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Vitamin D status and its relation to insulin resistance in a Mexican pediatric population

  • Yunue Flores Ruelas , Mario Del Toro Equihua , Norma Alejandra Jiménez Solís , Luz Margarita Baltazar Rodríguez , Ivan Delgado Enciso and Carmen Alicia Sánchez Ramírez ORCID logo EMAIL logo
Published/Copyright: February 29, 2020

Abstract

Background

Obesity in children and adolescents has increased alarmingly, placing them at a higher risk for impaired glucose tolerance and type 2 diabetes. The prevalence of vitamin D deficiency has increased as well. Vitamin D is critical for glucose homeostasis and insulin secretion. Studies on adults have reported an inverse association between vitamin D levels and insulin resistance (IR), but the results in children are inconsistent. The aim of our study was to determine the association between IR and serum vitamin D levels in obese Mexican children and adolescents.

Methods

A cross-sectional study was performed on 227 children and adolescents between 6 and 19 years of age. Obesity was diagnosed through body mass index (BMI) for age, according to the World Health Organization (WHO) criteria (2007). 25-Hydroxyvitamin D (25[OH]D) was measured using an immunoassay technique and the homeostatic model assessment of insulin resistance (HOMA-IR) was calculated using the Matthews equation. Student’s t-test was carried out.

Results

The mean serum 25(OH)D level was 35.80 ng/mL, and 55.1% of the subjects had levels classified as sufficient, 33.5% as insufficient, and 11.5% as deficient. The mean level of HOMA-IR was 3.16, and 70% of the subjects were diagnosed with IR. Fasting insulin levels and HOMA-IR were significantly different in adolescents with hypovitaminosis, compared with adolescents in the vitamin D sufficiency group (p = 0.01 and p = 0.03, respectively).

Conclusions

The insulin levels and HOMA-IR were higher in adolescents with hypovitaminosis. The girls presented higher levels of insulin and HOMA-IR than the boys.


Corresponding author: Carmen Alicia Sánchez Ramírez, MD, PhD, Nutrition Laboratory. School of Medicine, Facultad de Medicina, Universidad de Colima, Av. Universidad 33 Colonia Las Víboras, CP 28010,Colima, México, Phone: +52 31261099, Fax: +52 31261099

Acknowledgments

The authors wish to thank everyone who took part in this project, with special thanks to Gusti Gould for the English language editing. We also express our gratitude for the financial support received (FRABA-2014 reference number: 859/13) and to the CONACYT for the doctoral scholarship granted to the first author.

  1. Author contributions: YF and CAS performed the design, execution, data analysis, and drafting of the manuscript. YF and NAJ directed the enrollment in the study and its execution. YFR, NAJ, and MT performed the biochemical analyses. MB and ID supervised the study design and data analysis. All co-authors critically reviewed the manuscript and approved the final version.

  2. Research funding: FRABA-2014 reference number: 859/13.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

  6. Conflicts of interest: The authors declare there are no conflicts of interest.

References

1. Chiarelli F, Marcovecchio ML. Insulin resistance and obesity in childhood. Eur J Endocrinol 2008;159(Suppl 1):S67–74.10.1530/EJE-08-0245Search in Google Scholar PubMed

2. Marcovecchio ML, Mohn A, Chiarelli F. Obesity and insulin resistance in children. J Pediatr Gastroenterol Nutr 2010;51(Suppl 3):S149–50.10.1097/MPG.0b013e3181f853f9Search in Google Scholar PubMed

3. 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

4. Han F, Lv Y, Gong L, Liu H, Wan ZR, et al. VDR gene variation and insulin resistance related diseases. Lipids Health Dis 2017;16:157.10.1186/s12944-017-0477-7Search in Google Scholar PubMed PubMed Central

5. Wang L, Wang H, Wen H, Tao H, Zhao X. Relationship between HOMA-IR and serum vitamin D in Chinese children and adolescents. J Pediatr Endocrinol Metab 2016;29:777–81.10.1515/jpem-2015-0422Search in Google Scholar PubMed

6. Levy-Marchal C, Arslain S, Cutfield W, Sinaiko A, Druet C. Insulin resistance in children: consensus, perspective, and future directions. J Clin Endocr Metab 2010;95:5189–98.10.1210/jc.2010-1047Search in Google Scholar PubMed PubMed Central

7. World Health Organization. WHO Multicentre Growth Reference Study Group. WHO Child Growth Standards: length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age: methods and development. Available at: https://www.who.int/childgrowth/standards/technical_report/en/.Search in Google Scholar

8. de Onis M, Habicht JP. Anthropometric reference data for international use: recommendations from a World Health Organization Expert Committee. Am J Clin Nutr 1996;64:650–8.10.1093/ajcn/64.4.650Search in Google Scholar PubMed

9. Romero E, Vázquez E, Machado A, Larrosa A. Guías clínicas para el diagnóstico, tratamiento y prevención del sobrepeso y obesidad en pediatría. Comité de Nutrición. Confederación Nacional de Pediatría, A.C. [Clinical guidelines for the treatment and prevention of overweight and obesity in pediatrics. Nutrition comittee. National Confederation of Pediatrics.] Pediatr Méx 2012;14:186–96.Search in Google Scholar

10. Fernández JR, Redden DT, Pietrobelli A, Allison DB. Waist circumference percentiles in nationally representative samples of African-American, European-American, and Mexican-American children and adolescents. J Pediatr 2004;145:439–44.10.1016/j.jpeds.2004.06.044Search in Google Scholar PubMed

11. Sharifi F, Mousavinasab N, Mellati AA. Defining a cutoff point for vitamin D deficiency based on insulin resistance in children. Diabetes Metab Syndr 2013;7:210–3.10.1016/j.dsx.2013.10.015Search in Google Scholar PubMed

12. Garmendia ML, Lera L, Sánchez H, Uauy R, Albala C. Valores normativos de resistencia a la insulina mediante HOMA-IR en adultos mayores de Santiago de Chile [Normative values of insulin resistance through HOMA-IR in older adults of Santiago de Chile]. Rev Med Chil 2009;137:1409–16.10.4067/S0034-98872009001100001Search in Google Scholar

13. Aradillas C, Malacara JM, Garay ME, Guizar J, Camacho N, et al. Prediabetes in rural and urban children in 3 states in Mexico. J Cardiometab Syndr 2007;2:35–9.10.1111/j.1559-4564.2007.05847.xSearch in Google Scholar PubMed

14. Wimalawansa SJ. Associations of vitamin D with insulin resistance, obesity, type 2 diabetes, and metabolic syndrome. J Steroid Biochem Mol Biol 2018;175:177–89.10.1016/j.jsbmb.2016.09.017Search in Google Scholar PubMed

15. Fu Z, Xu C, Shu Y, Xie Z, Lu C, et al. Serum 25-hydroxyvitamin D is associated with obesity and metabolic parameters in US children. Public Health Nutr 2019;23:1–9.10.1017/S1368980019001137Search in Google Scholar PubMed

16. Nader NS, Aguirre-Castaneda R, Wallace J, Singh R, Weaver A, et al. Effect of vitamin D3 supplementation on serum 25(OH)D, lipids and markers of insulin resistance in obese adolescents: a prospective, randomized, placebo-controlled pilot trial. Horm Res Paediatr 2014;82:107–12.10.1159/000362449Search in Google Scholar PubMed

17. Sethuraman U, Zidan MA, Hanks L, Bagheri M, Ashraf A. Impact of vitamin D treatment on 25 hydroxy vitamin D levels and insulin homeostasis in obese African American adolescents in a randomized trial. J Clin Transl Endocrinol 2018;12:13–9.10.1016/j.jcte.2018.03.002Search in Google Scholar PubMed PubMed Central

18. Cizmecioglu FM, Etiler N, Görmüş U, Hamzaoglu O, Hatun S. Hypovitaminosis D in obese and overweight schoolchildren. J Clin Res Pediatr Endocrinol 2008;1:89–96.10.4008/jcrpe.v1i2.43Search in Google Scholar PubMed PubMed Central

19. Gutiérrez S, Gavela T, Dominguez MN, Gutiérrez E, Rovira A, et al. The influence of puberty on vitamin D status in obese children and the relation between vitamin D deficiency and insulin resistance. J Pediatr Endocr Met 2015;28:105–10.10.1515/jpem-2014-0033Search in Google Scholar PubMed

20. Buyukinan M, Ozen S, Kokkun S, Ulas E. The relation of vitamin D deficiency with puberty and insulin resistance in obese children and adolescents. J Pediatr Endocr Metab 2012;25:83–7.10.1515/jpem-2011-0426Search in Google Scholar PubMed

21. 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. Article ID: 173581, 8 pages.10.1155/2012/173581Search in Google Scholar PubMed PubMed Central

22. Peterson C, Tosh A, Belenchia A. Vitamin D insufficiency and insulin resistance in obese adolescents. Ther Adv Endocrinol Metab 2014;5:166–89.10.1177/2042018814547205Search in Google Scholar PubMed PubMed Central

23. Murphy MJ, Hosking J, Metcalf BS, Voss LD, Jeffery AN, et al. Distribution of adiponectine, leptin, and metabolic correlates of insulin resistance; a longitudinal study in British children; 1: prepuberty (EarlyBird 15). Clin Chem 2008;54:1298–306.10.1373/clinchem.2008.103499Search in Google Scholar PubMed

24. d´Annunzio G, Vanelli M, Pistorio A, Minuto N, Bergamino L, et al. Insulin resistance and secretion indexes in healthy Italian children and adolescents. Acta Biomed 2009;80:21–8.Search in Google Scholar

25. Almeida CA, Pinho AP, Ricco RG, Pepato MT, Brunetti IL. Determination of glycemia and insulinemia and the homeostasis model assessment (HOMA) in schoolchildren and adolescents with normal body mass index. J Pediatr (Rio J) 2008;84:136–40.10.2223/JPED.1767Search in Google Scholar PubMed

26. Instituto Nacional de Salud Pública. INSP Efectos de la vitamina D sobre la salud, la respuesta inmune y el neurodesarrollo en niños, 2012. [National Institute of Public Health. NIPH Effects of vitamin D on health, the immune response and neurodevelopment in children, 2012] Available at: http://www.insp.mx/produccion-editorial/novedades-editoriales/2626-efectos-vitamina-d-salud-respuesta-inmune-neurodesarrollo-ninos.html.Search in Google Scholar

27. Bellone S, Esposito S, Giglione E, Genoni G, Fiorito C, et al. Vitamin D levels in a pediatric population of normal weight and obese subjects. J Endocrinol Invest 2014;37:805–9.10.1007/s40618-014-0108-3Search in Google Scholar PubMed

28. Huang K, Jiang YJ, Fu JF, Liang JF, Zhu H, et al. The relationship between serum 25 hydroxyvitamin D and glucose homeostasis in obese children and adolescents in Zhejiang, China. Endocr Pract 2015;21:1117–24.10.4158/EP15694.ORSearch in Google Scholar PubMed

29. Smotkin-Tangorra M, Purushothaman R, Gupta A, Nejati G, Anhalt H, et al. Prevalence of vitamin D insufficiency in obese children and adolescents. J Pediatr Endocrinol Metab 2007;20:817–23.10.1515/JPEM.2007.20.7.817Search in Google Scholar PubMed

30. Reinehr T, de Sousa G, Alexy U, Kersting M, Andler W. Vitamin D status and parathyroid hormone in obese children before and after weight loss. Eur J Endocrinol 2007;157:225–32.10.1530/EJE-07-0188Search in Google Scholar PubMed

31. Takiishi T, Gysemans C, Bouillon R, Mathieu C. Vitamin D and diabetes. Endocrinol Metab Clin North Am 2010;39: 419–46.10.1016/j.ecl.2010.02.013Search in Google Scholar PubMed

32. 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

33. Ghobadi S, Rostami ZH, Marzijarani MS, Faghih S. Association of vitamin D status and metabolic syndrome components in Iranian children. Int J Prev Med 2019;10:77.10.4103/ijpvm.IJPVM_242_17Search in Google Scholar PubMed PubMed Central

34. Mark S, Lambert M, Delvin EE, O’Loughlin J, Tremblay A, et al. Higher vitamin D intake is needed to achieve serum 25(OH)D levels greater than 50 nmol/l in Québec youth at high risk of obesity. Eur J Clin Nutr 2011;65:486–92.10.1038/ejcn.2011.5Search in Google Scholar PubMed

35. Belenchia AM, Tosh AK, Hillman LS, Peterson CA. Correcting vitamin D insufficiency improves insulin sensitivity in obese adolescents: a randomized controlled trial. Am J Clin Nutr 2013;97:774–81.10.3945/ajcn.112.050013Search in Google Scholar PubMed

36. Kelishadi R, Salek S, Salek M, Hashemipour M, Movahedian M. Effects of vitamin D supplementation on insulin resistance and cardiometabolic risk factors in children with metabolic syndrome: a triple-masked controlled trial. J Pediatr 2014;90:28–34.10.1016/j.jped.2013.06.006Search in Google Scholar PubMed

37. Instituto Nacional de Estadística y Geografía INEGI. Síntesis de Información Geográfica del estado de Colima. [National Institute of Statistics and Geography. NISG synthesis of geographic information of the state of Colima, México.] Available http://www.cuentame.inegi.org.mx/monografias/informacion/col/territorio/clima.aspx?tema=me&e=06.Search in Google Scholar

38. Castanedo JP, Torres B, Sobrevilla S, Ehnis A, Gordillo A. Estimación del tiempo de exposición solar para quemadura en población mexicana [Estimation of sun exposure time for sunburn in Mexican population]. Gac Méd Méx 2012;1489:243–7.Search in Google Scholar

39. Fitzpatrick TB. The validity and practicality of sun-reactive skin types I through VI. Arch Dermatol 1988;124:869–71.10.1001/archderm.1988.01670060015008Search in Google Scholar

Received: 2019-10-28
Accepted: 2020-01-14
Published Online: 2020-02-29
Published in Print: 2020-04-28

©2020 Walter de Gruyter GmbH, Berlin/Boston

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