Shulhai A-M.A., Pavlyshyn H.A.

LEVELS OF VITAMIN D AND CARDIOMETABOLIC RISK FACTORS IN OBESITY ADOLESCENTS

---

About the author:	Shulhai A-M.A., Pavlyshyn H.A.
Heading	CLINICAL MEDICINE
Type of article	Scentific article
Annotation	The growth in the number of adolescents with obesity is an important global problem. The aim of the work was to examine the relationship between the levels of vitamin D and proatherogenic cardiometabolic risk factors in adolescents with obesity. 168 adolescents with obesity were examined. The average age of teenagers was 15.1 ± 2.1 years. None of the adolescents had obesity due to endocrine diseases. Parameters that were determined in all children included: undertaking anthropometric measurements, general examinations, biochemical parameters, including lipid metabolism, fasting glucose, insulin, measuring the homeostasis model assessment for insulin resistance, blood pressure measurement and determination of vitamin D status. Among all adolescents, vitamin D deficiency was defined in 75.6 % and insufficiency in 20.3 %. Conforming to the 2007 International Diabetes Federation criteria metabolic syndrome was diagnosed in 57.2 % in adolescents with obesity. All results were processed using statistical analysis. It showed the inverse correlations between vitamin D level and body mass index, waist circumference, levels of low-density lipoprotein cholesterol, total cholesterol, systolic blood pressure and insulin levels. There were no statistically significant associations of calcidiol with triglycerides, high-density lipoprotein cholesterol and fasting blood sugar levels. The most frequent proatherogenic metabolic risk factors occur when obesity is combined with vitamin D deficiency. The obtained results permitted to make the following conclusions: 1. In children of adolescence with obesity in 75.6% deficiency is defined, and in 20.3% insufficiency of vitamin D. 2. In obesity, which is accompanied by insufficiency and deficiency of vitamin D, the indices of proatherogenic metabolic disorders increase, insulin resistance increases and the content of high density lipoprotein cholesterol, which provides antiatherogenic properties, decreases. 3. It has been found that 25 (OH) D has a reversible probable relationship with body mass index, waist circumference, systolic blood pressure, low density lipoprotein cholesterol, total cholesterol, and basal insulin. 4. In adolescents, obesity is accompanied by the development of metabolic syndrome, which is more often manifested in boys. Vitamin D deficiency contributes to an increase in the number of cardiometabolic risk factors. Prospects for further research lie in developing adequate methods for the treatment of obesity and metabolic syndrome, which are combined with D hypovitaminosis.
Tags	vitamin D, metabolic syndrome, children, obesity, cardiometabolic disorders
Bibliography	Alaklabi AM, Alsharairi NA. Current Evidence on Vitamin D Deficiency and Metabolic Syndrome in Obese Children: What Does the Evidence from Saudi Arabia Tell US. Children (Basel). 2018 Jan; 5(1): 11. doi: 10.3390/children5010011 Chen S, Law CS, Grigsby CL, Olsen K, Hong T-T, Zhang Y. Cardiomyocyte-Specific Deletion of the Vitamin D Receptor Gene Results in Cardiac Hypertrophy. Circulation. 2011; 124: 1838–1847. doi.org/10.1161/Circulationaha.111.032680. Cheng S, Massaro J, Fox C.  Adiposity, Cardiometabolic Risk, and Vitamin D Status: The Framingham Heart Study Diabetes 2010 Jan; 59(1): 242-248. doi.org/10.2337/db09-1011 Cordeiro A, Santos A, Bernardes M, Ramalho A, Martins MJ. Vitamin D metabolism in human adipose tissue: could it explain low vitamin D status in obesity. Horm Mol Biol Clin Investig. 2017; 33(2). doi: 10.1515/hmbci-2017-0003. Jackson-Leach R, Montague F, Lobstein T. Obesity Atlas for the European Union: 2017 [Internet]. World Obesity Federation; 2016 [Data compiled November 2016]. Available from: https://content.worldobesity.org/site_media/uploads/eu-atlas-2017-v3.pdf Jeddi S, Syedmoradi L, Bagheripour F, Ghasemi A. The Effects of Vitamin D on Insulin Release From Isolated Islets of Rats Int J Endocrinol Metab. 2015 Jan; 13(1): e20620. doi: 10.5812/ijem.20620 Kumaratne M, Gayle Early G, Cisneros J. Vitamin D Deficiency and Association With Body Mass Index and Lipid Levels in Hispanic American Adolescents. Glob Pediatr Health. 2017; 4: 1-6. doi: 10.1177/2333794X17744141 Moreira TS, Hamadeh MJ. The role of vitamin D deficiency in the pathogenesis of type 2 diabetes mellitus. The European e-Journal of Clinical Nutrition and Metabolism. 2010; 5(4):155-165. doi.org/10.1016/j.eclnm.2010.05.001 Min B. Effects of Vitamin D on Blood Pressure and Endothelial Function. Korean J Physiol Pharmacol. 2013 Oct; 17(5): 385–392. doi: 10.4196/kjpp.2013.17.5.385 Pludowski P, Karczmarewicz E, Bayer M, Carter G, Chlebna-Sokol D, Czech-Kowalska J, et al. Practical guidelines for the supplementation of vitamin D and the treatment of deficits in Central Europe - recommended vitamin D intakes in the general population and groups at risk of vitamin D deficiency. Endokrynol Pol. 2013; 64(4): 319-27. Stephanie TC, Anthony UO, Sheela NM. Cardiometabolic risk in obese children. Ann N Y Acad Sci. 2018 January; 1411(1): 166–183. doi:10.1111/nyas.13602. Strange RC, Shipman KE, Ramachandran S. Metabolic syndrome: A review of the role of vitamin D in mediating susceptibility and outcome. World J Diabetes. 2015 Jul 10; 6(7): 896–911. doi: 10.4239/wjd.v6.i7.896 Tabrizi R, Moosazadeh M, Akbari M. High Prevalence of Vitamin D Deficiency among Iranian Population: A Systematic Review and Meta-Analysis. Iran J Med Sci. 2018 Mar; 43(2): 125–139. PMID: 29749981 Tanner JM. Growth at adolescence: with a general consideration of the effects of hereditary and environmental factors upon growth and maturation from birth to maturity. 2nd ed. Oxford, England: Blackwell Scientific; 1962. 325p. Zielinska NB. Obesity and metabolic syndrome in children. Clinical Endocrinology and Endocrine Surgery. 2013; 4 (45): 62-72.
Publication of the article	«World of Medicine and Biology» №2(68), 2019 year, 148-153 pages, index UDK 616.391:577.161.2:516.1:616-008.9-056.52]-053.6
DOI	10.26724/2079-8334-2019-2-68-148-153