin D status is associated with T2D risk
factors in obese children
Author’s Conclusions
Study results show a negative relationship between vitamin D status and BMI in children
Glucose metabolism is related to vitamin D status
Limitation: unable to account for physical activity or sun-light exposure Could aid in better understanding differences in
vitamin D status between the 2 groups
Implications for Practice
Nutrition Professionals: Raise awareness of dietary factors negatively affecting
vitamin D status in children (breakfast skipping, soda consumption)
Highlight need for early dietary interventions
Clinical Professionals: Suggests need for further study of vitamin D
supplementation as a potential treatment for conditions such as insulin resistance