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Licensed Unlicensed Requires Authentication Published by De Gruyter November 9, 2021

The association between vitamin D levels and metabolic syndrome components among metropolitan adolescent population

  • Yi-Xiong Gao , Jian Zhang ORCID logo EMAIL logo , Qingqing Man , Yuqian Li and Shanshan Jia

Abstract

Objectives

Vitamin D promotes both lipolysis and lipogenesis, and some pediatric studies showed inconsistent associations between vitamin D and metabolic syndrome (MetS). This cross-sectional study aimed to examine the association between vitamin D levels and MetS components among metropolitan adolescents.

Methods

A total of 4,149 adolescents aged 10–18 years were recruited from 23 metropolises in China. The MetS conditions were assessed according to the International Diabetes Federation consensus definition, and the serum 25-hydroxy vitamin D (25(OH)D) concentrations were analyzed. The association between MetS components and serum 25(OH)D levels was analyzed by the logistic regression model. Restricted cubic spline was applied to the model nonlinear association.

Results

Prevalence of vitamin D deficiency was 74.9%, and 41.2% of study participants had at least one MetS component. After adjustment, the significant trend for a lower waist-to-height ratio was not observed in study participants with higher serum 25(OH)D quartile (p=0.57), but a significant nonlinear association between abdominal obesity and serum 25(OH)D levels was found (p=0.04): the highest risk of abdominal obesity occurred at 14.1 ng/mL of serum 25(OH)D. The association of serum 25(OH)D was significantly inverse with MetS (OR: 0.95; 95% CI: 0.92–0.98), but not with raised triglycerides (OR: 0.99; 95% CI: 0.96–1.01), raised blood pressure (OR: 0.99; 95% CI: 0.97–1.01) and impaired fasting glycemia (OR: 1.03; 95% CI: 1.01–1.04).

Conclusions

The net effect of vitamin D on lipid metabolism may be concentration-dependent, and the actual effect of vitamin D on MetS process may be complex among metropolitan adolescents, though serum 25(OH)D is inversely associated with MetS.


Corresponding author: Jian Zhang, PhD, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 100050, Peking, China, Phone: +86 10 66237147, E-mail:

Award Identifier / Grant number: 2016YFC1305201

Funding source: Nutrition and Health Surveillance for Children and Nursing Mothers in China 2017

Award Identifier / Grant number: 2017-021

Acknowledgments

Ms. Yuehua Hu from China CDC, Mr. Qianrang Zhu from Jiangsu CDC, and Mr. Lianlong Yu from Shandong CDC provided assistance in statistical analysis.

  1. Research funding: This study was supported by the National Key Research and Development Program of China (grant number: 2016YFC1305201), and Nutrition and Health Surveillance for Children and Nursing Mothers in China 2017 (grant number: 2017-021).

  2. Author contributions: Y. X. G. carried out data analysis and drafted the initial article. J. Z. conceived and planned the project. Q. M., Y. L., and S. J. acquired the data and provided critical feedback to the article. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  3. Competing interest: Authors state no conflict of interest.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethical approval: The local Institutional Review Board deemed the study exempt from review.

References

1. Engin, A. The definition and prevalence of obesity and metabolic syndrome. Adv Exp Med Biol 2017;960:1–17. https://doi.org/10.1007/978-3-319-48382-5_1.Search in Google Scholar

2. International Diabetes Federation. The IDF consensus definition of the metabolic syndrome in children and adolescents. Brussels, Belgium: International Diabetes Federation; 2007.Search in Google Scholar

3. Zhao, Y, Yu, Y, Li, H, Li, M, Zhang, D, Guo, D, et al.. The association between metabolic syndrome and biochemical markers in Beijing adolescents. Int J Environ Res Publ Health 2019;16:4557. https://doi.org/10.3390/ijerph16224557.Search in Google Scholar

4. Lafortuna, CL, Adorni, F, Agosti, F, de Col, A, Sievert, K, Siegfried, W, et al.. Prevalence of the metabolic syndrome among extremely obese adolescents in Italy and Germany. Diabetes Res Clin Pract 2010;88:14–21. https://doi.org/10.1016/j.diabres.2010.01.008.Search in Google Scholar

5. Reis, JP, von Mühlen, D, Miller, ER, Michos, ED, Appel, LJ. Vitamin D status and cardiometabolic risk factors in the United States adolescent population. Pediatrics 2009;124:e371–9. https://doi.org/10.1542/peds.2009-0213.Search in Google Scholar

6. Morrison, JA, Friedman, LA, Gray-McGuire, C. Metabolic syndrome in childhood predicts adult cardiovascular disease 25 years later: the Princeton lipid research clinics follow-up study. Pediatrics 2007;120:340–5. https://doi.org/10.1542/peds.2006-1699.Search in Google Scholar

7. Morrison, JA, Friedman, LA, Wang, P, Glueck, CJ. Metabolic syndrome in childhood predicts adult metabolic syndrome and type 2 diabetes mellitus 25 to 30 years later. J Pediatr 2008;152:201–6. https://doi.org/10.1016/j.jpeds.2007.09.010.Search in Google Scholar

8. Abbas, MA. Physiological functions of vitamin D in adipose tissue. J Steroid Biochem Mol Biol 2017;165:369–81. https://doi.org/10.1016/j.jsbmb.2016.08.004.Search in Google Scholar

9. Khan, RJ, Riestra, P, Gebreab, SY, Wilson, JG, Gaye, A, Xu, R, et al.. Vitamin D receptor gene polymorphisms are associated with abdominal visceral adipose tissue volume and serum adipokine concentrations but not with body mass index or waist circumference in African Americans: the Jackson heart study. J Nutr 2016;146:1476–82. https://doi.org/10.3945/jn.116.229963.Search in Google Scholar

10. McCarty, MF, Thomas, CA. PTH excess may promote weight gain by impeding catecholamine-induced lipolysis-implications for the impact of calcium, vitamin D, and alcohol on body weight. Med Hypotheses 2003;61:535–42. https://doi.org/10.1016/s0306-9877(03)00227-5.Search in Google Scholar

11. Sun, X, Zemel, MB. Role of uncoupling protein 2 (UCP2) expression and 1alpha, 25-dihydroxyvitamin D3 in modulating adipocyte apoptosis. Faseb J 2004;18:1430–2. https://doi.org/10.1096/fj.04-1971fje.Search in Google Scholar PubMed

12. Narvaez, CJ, Simmons, KM, Brunton, J, Salinero, A, Chittur, SV, Welsh, JE. Induction of STEAP4 correlates with 1,25-dihydroxyvitamin D3 stimulation of adipogenesis in mesenchymal progenitor cells derived from human adipose tissue. J Cell Physiol 2013;228:2024–36. https://doi.org/10.1002/jcp.24371.Search in Google Scholar PubMed

13. Shi, H, Norman, AW, Okamura, WH, Sen, A, Zemel, MB. 1 alpha, 25-dihydroxyvitamin D3 inhibits uncoupling protein 2 expression in human adipocytes. Faseb J 2002;16:1808–10. https://doi.org/10.1096/fj.02-0255fje.Search in Google Scholar PubMed

14. Shi, H, Norman, AW, Okamura, WH, Sen, A, Zemel, MB. 1 alpha, 25-Dihydroxyvitamin D3 modulates human adipocyte metabolism via nongenomic action. Faseb J 2001;15:2751–3. https://doi.org/10.1096/fj.01-0584fje.Search in Google Scholar PubMed

15. Petersen, RA, Dalskov, SM, Sørensen, LB, Hjorth, MF, Andersen, R, Tetens, I, et al.. Vitamin D status is associated with cardiometabolic markers in 8–11-year-old children, independently of body fat and physical activity. Br J Nutr 2015;114:1647–55. https://doi.org/10.1017/s0007114515003372.Search in Google Scholar PubMed

16. Fu, J, Han, L, Zhao, Y, Li, G, Zhu, Y, Li, Y, et al.. Vitamin D levels are associated with metabolic syndrome in adolescents and young adults: the BCAMS study. Clin Nutr 2019;38:2161–7. https://doi.org/10.1016/j.clnu.2018.08.039.Search in Google Scholar PubMed

17. Rafraf, M, Hasanabad, SK, Jafarabadi, MA. Vitamin D status and its relationship with metabolic syndrome risk factors among adolescent girls in Boukan, Iran. Publ Health Nutr 2014;17:803–9. https://doi.org/10.1017/s1368980013003340.Search in Google Scholar

18. Tang, Z, Huang, S, Ma, R, Zheng, H, Zhu, Y. Low vitamin D status is associated with obesity but no other cardiovascular risk factors in Chinese children and adolescents. Nutr Metabol Cardiovasc Dis 2020;30:1573–81. https://doi.org/10.1016/j.numecd.2020.05.019.Search in Google Scholar PubMed

19. Bailey, BA, Manning, T, Peiris, AN. The impact of living in rural and urban areas: vitamin D and medical costs in veterans. J Rural Health 2012;28:356–63. https://doi.org/10.1111/j.1748-0361.2012.00407.x.Search in Google Scholar PubMed

20. Globalization and World Cities Research Network. The world according to GaWC 2016. Available from: https://www.lboro.ac.uk/gawc/world2016t.html [Accessed 30 Jun 2021].Search in Google Scholar

21. Holick, MF, Binkley, NC, Bischoff-Ferrari, HA, Gordon, CM, Hanley, DA, Heaney, RP, et al.. Evaluation, treatment, and prevention of vitamin D deficiency: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2011;96:1911–30. https://doi.org/10.1210/jc.2011-0385.Search in Google Scholar PubMed

22. McCarthy, HD, Cole, TJ, Fry, T, Jebb, SA, Prentice, AM. Body fat reference curves for children. Int J Obes 2006;30:598–602. https://doi.org/10.1038/sj.ijo.0803232.Search in Google Scholar PubMed

23. Desquilbet, L, Mariotti, F. Dose-response analyses using restricted cubic spline functions in public health research. Stat Med 2010;29:1037–57. https://doi.org/10.1002/sim.3841.Search in Google Scholar PubMed

24. Després, JP, Lemieux, I. Abdominal obesity and metabolic syndrome. Nature 2006;444:881–7. https://doi.org/10.1038/nature05488.Search in Google Scholar PubMed

25. Ahmed, B, Sultana, R, Greene, MW. Adipose tissue and insulin resistance in obese. Biomed Pharmacother 2021;137:111315. https://doi.org/10.1016/j.biopha.2021.111315.Search in Google Scholar PubMed

26. Ormazabal, V, Nair, S, Elfeky, O, Aguayo, C, Salomon, C, Zuñiga, FA. Association between insulin resistance and the development of cardiovascular disease. Cardiovasc Diabetol 2018;17:122. https://doi.org/10.1186/s12933-018-0762-4.Search in Google Scholar PubMed PubMed Central

27. Vaněčková, I, Maletínská, L, Behuliak, M, Nagelová, V, Zicha, J, Kuneš, J. Obesity-related hypertension: possible pathophysiological mechanisms. J Endocrinol 2014;223:R63–78.10.1530/JOE-14-0368Search in Google Scholar PubMed

28. Segura, J, Ruilope, LM. Obesity, essential hypertension and renin-angiotensin system. Publ Health Nutr 2007;10:1151–5. https://doi.org/10.1017/s136898000700064x.Search in Google Scholar

29. Ross, AC, Manson, JE, Abrams, SA, Aloia, JF, Brannon, PM, Clinton, SK, et al.. 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 2011;96:53–8. https://doi.org/10.1210/jc.2010-2704.Search in Google Scholar PubMed PubMed Central

30. Williams, DM, Fraser, A, Lawlor, DA. Associations of vitamin D, parathyroid hormone and calcium with cardiovascular risk factors in US adolescents. Heart 2011;97:315–20. https://doi.org/10.1136/hrt.2010.203224.Search in Google Scholar PubMed PubMed Central

31. Snijder, MB, Lips, P, Seidell, JC, Visser, M, Deeg, DJH, Dekker, JM, et al.. Vitamin D status and parathyroid hormone levels in relation to blood pressure: a population-based study in older men and women. J Intern Med 2007;261:558–65. https://doi.org/10.1111/j.1365-2796.2007.01778.x.Search in Google Scholar PubMed

32. Al-Hraishawi, H, Dellatore, PJ, Cai, X, Wang, X. Intact parathyroid hormone levels and primary hyperparathyroidism. Endocr Res 2017;42:241–5. https://doi.org/10.1080/07435800.2017.1292528.Search in Google Scholar PubMed

33. Jafari, T, Fallah, AA, Rostampour, N, Mahmoodnia, L. Vitamin D ameliorates systolic but not diastolic blood pressure in patients with type 2 diabetes: results from a meta-analysis of randomized controlled trials. Int J Vitam Nutr Res 2018;88:90–9. https://doi.org/10.1024/0300-9831/a000291.Search in Google Scholar

34. Kelishadi, R, Ardalan, G, Motlagh, ME, Shariatinejad, K, Heshmat, R, Poursafa, P, et al.. National report on the association of serum vitamin D with cardiometabolic risk factors in the pediatric population of the Middle East and North Africa (MENA): the CASPIAN-III Study. Nutrition 2014;30:33–8. https://doi.org/10.1016/j.nut.2013.05.018.Search in Google Scholar

35. State council of China. Notice of state council on adjusting the standards for city size classification. Available from: http://www.gov.cn/zhengce/content/2014-11/20/content_9225.htm [Accessed 30 Jun 2021].Search in Google Scholar

36. Yang, G, Wang, Y, Zeng, Y, Gao, GF, Liang, X, Zhou, M, et al.. Rapid health transition in China, 1990–2010: findings from the Global Burden of disease study 2010. Lancet 2013;381:1987–2015. https://doi.org/10.1016/s0140-6736(13)61097-1.Search in Google Scholar

37. Elks, CM, Francis, J. Central adiposity, systemic inflammation, and the metabolic syndrome. Curr Hypertens Rep 2010;12:99–104. https://doi.org/10.1007/s11906-010-0096-4.Search in Google Scholar PubMed

38. Dabelea, D, Mayer-Davis, EJ, Saydah, S, Imperatore, G, Linder, B, Divers, J, et al.. Prevalence of type 1 and type 2 diabetes among children and adolescents from 2001 to 2009. J Am Med Assoc 2014;311:1778–86. https://doi.org/10.1001/jama.2014.3201.Search in Google Scholar PubMed PubMed Central

39. del Giudice, EM, Grandone, A, Cirillo, G, Capristo, C, Marzuillo, P, Sessa, AD, et al.. Bioavailable vitamin D in obese children: the role of insulin resistance. J Clin Endocrinol Metab 2015;100:3949–55. https://doi.org/10.1210/jc.2015-2973.Search in Google Scholar PubMed

Received: 2021-07-05
Accepted: 2021-10-04
Published Online: 2021-11-09
Published in Print: 2022-01-27

© 2021 Walter de Gruyter GmbH, Berlin/Boston

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