Association of vitamin D concentrations with adiposity indices among preadolescent children in Korea
-
Hye Ah Lee
and Hyesook Park
Abstract
Background and Objective: We aimed to investigate the association between serum 25-hydroxyvitamin D (25(OH)D) and anthropometric indicators of adiposity among Korean preadolescent children aged 7–9 years.
Subjects and Methods: Children aged 7 to 9 from the Ewha Birth & Growth Cohort were followed up from July to August 2011. Serum 25(OH)D concentration was measured using radio immunoassay. We assessed the magnitude of cross-sectional association with vitamin D concentrations and indicators of adiposity [body mass index (BMI), waist circumference (WC), mid-arm circumference (MAC), body fat mass (BFM), percent body fat (PBF), and triceps skinfold thickness (TSF)] using multiple linear and logistic regression analyses adjusted for sex, age, birth order, maternal education, and fruit/fruit juice intake.
Results: Thirty-two (16%) out of a total of 205 children showed an optimal level of serum 25(OH)D, but most children did not reach a sufficient level (<30 ng/mL) even in summer. The level of 25(OH)D was inversely associated with BMI (β=–0.10, p<0.01), WC (β=–0.28, p<0.01), and BFM (β=–0.12, p=0.02) after adjusting for confounding factors and showed marginal boundary with PBF (β=–0.20, p=0.06) and TSF (β=–0.11, p=0.08). Regarding the risk of overweight, a 13% protective effect per 1 ng/mL increase of 25(OH)D was shown even after adjusting for relevant confounding factors (adjusted odds ratio=0.87, 95% confidence interval 0.78–0.98).
Conclusions: We found that the 25(OH)D concentrations were inversely associated with adiposity indices in preadolescent children. This study suggests that adequate vitamin D intake in growing children is crucial to maintain an optimal vitamin D level to prevent obesity and obesity-related health problems later in life.
This work was supported by a grant from the National Research Foundation of Korea funded by the Korean government (2010-0026225).
Authors’ contributions:
HS Kim and HS Park are the guarantors of this work. For the whole manuscript, HA Lee wrote the paper with statistical analysis and data collection. EA Park, SJ Cho, HS Kim, SY Oh, and YJ Kim helped with study participant recruitment and gave advice for the study design. EA Park, SJ Cho, HS Kim, YJ Kim, HY Lee, HS Gwak, EH Ha, HS Kim, and HS Park gave advice for the writing of the paper. All authors were involved in the writing of the paper and had final approval of the submitted and published versions.
Conflict of interest statement:
The authors have nothing to disclose.
References
1. Oh K, Jang MJ, Lee NY, Moon JS, Lee CG, et al. Prevalence and trends in obesity among Korean children and adolescents in 1997 and 2005. Korean J Pediatr 2008;5:950–5 (Korean).10.3345/kjp.2008.51.9.950Search in Google Scholar
2. Schrager S. Dietary calcium intake and obesity. J Am Board Fam Pract 2005;18:205–10.10.3122/jabfm.18.3.205Search in Google Scholar PubMed
3. Mai XM, Chen Y, Camargo CA Jr, Langhammer A. Cross-sectional and prospective cohort study of serum 25-hydroxyvitamin D level and obesity in adults: the HUNT study. Am J Epidemiol 2012;175:1029–36.10.1093/aje/kwr456Search in Google Scholar PubMed
4. Gilbert-Diamond D, Baylin A, Mora-Plazas M, Marin C, Arsenault JE, et al. Vitamin D deficiency and anthropometric indicators of adiposity in school-age children: a prospective study. Am J Clin Nutr 2010;92:1446–51.10.3945/ajcn.2010.29746Search in Google Scholar PubMed PubMed Central
5. Huh SY, Gordon CM. Vitamin D deficiency in children and adolescents: epidemiology, impact and treatment. Rev Endocr Metab Disord 2008;9:161–70.10.1007/s11154-007-9072-ySearch in Google Scholar PubMed
6. Lenders CM, Feldman HA, Von Scheven E, Merewood A, Sweeney C, et al. Elizabeth Glaser Pediatric Research Network Obesity Study Group. Relation of body fat indexes to vitamin D status and deficiency among obese adolescents. Am J Clin Nutr 2009;90:459–67.10.3945/ajcn.2008.27275Search in Google Scholar PubMed PubMed Central
7. Garanty-Bogacka B, Syrenicz M, Goral J, Krupa B, Syrenicz J, et al. Serum 25-hydroxyvitamin D (25-OH-D) in obese adolescents. Endokrynol Pol 2011;62:506–11.Search in Google Scholar
8. Kumar J, Muntner P, Kaskel FJ, Hailpern SM, Melamed ML. Prevalence and associations of 25-hydroxyvitamin D deficiency in US children: NHANES 2001–2004. Pediatrics 2009;124: e362–70.10.1542/peds.2009-0051Search in Google Scholar PubMed PubMed Central
9. Roth CL, Elfers C, Kratz M, Hoofnagle AN. Vitamin d deficiency in obese children and its relationship to insulin resistance and adipokines. J Obes 2011;2011:495101. DOI: 10.1155/2011/495101.10.1155/2011/495101Search in Google Scholar PubMed PubMed Central
10. Poomthavorn P, Saowan S, Mahachoklertwattana P, Chailurkit L, Khlairit P. Vitamin D status and glucose homeostasis in obese children and adolescents living in the tropics. Int J Obes (Lond) 2012;36:491–5.10.1038/ijo.2011.260Search in Google Scholar PubMed
11. Sacheck J, Goodman E, Chui K, Chomitz V, Must A, et al. Vitamin D deficiency, adiposity, and cardiometabolic risk in urban schoolchildren. J Pediatr 2011;159:945–50.10.1016/j.jpeds.2011.06.001Search in Google Scholar PubMed PubMed Central
12. Khadgawat R, Thomas T, Gahlot M, Tandon N, Tangpricha V, et al. The effect of puberty on interaction between vitamin D status and insulin resistance in obese Asian-Indian children. Int J Endocrinol 2012;2012:173581. DOI: 10.1155/2012/173581.10.1155/2012/173581Search in Google Scholar PubMed PubMed Central
13. Min JW, Kong KA, Park BH, Hong JH, Park EA, et al. Effect of postnatal catch-up growth on blood pressure in children at 3 years of age. J Hum Hypertens 2007;21(11):868–74.10.1038/sj.jhh.1002215Search in Google Scholar PubMed
14. Ross AC, Taylor CL, Yaktine AL, Del Valle HB, editors. Committee to Review Dietary Reference Intakes for Vitamin D and Calcium, Institute of Medicine. Dietary reference intakes for calcium and vitamin D. Washington, DC: National Academies Press, 2010.Search in Google Scholar
15. Korea Center for Disease Control and Prevention, The Korean Pediatric Society, The Committee for the Development of Growth Standard for Korean Children and Adolescents. 2007 Korean Children and Adolescents Growth Standard (commentary for the development of 2007 growth chart). (Government report online). Seoul: Division of Chronic Disease Surveillance, 2007 Nov. Available from: http://www.cdc.go.kr (Korean).Search in Google Scholar
16. Rodríguez-Rodríguez E, Navia-Lombán B, López-Sobaler AM, Ortega RM. Associations between abdominal fat and body mass index on vitamin D status in a group of Spanish schoolchildren. Eur J Clin Nutr 2010;64:461–7.10.1038/ejcn.2010.26Search in Google Scholar PubMed
17. Andıran N, Çelik N, Akça H, Doğan G. Vitamin D deficiency in children and adolescents. J Clin Res Pediatr Endocrinol 2012;4:25–9.10.4274/jcrpe.574Search in Google Scholar PubMed PubMed Central
18. Choi HS, Oh HJ, Choi H, Choi WH, Kim JG, et al. Vitamin D insufficiency in Korea – a greater threat to younger generation: the Korea National Health and Nutrition Examination Survey (KNHANES) 2008. J Clin Endocrinol Metab 2011;96:643–51.10.1210/jc.2010-2133Search in Google Scholar PubMed
19. Lee SH, Kim SM, Park HS, Choi KM, Cho GJ, et al. Serum 25-hydroxyvitamin D levels, obesity and the metabolic syndrome among Korean children. Nutr Metab Cardiovasc Dis 2012 (Epub ahead of print).10.1016/j.numecd.2012.04.013Search in Google Scholar PubMed
20. DeLong LK, Wetherington S, Hill N, Kumari M, Gammon B, et al. Vitamin D levels, dietary intake, and photoprotective behaviors among patients with skin cancer. Semin Cutan Med Surg 2010;29:185–9.10.1016/j.sder.2010.06.001Search in Google Scholar PubMed
21. Foss YJ. Vitamin D deficiency is the cause of common obesity. Med Hypotheses 2009;72:314–21.10.1016/j.mehy.2008.10.005Search in Google Scholar PubMed
22. Olson ML, Maalouf NM, Oden JD, White PC, Hutchison MR. Vitamin D deficiency in obese children and its relationship to glucose homeostasis. J Clin Endocrinol Metab 2012;97:279–85.10.1210/jc.2011-1507Search in Google Scholar PubMed PubMed Central
23. Ortega RM, Aparicio A, Rodríguez-Rodríguez E, Bermejo LM, Perea JM, et al. Preliminary data about the influence of vitamin D status on the loss of body fat in young overweight/obese women following two types of hypocaloric diet. Br J Nutr 2008;100:269–72.10.1017/S0007114508894354Search in Google Scholar PubMed
24. Hsia J, Heiss G, Ren H, Allison M, Dolan NC, et al. Women’s Health Initiative Investigators. Calcium/vitamin D supplementation and cardiovascular events. Circulation 2007;115:846–54.10.1161/CIRCULATIONAHA.106.673491Search in Google Scholar PubMed
25. Holecki M, Zahorska-Markiewicz B, Wiecek A, Mizia-Stec K, Nieszporek T, et al. Influence of calcium and vitamin D supplementation on weight and fat loss in obese women. Obes Facts 2008;1:274–9.10.1159/000169831Search in Google Scholar PubMed PubMed Central
26. Xue B, Greenberg AG, Kraemer FB, Zemel MB. Mechanism of intracellular calcium ((Ca2+)i) inhibition of lipolysis in human adipocytes. FASEB J 2001;15(13):2527–9.10.1096/fj.01-0278fjeSearch in Google Scholar PubMed
27. Wood RJ. Vitamin D and adipogenesis: new molecular insights. Nutr Rev 2008;66:40–6.10.1111/j.1753-4887.2007.00004.xSearch in Google Scholar PubMed
28. Wortsman J, Matsuoka LY, Chen TC, Lu Z, Holick MF. Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr 2000;72:690–3.10.1093/ajcn/72.3.690Search in Google Scholar PubMed
29. Hyppönen E, Hartikainen AL, Sovio U, Järvelin MR, Pouta A. Does vitamin D supplementation in infancy reduce the risk of pre-eclampsia? Eur J Clin Nutr 2007;61:1136–9.10.1038/sj.ejcn.1602625Search in Google Scholar PubMed
30. Berkey CS, Rockett HR, Field AE, Gillman MW, Frazier AL, et al. Activity, dietary intake, and weight changes in a longitudinal study of preadolescent and adolescent boys and girls. Pediatrics 2000;105:E56.10.1542/peds.105.4.e56Search in Google Scholar PubMed
©2013 by Walter de Gruyter Berlin Boston
Articles in the same Issue
- Masthead
- Masthead
- Review article
- Tamoxifen therapy for the management of pubertal gynecomastia: a systematic review
- Images in pediatric endocrinology
- Solitary median maxillary central incisor, a clinical predictor of hypoplastic anterior pituitary, ectopic neurohypophysis and growth hormone deficiency
- A rare case of granuloma annulare in a 6-year-old child with type 1 diabetes
- Original articles
- The arginine stimulation test: timing of peak is not a helpful parameter in the diagnosis of growth hormone deficiency
- The relationship between adiposity and stature in prepubertal children with celiac disease
- Influence of micronutrient status and socioeconomic gradient on growth indices of 2–18-year-old Indian girls
- Phosphotyrosine phosphatases in GH-stimulated skin fibroblasts from children with idiopathic short stature
- The relation between salivary cortisol and the metabolic syndrome score in girls
- Association of vitamin D concentrations with adiposity indices among preadolescent children in Korea
- Association of serum resistin levels with metabolic syndrome and early atherosclerosis in obese Chinese children
- Characteristics of infants at risk of hypoglycaemia secondary to being ‘infant of a diabetic mother’
- Parental dyadic coping in families of children and adolescents with type 1 diabetes
- Pigmentary hypertrichosis and non-autoimmune insulin-dependent diabetes mellitus (PHID) syndrome is associated with severe chronic inflammation and cardiomyopathy, and represents a new monogenic autoinflammatory syndrome
- Effect of insulin therapy on IGF-1 level in children with new-onset type 1 diabetes mellitus: a comparison between DKA and non-DKA
- Mutation analysis of the SRD5A2, AR and SF-1 genes in 52 Chinese boys with hypospadias
- Sexual development in prepubertal obese boys: a 4-year longitudinal study
- Genetic diagnosis of one family with incomplete clinical data
- Patient reports
- Complete androgen insensitivity syndrome and discordant Müllerian remnants: two cases with novel mutation in the androgen receptor
- Psychosexual outcomes in three siblings with partial androgen insensitivity syndrome: impact of nature versus nurture
- Ambiguous genitalia in a 48, XXYY newborn: a casual relationship or a coincidence?
- Gonadal function of beta-thalassemics following stem cell transplantation conditioned with myeloablative and reduced intensity regimens
- Significant testicular enlargement in a 6.5-year-old boy with monorchism and testicular microlithiasis
- Report of the first case of precocious puberty in Rett syndrome
- Type II vitamin D-dependent rickets with diabetic ketoacidosis
- Pituitary gigantism presenting with depressive mood disorder and diabetic ketoacidosis in an Asian adolescent
- A rare association between Rathke’s cyst and hypophysitis in a patient with delayed sex development and growth failure
- Diabetes mellitus with Laron syndrome: case report
- Wegener granulomatosis as an uncommon cause of panhypopituitarism in childhood
- Rare cases of autoimmune hypothyroidism in young children
- Cushing syndrome related to leukemic infiltration of the central nervous system: a case report and a possible role of LIF
- Early presentation of bilateral gonadoblastomas in a Denys-Drash syndrome patient: a cautionary tale for prophylactic gonadectomy
- Identification of a novel homozygous mutation (S144I) in a Malay patient with maple syrup urine disease
- Virilization in two pre-pubertal children exposed to topical androgen
- A family with Camurati-Engelman disease. The role of the missense p.R218C mutation in TGFB1 in bones and endocrine glands
- Short communications
- Plasma ceramides are elevated in female children and adolescents with type 2 diabetes
- Assessment of contractility and myocardial function in small and appropriate for gestational age premature neonates using the stress-velocity relationship and tissue Doppler imaging immediately after birth
- Letter to the Editors
- Homeostasis model assessment of insulin resistance may not be reliable to evaluate insulin sensitivity in young obese children
- Type 1 diabetes in women with endometriosis: what is the risk of occurrence?
- How should we manage vitamin D-deficient adolescents?
- Should neonatal hyperparathyroidism associated with mucolipidosis II/III be treated pharmacologically?a
Articles in the same Issue
- Masthead
- Masthead
- Review article
- Tamoxifen therapy for the management of pubertal gynecomastia: a systematic review
- Images in pediatric endocrinology
- Solitary median maxillary central incisor, a clinical predictor of hypoplastic anterior pituitary, ectopic neurohypophysis and growth hormone deficiency
- A rare case of granuloma annulare in a 6-year-old child with type 1 diabetes
- Original articles
- The arginine stimulation test: timing of peak is not a helpful parameter in the diagnosis of growth hormone deficiency
- The relationship between adiposity and stature in prepubertal children with celiac disease
- Influence of micronutrient status and socioeconomic gradient on growth indices of 2–18-year-old Indian girls
- Phosphotyrosine phosphatases in GH-stimulated skin fibroblasts from children with idiopathic short stature
- The relation between salivary cortisol and the metabolic syndrome score in girls
- Association of vitamin D concentrations with adiposity indices among preadolescent children in Korea
- Association of serum resistin levels with metabolic syndrome and early atherosclerosis in obese Chinese children
- Characteristics of infants at risk of hypoglycaemia secondary to being ‘infant of a diabetic mother’
- Parental dyadic coping in families of children and adolescents with type 1 diabetes
- Pigmentary hypertrichosis and non-autoimmune insulin-dependent diabetes mellitus (PHID) syndrome is associated with severe chronic inflammation and cardiomyopathy, and represents a new monogenic autoinflammatory syndrome
- Effect of insulin therapy on IGF-1 level in children with new-onset type 1 diabetes mellitus: a comparison between DKA and non-DKA
- Mutation analysis of the SRD5A2, AR and SF-1 genes in 52 Chinese boys with hypospadias
- Sexual development in prepubertal obese boys: a 4-year longitudinal study
- Genetic diagnosis of one family with incomplete clinical data
- Patient reports
- Complete androgen insensitivity syndrome and discordant Müllerian remnants: two cases with novel mutation in the androgen receptor
- Psychosexual outcomes in three siblings with partial androgen insensitivity syndrome: impact of nature versus nurture
- Ambiguous genitalia in a 48, XXYY newborn: a casual relationship or a coincidence?
- Gonadal function of beta-thalassemics following stem cell transplantation conditioned with myeloablative and reduced intensity regimens
- Significant testicular enlargement in a 6.5-year-old boy with monorchism and testicular microlithiasis
- Report of the first case of precocious puberty in Rett syndrome
- Type II vitamin D-dependent rickets with diabetic ketoacidosis
- Pituitary gigantism presenting with depressive mood disorder and diabetic ketoacidosis in an Asian adolescent
- A rare association between Rathke’s cyst and hypophysitis in a patient with delayed sex development and growth failure
- Diabetes mellitus with Laron syndrome: case report
- Wegener granulomatosis as an uncommon cause of panhypopituitarism in childhood
- Rare cases of autoimmune hypothyroidism in young children
- Cushing syndrome related to leukemic infiltration of the central nervous system: a case report and a possible role of LIF
- Early presentation of bilateral gonadoblastomas in a Denys-Drash syndrome patient: a cautionary tale for prophylactic gonadectomy
- Identification of a novel homozygous mutation (S144I) in a Malay patient with maple syrup urine disease
- Virilization in two pre-pubertal children exposed to topical androgen
- A family with Camurati-Engelman disease. The role of the missense p.R218C mutation in TGFB1 in bones and endocrine glands
- Short communications
- Plasma ceramides are elevated in female children and adolescents with type 2 diabetes
- Assessment of contractility and myocardial function in small and appropriate for gestational age premature neonates using the stress-velocity relationship and tissue Doppler imaging immediately after birth
- Letter to the Editors
- Homeostasis model assessment of insulin resistance may not be reliable to evaluate insulin sensitivity in young obese children
- Type 1 diabetes in women with endometriosis: what is the risk of occurrence?
- How should we manage vitamin D-deficient adolescents?
- Should neonatal hyperparathyroidism associated with mucolipidosis II/III be treated pharmacologically?a