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Journal of Pediatric Endocrinology and Metabolism

Editor-in-Chief: Kiess, Wieland

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Volume 26, Issue 11-12


Vitamin D status is associated with early markers of cardiovascular disease in prepubertal children

Benjamin U. Nwosu
  • Corresponding author
  • Division of Endocrinology, Department of Pediatrics, University of Massachusetts Medical School, MA, USA
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/ Louise Maranda
  • Department of Quantitative Health Sciences, University of Massachusetts Medical School, MA, USA
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/ Karen Cullen
  • Division of Endocrinology, Department of Pediatrics, University of Massachusetts Medical School, MA, USA
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/ Carol Ciccarelli
  • Division of Endocrinology, Department of Pediatrics, University of Massachusetts Medical School, MA, USA
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/ Mary M. Lee
  • Division of Endocrinology, Department of Pediatrics, University of Massachusetts Medical School, MA, USA
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Published Online: 2013-07-02 | DOI: https://doi.org/10.1515/jpem-2013-0086


Background: The associations of 25-hydroxyvitamin D [25(OH)D], non-high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL), and related markers of early cardiovascular disease (CVD) are unclear in prepubertal children.

Objective: To investigate the association of 25(OH)D with markers of CVD. The hypothesis was that 25(OH)D would vary inversely with non-HDL-C.

Subjects and methods: A prospective cross-sectional study of children (n=45; 26 males, 19 females) of mean age 8.3±2.5 years to investigate the relationships between 25(OH)D and glucose, insulin, high-sensitivity C-reactive protein, and lipids. Vitamin D deficiency was defined as 25(OH)D <20 ng/mL; overweight as body mass index (BMI) ≥85th but <95th percentile; and obesity as BMI >95th percentile.

Results: Twenty subjects (44.4%) had BMI <85%, and 25 had BMI of ≥85%. Eleven participants (24.4%) had 25(OH)D of <20 ng/mL, and 10 (22.2%) had 25(OH)D of >30 ng/mL. Patients with 25(OH)D of <20 ng/mL had significantly elevated non-HDL-C (136.08±44.66 vs. 109.88±28.25, p=0.025), total cholesterol (TC)/HDL ratio (3.89±1.20 vs. 3.21±0.83, p=0.042), and triglycerides (TG) (117.09±71.27 vs. 73.39±46.53, p=0.024), while those with 25(OH)D of >30 ng/mL had significantly lower non-HDL-C, TC/HDL, TG, and LDL (82.40±18.03 vs. 105.15±28.38, p=0.006). Multivariate analysis showed significant inverse correlations between 25(OH)D and non-HDL cholesterol (β=–0.337, p=0.043), and TC/HDL ratio (β=–0.339, p=0.028), and LDL (β=–0.359, p=0.016), after adjusting for age, race, sex, BMI, and seasonality.

Conclusions: Vitamin D varied inversely with non-HDL, TC/HDL, and LDL. A 25(OH)D level of 30 ng/mL is associated with optimal cardioprotection in children.

Keywords: cardiovascular disease; prepubertal children; vitamin D status


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About the article

Corresponding author: Benjamin U. Nwosu, MD, Associate Professor, Division of Endocrinology, Department of Pediatrics, University of Massachusetts Medical School, 55 Lake Avenue N, Worcester, MA 01655, USA, Phone: +1 508-334-7872, Fax: +1 508-856-4287, E-mail:

Received: 2013-03-07

Accepted: 2013-06-03

Published Online: 2013-07-02

Published in Print: 2013-11-01

Citation Information: Journal of Pediatric Endocrinology and Metabolism, Volume 26, Issue 11-12, Pages 1067–1075, ISSN (Online) 2191-0251, ISSN (Print) 0334-018X, DOI: https://doi.org/10.1515/jpem-2013-0086.

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