Skip to main content
Top
Published in: Endocrine 2/2016

01-08-2016 | Original Article

25-Hydroxyvitamin D insufficiency discriminates cardiovascular risk factors accumulation in peri-pubertal boys undergoing overweight screening

Authors: Andrea Di Nisio, Luca De Toni, Elvio D’Addato, Maria R. Pizzo, Pasquale Sabatino, Carlo Foresta

Published in: Endocrine | Issue 2/2016

Login to get access

Abstract

The aim of this study was to evaluate the possible association between cardiometabolic risk factors accumulation and vitamin D status in a cohort of Italian normal weight and overweight male children. 108 boys enrolled in an andrological health prevention project underwent physical examination, anthropometric measurements, and fasting blood sampling. Serum blood glucose, HDL-cholesterol, triglycerides, parathyroid hormone, and 25-hydroxyvitamin D (25(OH)D) were measured. Cardiovascular risk factors were defined according to the National Cholesterol Education Program Adult Treatment Panel III modified for age. Lean and overweight subjects differed in terms of waist circumference (P < 0.001), HDL-cholesterol (P = 0.001), triglycerides (P = 0.001), systolic blood pressure (P < 0.001) and diastolic blood pressure (P = 0.002). Both groups had similar mean 25(OH)D levels (P = 0.160) and were below the sufficiency threshold: indeed only 24 % of normal weight had 25(OH)D ≥30 ng/ml, and even less in the overweight/obese group (8 %, P = 0.03 vs. normal weight). A significant accumulation of risk factors in course of 25(OH)D insufficiency was detected in both the whole cohort and in the normal weight group (P = 0.003 and P = 0.04, respectively) with odd ratios of 1.31 (1.16–1.49 95%CI) and 1.41 (1.18–1.69 95%CI), respectively. In course of vitamin D deficiency, the odd ratios were 2.24 (1.34–3.77 95%CI, P = 0.003) in the whole cohort and 2.40 (1.27–4.82 95%CI, P = 0.03) in lean subjects. We reported a considerable occurrence of cardiovascular risk factors in course of hypovitaminosis D in overweight/obese boys and even in lean subjects, which normally would not have been further evaluated by considering the sole BMI-related parameters. In this regard, 25(OH)D levels appear as a potential discriminating parameter able to identify male children at higher health risk.
Appendix
Available only for authorised users
Literature
1.
go back to reference G. Jones, S.A. Strugnell, H.F. DeLuca, Current understanding of the molecular actions of vitamin D. Physiol. Rev. 78, 1193–1231 (1998)PubMed G. Jones, S.A. Strugnell, H.F. DeLuca, Current understanding of the molecular actions of vitamin D. Physiol. Rev. 78, 1193–1231 (1998)PubMed
2.
go back to reference Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Dietary reference intakes for calcium, magnesium, phosphorus, vitamin D, and fluoride (Food and Nutrition Board, Institute of Medicine National Academy Press, Washington, DC, 1997) Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Dietary reference intakes for calcium, magnesium, phosphorus, vitamin D, and fluoride (Food and Nutrition Board, Institute of Medicine National Academy Press, Washington, DC, 1997)
4.
go back to reference M.F. Holick, N.C. Binkley, H.A. Bischoff-Ferrari, C.M. Gordon, D.A. Hanley, R.P. Heaney, M.H. Murad, C.M. Weaver, Endocrine society: evaluation, treatment, and prevention of vitamin D deficiency: an endocrine society clinical practice guideline. J. Clin. Endocrinol. Metab. 96(7), 1911–1930 (2011). doi:10.1210/jc.2011-0385 CrossRefPubMed M.F. Holick, N.C. Binkley, H.A. Bischoff-Ferrari, C.M. Gordon, D.A. Hanley, R.P. Heaney, M.H. Murad, C.M. Weaver, Endocrine society: evaluation, treatment, and prevention of vitamin D deficiency: an endocrine society clinical practice guideline. J. Clin. Endocrinol. Metab. 96(7), 1911–1930 (2011). doi:10.​1210/​jc.​2011-0385 CrossRefPubMed
6.
go back to reference M.L. Melamed, J. Kumar, Low levels of 25-hydroxyvitamin D in the pediatric populations: prevalence and clinical outcomes. Ped. Health 4(1), 89–97 (2010)CrossRefPubMedPubMedCentral M.L. Melamed, J. Kumar, Low levels of 25-hydroxyvitamin D in the pediatric populations: prevalence and clinical outcomes. Ped. Health 4(1), 89–97 (2010)CrossRefPubMedPubMedCentral
7.
go back to reference Institute of Medicine (US) Standing Committee (IOM), Dietary reference intakes for calcium and vitamin D (National Academies Press, Washington, DC, 2011) Institute of Medicine (US) Standing Committee (IOM), Dietary reference intakes for calcium and vitamin D (National Academies Press, Washington, DC, 2011)
10.
go back to reference M.F. Holick, The D-batable Institute of Medicine report: a D-lightful perspective. Endocr. Pract. 17, 143–149 (2011)CrossRefPubMed M.F. Holick, The D-batable Institute of Medicine report: a D-lightful perspective. Endocr. Pract. 17, 143–149 (2011)CrossRefPubMed
11.
go back to reference A.C. Ross, J.E. Manson, S.A. Abrams, J.F. Aloia, P.M. Brannon, S.K. Clinton, R.A. Durazo-Arvizu, J.C. Gallagher, R.L. Gallo, G. Jones, C.S. Kovacs, S.T. Mayne, C.J. Rosen, S.A. Shapses, The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J. Clin. Endocrinol. Metab. 96, 53–58 (2011). doi:10.1210/jc.2010-2704 CrossRefPubMed A.C. Ross, J.E. Manson, S.A. Abrams, J.F. Aloia, P.M. Brannon, S.K. Clinton, R.A. Durazo-Arvizu, J.C. Gallagher, R.L. Gallo, G. Jones, C.S. Kovacs, S.T. Mayne, C.J. Rosen, S.A. Shapses, The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J. Clin. Endocrinol. Metab. 96, 53–58 (2011). doi:10.​1210/​jc.​2010-2704 CrossRefPubMed
13.
go back to reference D. Martins, M. Wolf, D. Pan, A. Zadshir, N. Tareen, R. Thadhani, A. Felsenfeld, B. Levine, R. Mehrotra, K. Norris, Prevalence of cardiovascular risk factors and the serum levels of 25- hydroxyvitamin D in the United States: data from the Third National Health and Nutrition Examination Survey. Arch. Intern. Med. 167, 1159–1165 (2007). doi:10.1001/archinte.167.11.1159 CrossRefPubMed D. Martins, M. Wolf, D. Pan, A. Zadshir, N. Tareen, R. Thadhani, A. Felsenfeld, B. Levine, R. Mehrotra, K. Norris, Prevalence of cardiovascular risk factors and the serum levels of 25- hydroxyvitamin D in the United States: data from the Third National Health and Nutrition Examination Survey. Arch. Intern. Med. 167, 1159–1165 (2007). doi:10.​1001/​archinte.​167.​11.​1159 CrossRefPubMed
15.
go back to reference L. Wang, J. Ma, J.E. Manson, J.E. Buring, J.M. Gaziano, H.D. Sesso, A prospective study of plasma vitamin D metabolites, vitamin D receptor gene polymorphisms, and risk of hypertension in men. Eur. J. Nutr. 52(7), 1771–1779 (2013). doi:10.1007/s00394-012-0480-8 CrossRefPubMed L. Wang, J. Ma, J.E. Manson, J.E. Buring, J.M. Gaziano, H.D. Sesso, A prospective study of plasma vitamin D metabolites, vitamin D receptor gene polymorphisms, and risk of hypertension in men. Eur. J. Nutr. 52(7), 1771–1779 (2013). doi:10.​1007/​s00394-012-0480-8 CrossRefPubMed
16.
go back to reference A. Zittermann, S. Prokop, The role of vitamin D for cardiovascular disease and overall mortality. Adv. Exp. Med. Biol. 810, 106–119 (2014)PubMed A. Zittermann, S. Prokop, The role of vitamin D for cardiovascular disease and overall mortality. Adv. Exp. Med. Biol. 810, 106–119 (2014)PubMed
18.
go back to reference L. De Toni, V. De Filippis, S. Tescari, M. Ferigo, A. Ferlin, V. Scattolini, A. Avogaro, R. Vettor, C. Foresta, Uncarboxylated Osteocalcin stimulates 25-hydroxy-vitamin D production in Leydig cell line through a GPRC6A-dependent pathway. Endocrinology 155(11), 4266–4274 (2014). doi:10.1210/en.2014-1283 CrossRefPubMed L. De Toni, V. De Filippis, S. Tescari, M. Ferigo, A. Ferlin, V. Scattolini, A. Avogaro, R. Vettor, C. Foresta, Uncarboxylated Osteocalcin stimulates 25-hydroxy-vitamin D production in Leydig cell line through a GPRC6A-dependent pathway. Endocrinology 155(11), 4266–4274 (2014). doi:10.​1210/​en.​2014-1283 CrossRefPubMed
19.
go back to reference V. Ganji, X. Zhang, N. Shaikh, V. Tangpricha, Serum 25-hydroxyvitamin D concentrations are associated with prevalence of metabolic syndrome and various cardiometabolic risk factors in US children and adolescents based on assay-adjusted serum 25-hydroxyvitamin D data from NHANES 2001–2006. Am. J. Clin. Nutr. 94, 225–233 (2011). doi:10.3945/ajcn.111.013516 CrossRefPubMed V. Ganji, X. Zhang, N. Shaikh, V. Tangpricha, Serum 25-hydroxyvitamin D concentrations are associated with prevalence of metabolic syndrome and various cardiometabolic risk factors in US children and adolescents based on assay-adjusted serum 25-hydroxyvitamin D data from NHANES 2001–2006. Am. J. Clin. Nutr. 94, 225–233 (2011). doi:10.​3945/​ajcn.​111.​013516 CrossRefPubMed
20.
go back to reference D.S. Freedman, W.H. Dietz, S.R. Srinivasan, G.S. Berenson, The relation of overweight to cardiovascular risk factors among children and adolescents: the Bogalusa Heart Study. Pediatrics 103, 1175–1182 (1999)CrossRefPubMed D.S. Freedman, W.H. Dietz, S.R. Srinivasan, G.S. Berenson, The relation of overweight to cardiovascular risk factors among children and adolescents: the Bogalusa Heart Study. Pediatrics 103, 1175–1182 (1999)CrossRefPubMed
21.
go back to reference P.G. Kopelman, Obesity as a medical problem. Nature 404(6778), 635–643 (2000)PubMed P.G. Kopelman, Obesity as a medical problem. Nature 404(6778), 635–643 (2000)PubMed
22.
go back to reference C.L. Ogden, R.J. Kuczmarski, K.M. Flegal, Z. Mei, S. Guo, R. Wei, L.M. Grummer-Strawn, L.R. Curtin, A.F. Roche, C.L. Johnson, Centers for disease control and prevention 2000 growth charts for the United States: improvements to the 1977 National Center for Health Statistics version. Pediatrics 109, 45–60 (2002). doi:10.1542/peds.109.1.45 CrossRefPubMed C.L. Ogden, R.J. Kuczmarski, K.M. Flegal, Z. Mei, S. Guo, R. Wei, L.M. Grummer-Strawn, L.R. Curtin, A.F. Roche, C.L. Johnson, Centers for disease control and prevention 2000 growth charts for the United States: improvements to the 1977 National Center for Health Statistics version. Pediatrics 109, 45–60 (2002). doi:10.​1542/​peds.​109.​1.​45 CrossRefPubMed
25.
go back to reference J.M. Tanner, R.H. Whitehouse, Clinical longitudinal standards for height, weight, height velocity, weight velocity, and stages of puberty. Arch. Dis. Child. 51, 170–179 (1976)CrossRefPubMedPubMedCentral J.M. Tanner, R.H. Whitehouse, Clinical longitudinal standards for height, weight, height velocity, weight velocity, and stages of puberty. Arch. Dis. Child. 51, 170–179 (1976)CrossRefPubMedPubMedCentral
27.
go back to reference S. Cook, M. Weitzman, P. Auinger, M. Nguyen, W.H. Dietz, Prevalence of a metabolic syndrome phenotype in adolescents: findings from the third National Health and Nutrition Examination Survey, 1988–1994. Arch. Pediatr. Adolesc. Med. 157(8), 821–827 (2003). doi:10.1001/archpedi.157.8.821 CrossRefPubMed S. Cook, M. Weitzman, P. Auinger, M. Nguyen, W.H. Dietz, Prevalence of a metabolic syndrome phenotype in adolescents: findings from the third National Health and Nutrition Examination Survey, 1988–1994. Arch. Pediatr. Adolesc. Med. 157(8), 821–827 (2003). doi:10.​1001/​archpedi.​157.​8.​821 CrossRefPubMed
28.
go back to reference J.R. Fernandez, D.T. Redden, A. Pietrobelli, D.B. Allison, Waist circumference percentiles in nationally representative samples of African-American, European-American, and Mexican-American children and adolescents. J. Pediatr. 145(4), 439–444 (2004)CrossRefPubMed J.R. Fernandez, D.T. Redden, A. Pietrobelli, D.B. Allison, Waist circumference percentiles in nationally representative samples of African-American, European-American, and Mexican-American children and adolescents. J. Pediatr. 145(4), 439–444 (2004)CrossRefPubMed
30.
go back to reference A. Colao, G. Muscogiuri, M. Rubino, L. Vuolo, C. Pivonello, P. Sabatino, M. Pizzo, G. Campanile, R. Fittipaldi, G. Lombardi, C. Di Somma, Hypovitaminosis D in adolescents living in the land of sun is correlated with incorrect life style: a survey study in Campania region. Endocrine 49(2), 521–527 (2015). doi:10.1007/s12020-014-0483-8 CrossRefPubMed A. Colao, G. Muscogiuri, M. Rubino, L. Vuolo, C. Pivonello, P. Sabatino, M. Pizzo, G. Campanile, R. Fittipaldi, G. Lombardi, C. Di Somma, Hypovitaminosis D in adolescents living in the land of sun is correlated with incorrect life style: a survey study in Campania region. Endocrine 49(2), 521–527 (2015). doi:10.​1007/​s12020-014-0483-8 CrossRefPubMed
31.
go back to reference B. Franchi, M. Piazza, M. Sandri, L. Tenero, P. Comberiati, A.L. Boner, C. Capristo, 25-hydroxyvitamin D serum level in children of different ethnicity living in Italy. Eur. J. Pediatr. (2014). doi:10.1007/s00431-014-2451-y B. Franchi, M. Piazza, M. Sandri, L. Tenero, P. Comberiati, A.L. Boner, C. Capristo, 25-hydroxyvitamin D serum level in children of different ethnicity living in Italy. Eur. J. Pediatr. (2014). doi:10.​1007/​s00431-014-2451-y
32.
go back to reference J. Valtueña, L. Gracia-Marco, G. Vicente-Rodríguez, M. González-Gross, I. Huybrechts, J.P. Rey-López, T. Mouratidou, I. Sioen, M.I. Mesana, A.E. Martínez, K. Widhalm, L.A. Moreno, HELENA Study Group. Vitamin D status and physical activity interact to improve bone mass in adolescents. The HELENA Study. Osteoporos. Int. 23(8), 2227–2237 (2012)CrossRefPubMed J. Valtueña, L. Gracia-Marco, G. Vicente-Rodríguez, M. González-Gross, I. Huybrechts, J.P. Rey-López, T. Mouratidou, I. Sioen, M.I. Mesana, A.E. Martínez, K. Widhalm, L.A. Moreno, HELENA Study Group. Vitamin D status and physical activity interact to improve bone mass in adolescents. The HELENA Study. Osteoporos. Int. 23(8), 2227–2237 (2012)CrossRefPubMed
33.
go back to reference F. Vierucci, M. Del Pistoia, M. Fanos, P. Erba, G. Saggese, Prevalence of hypovitaminosis D and predictors of vitamin D status in Italian healthy adolescents. Ital. J. Pediatr. 5, 40–54 (2014). doi:10.1186/1824-7288-40-54 F. Vierucci, M. Del Pistoia, M. Fanos, P. Erba, G. Saggese, Prevalence of hypovitaminosis D and predictors of vitamin D status in Italian healthy adolescents. Ital. J. Pediatr. 5, 40–54 (2014). doi:10.​1186/​1824-7288-40-54
35.
go back to reference C. Buffington, B. Walker, G.S. Cowan Jr, D. Scruggs, Vitamin D deficiency in the morbidly obese. Obes. Surg. 3, 421–424 (1993)CrossRefPubMed C. Buffington, B. Walker, G.S. Cowan Jr, D. Scruggs, Vitamin D deficiency in the morbidly obese. Obes. Surg. 3, 421–424 (1993)CrossRefPubMed
36.
go back to reference J. Wortsman, L.Y. Matsuoka, T.C. Chen, Z. Lu, M.F. Holick, Decreased bioavailability of vitamin D in obesity. Am. J. Clin. Nutr. 72, 690–693 (2000)PubMed J. Wortsman, L.Y. Matsuoka, T.C. Chen, Z. Lu, M.F. Holick, Decreased bioavailability of vitamin D in obesity. Am. J. Clin. Nutr. 72, 690–693 (2000)PubMed
37.
go back to reference W.D. Johnson, J.J.M. Kroon, F.L. Greenway, C. Bouchard, D. Ryan, P.T. Katzmarzyk, Prevalence of risk factors for metabolic syndrome in adolescents: national Health and Nutrition Examination Survey (NHANES), 2001–2006. Arch. Pediatr. Adolesc. Med. 163, 371–377 (2009). doi:10.1001/archpediatrics.2009.3 CrossRefPubMed W.D. Johnson, J.J.M. Kroon, F.L. Greenway, C. Bouchard, D. Ryan, P.T. Katzmarzyk, Prevalence of risk factors for metabolic syndrome in adolescents: national Health and Nutrition Examination Survey (NHANES), 2001–2006. Arch. Pediatr. Adolesc. Med. 163, 371–377 (2009). doi:10.​1001/​archpediatrics.​2009.​3 CrossRefPubMed
38.
39.
go back to reference S. Gutiérrez Medina, T. Gavela-Pérez, M.N. Domínguez-Garrido, E. Gutiérrez-Moreno, A. Rovira, C. Garcés, L. Soriano-Guillén, The influence of puberty on vitamin D status in obese children and the possible relation between vitamin D deficiency and insulin resistance. J. Pediatr. Endocrinol. Metab. 28(1–2), 105–110 (2015). doi:10.1515/jpem-2014-0033 PubMed S. Gutiérrez Medina, T. Gavela-Pérez, M.N. Domínguez-Garrido, E. Gutiérrez-Moreno, A. Rovira, C. Garcés, L. Soriano-Guillén, The influence of puberty on vitamin D status in obese children and the possible relation between vitamin D deficiency and insulin resistance. J. Pediatr. Endocrinol. Metab. 28(1–2), 105–110 (2015). doi:10.​1515/​jpem-2014-0033 PubMed
40.
go back to reference D.M. Harrington, A.E. Staiano, S.T. Broyles, A.K. Gupta, P.T. Katzmarzyk, BMI percentiles for the identification of abdominal obesity and metabolic risk in children and adolescents: evidence in support of the CDC 95th percentile. Eur. J. Clin. Nutr. 67(2), 218–222 (2013). doi:10.1038/ejcn.2012.203 CrossRefPubMed D.M. Harrington, A.E. Staiano, S.T. Broyles, A.K. Gupta, P.T. Katzmarzyk, BMI percentiles for the identification of abdominal obesity and metabolic risk in children and adolescents: evidence in support of the CDC 95th percentile. Eur. J. Clin. Nutr. 67(2), 218–222 (2013). doi:10.​1038/​ejcn.​2012.​203 CrossRefPubMed
41.
42.
go back to reference Y. Dong, I.S. Stallmann-Jorgensen, N.K. Pollock, R.A. Harris, D. Keeton, Y. Huang, K. Li, R. Bassali, D.H. Guo, J. Thomas, G.L. Pierce, J. White, M.F. Holick, H. Zhu, A 16-week randomized clinical trial of 2000 international units daily vitamin d-3 supplementation in black youth: 25-hydroxyvitamin d, adiposity, and arterial stiffness. J. Clin. Endocrinol. Metab. 95(10), 4584–4591 (2010). doi:10.1210/jc.2010-0606 CrossRefPubMed Y. Dong, I.S. Stallmann-Jorgensen, N.K. Pollock, R.A. Harris, D. Keeton, Y. Huang, K. Li, R. Bassali, D.H. Guo, J. Thomas, G.L. Pierce, J. White, M.F. Holick, H. Zhu, A 16-week randomized clinical trial of 2000 international units daily vitamin d-3 supplementation in black youth: 25-hydroxyvitamin d, adiposity, and arterial stiffness. J. Clin. Endocrinol. Metab. 95(10), 4584–4591 (2010). doi:10.​1210/​jc.​2010-0606 CrossRefPubMed
Metadata
Title
25-Hydroxyvitamin D insufficiency discriminates cardiovascular risk factors accumulation in peri-pubertal boys undergoing overweight screening
Authors
Andrea Di Nisio
Luca De Toni
Elvio D’Addato
Maria R. Pizzo
Pasquale Sabatino
Carlo Foresta
Publication date
01-08-2016
Publisher
Springer US
Published in
Endocrine / Issue 2/2016
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI
https://doi.org/10.1007/s12020-015-0725-4

Other articles of this Issue 2/2016

Endocrine 2/2016 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.