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Hajhashemy Z, Ziaei R, Askari G, Saneei P. Serum 25-Hydroxyvitamin D Is Associated With Prediabetes, Type 2 Diabetes Mellitus, and Insulin Resistance in Children: A Systematic Review and Dose-Response Meta-analysis of Epidemiologic Studies. Nutr Rev 2024:nuae060. [PMID: 38894627 DOI: 10.1093/nutrit/nuae060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024] Open
Abstract
CONTEXT Although several investigations have been conducted on the association between serum vitamin D levels and prediabetes and type 2 diabetes mellitus (T2DM) in children and adolescents, their findings are inconsistent. OBJECTIVE We conducted a systematic review and dose-response meta-analysis to summarize this subject. DATA SOURCES The electronic databases of ISI Web of Science, Scopus, PubMed, and motor engineering of Google Scholar were comprehensively searched up to May 2023. DATA EXTRACTION Epidemiologic studies that investigated the risk of hyperglycemia and insulin resistance in relation to serum 25-hydroxy vitamin D levels in children and adolescents were included. DATA ANALYSIS Twenty-two investigations, with a total of 38 622 participants, were systematically reviewed. Meta-analysis of 15 studies (n = 32 720 participants) showed that participants with the highest serum vitamin D levels had 42% lower risk of hyperglycemia, compared with those in the lowest category of serum vitamin D levels (relative risk [RR] = 0.58; 95%CI, 0.48, 0.71). Moreover, pooling 8 studies (n = 10 465 participants) illustrated that highest serum vitamin D level was associated with a 44% lower risk of insulin resistance compared with the lowest serum vitamin D level (RR = 0.56; 95%CI, 0.37, 0.83). Based on linear dose-response analysis, each 10 nmol/L increment in serum 25-hydroxy vitamin D was associated with a 6% decreased risk of hyperglycemia and insulin resistance in children. Furthermore, nonlinear dose-response analysis revealed that increasing serum vitamin D concentration from 40 nmol/L to sufficient values (>50 nmol/L) was associated with a decreasing trend in risk of hyperglycemia and insulin resistance. CONCLUSION This meta-analysis revealed inverse associations between serum vitamin D levels and hyperglycemia and insulin resistance in children and adolescents, in a dose-response manner. Increasing serum vitamin D concentration from 40 nmol/L to sufficient values (>50 nmol/L) was associated with a decreasing trend in hyperglycemia and insulin resistance risk. Systematic Review Registration: PROSPERO registration no. CRD42023458155.
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Affiliation(s)
- Zahra Hajhashemy
- Students' Research Committee, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
| | - Rahele Ziaei
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
| | - Gholamreza Askari
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
| | - Parvane Saneei
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
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Upadhyay PK, Thakur N, Vishwakarma VK, Srivastav RK, Ansari TM. Role of Vitamin D in Management of Diabetes and Unresolved Cardiovascular Diseases. Curr Diabetes Rev 2024; 20:e010923220647. [PMID: 37680158 DOI: 10.2174/1573399820666230901151019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 08/03/2023] [Accepted: 08/08/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Vitamin D deficiency is becoming a widely recognized global health issue. Serum values of 25-(OH) vitamin D (<20 ng/ml) are used to identify vitamin D deficiency. By prompting vascular endothelial cells to activate their nuclear receptor in cardio-myocytes, Vitamin D regulates obesity, Renin-angiotensin system (RAS), energy consumption, and pancreatic cell function. Vitamin D deficiency has been associated with diabetes, asthma, hyperlipidaemia, and pulmonary hypertension in humans. METHODS PubMed and Google Scholar databases were utilised to search the literature on vitamin D and related diseases. RESULT It is also linked to an elevated risk of death and heart disease. On the other hand, metaanalyses of vitamin D intervention and trials have found no substantial changes in insulin sensitivity, lipid markers, or blood pressure, which result in the association between deficiency of vitamin D and cardiovascular disease. CONCLUSION In this review, we present the most recent research on the effects of Vitamin D therapy on various cardiovascular diseases and diabetes, and explain the underlying mechanisms.
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Affiliation(s)
- Prabhat Kumar Upadhyay
- Institute of Pharmaceutical Research, GLA University, Mathura 281406, Uttar Pradesh, India
| | - Navneet Thakur
- Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Ritesh Kumar Srivastav
- Faculty of Pharmacy, Kamla Nehru Institute of Management and Technology, Sultanpur 228119, India
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Liu J, Fu L, Jin S, Jia Y, Zhang J, Sun C, Na L. Vitamin D status in children and its association with glucose metabolism in northern China: a combination of a cross-sectional and retrospective study. BMJ Open 2022; 12:e061146. [PMID: 36446458 PMCID: PMC9710338 DOI: 10.1136/bmjopen-2022-061146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES This study aimed to explore the vitamin D status of children in northern China and the association between vitamin D and glucose metabolism. DESIGN Cross-sectional study was conducted among child participants and retrospective study designs were conducted among adult participants. SETTING AND PARTICIPANTS Both studies were recruited from Harbin, 326 children were included in children's study, 8469 adults were included in adult study. PRIMARY AND SECONDARY OUTCOME MEASURES Physical examination, lifestyle and dietary habit data were recorded in all the participants. Serum insulin, glucose, 25(OH)D3 concentrations in children and serum glucose and lipids levels in adults were measured. Rickets history was also investigated in adults, which was used to define vitamin D deficiency in childhood. The associations were tested by linear regression and binary logistic regression. RESULT In the children's study, only 10.7% of participants were vitamin D sufficient (≥30 ng/mL). Inverse correlations between serum 25(OH)D3 concentration and fasting insulin and homeostasis model assessment - insulin resistance (HOMA-IR) were found, and children with lower serum 25(OH)D3 concentrations were likely to have insulin resistance (IR) (OR: 0.955, 95% CI: 0.917 to 0.995, p value: 0.027). In an adult study, rickets in childhood increased the risk of type 2 diabetes in male participants (OR=1.414, 95% CI=1.013 to 1.972; p value=0.042), but this result was not observed in female participants. CONCLUSION Our findings suggest that vitamin D deficiency is widespread in northern China. Vitamin D deficiency in childhood was associated with IR and increased the risk of type 2 diabetes in male adults.
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Affiliation(s)
- Junyi Liu
- Department of Clinical Nutrition, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
- Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Liqun Fu
- Department of Clinical Nutrition, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Shanshan Jin
- Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yubing Jia
- Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Jingyi Zhang
- Department of Nutrition and food hygiene, College of Public Health, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Changhao Sun
- Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Lixin Na
- Department of Nutrition and food hygiene, College of Public Health, Shanghai University of Medicine and Health Sciences, Shanghai, China
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A High Dose, Not Low Dose, of Vitamin D Ameliorates Insulin Resistance in Saudi Women. J Clin Med 2022; 11:jcm11216577. [DOI: 10.3390/jcm11216577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 11/09/2022] Open
Abstract
Vitamin D has been traditionally seen to be mainly involved in the regulation of bone homeostasis. However, vitamin D has also been clinically linked to various diseases, including metabolic syndrome. The aim of this study was to examine the effect of low and high doses of a vitamin D supplement on the serum levels of 25(OH)D3 and insulin resistance. A total of 120 females were recruited in this study and supplemented weekly with 25,000 IU vitamin D or 50,000 IU vitamin D for three months. Anthropometric measurements were taken at the beginning of the study. Blood samples were collected at the beginning of the study to determine the baseline of the clinical variables and collected again after three months. Insulin resistance was measured using Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). After vitamin D supplementation, a non-significant increase was observed in the serum levels of 25(OH)D3 in the group treated with a low dose of vitamin D (LDVD) and a highly significant increase was seen in the group treated with a high dose of vitamin D (HDVD). In the group treated with a higher dose (HDVD), a significant improvement in insulin sensitivity was observed. The high dose of vitamin D (50,000 IU) supplementation was more effective in both correcting the blood levels of vitamin D and improving the sensitivity of insulin.
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Daniel JB, de Farias Costa PR, Pereira M, Oliveira AM. Vitamin D deficiency and cardiometabolic risk factors in adolescents: systematic review and meta-analysis. Rev Endocr Metab Disord 2022; 23:995-1010. [PMID: 35713809 DOI: 10.1007/s11154-022-09736-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/11/2022] [Indexed: 10/18/2022]
Abstract
Vitamin D deficiency is associated with an increase in the occurrence of cardiometabolic events, but the evidence of this relationship in adolescence is still limited. Thus, we analyzed the association between vitamin D deficiency and cardiometabolic risk factors in adolescents. Observational studies were searching in PubMed/Medline, Embase, Scopus, Web of Science, Science Direct, Lilacs, and Google Scholar database. Random effects models were used to summarize standardized mean differences for as a summary measure. The certainty of the evidence was verified using the Cochrane recommendations. A total of 7537 studies were identified, of which 32 were included in the systematic review and 24 in the meta-analysis.Vitamin D deficiency was associated with increased systolic pressure (SMD = 0.22; 95%CI = 0.10; 0.34), diastolic pressure (SMD = 0.23; 95%CI = 0.10; 0.35), glycemia (SMD = 0.13; 95%CI = 0.05; 0.12), and insulin (SMD = 0.50; 95%CI = 0.15; 0.84), an increase in the HOMA index (SMD = 0.48; 95%CI = 0.36; 0.60), high triglyceride values (SMD = 0.30; 95%CI = 0.11; 0.49), and reduced HDL concentrations (SMD= -0.25; 95%CI = -0.46; -0.04). No statistically significant association was observed for glycated hemoglobin, LDL cholesterol, and total cholesterol. Most of the studies presented low and moderate risks of bias, respectively. The certainty of the evidence was very low for all the outcomes analyzed. Vitamin D deficiency was associated with increased exposure to the factors linked to the occurrence of cardiometabolic diseases in adolescents. Systematic Review Registration: PROSPERO (record number 42,018,086,298).
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Affiliation(s)
- Jonas Baltazar Daniel
- Institute of Collective Health, Federal University of Bahia, Rua Basílio da Gama, s/n, 40110-040, Salvador, Bahia, Brazil
| | | | - Marcos Pereira
- Institute of Collective Health, Federal University of Bahia, Rua Basílio da Gama, s/n, 40110-040, Salvador, Bahia, Brazil.
- Institute of Collective Health, Federal University of Bahia, R. Basílio da Gama, s/n - Canela, 40110-040, Salvador, Bahia, Brazil.
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Pojednic RM, Trussler EM, Navon JD, Lemire SC, Siu EC, Metallinos-Katsaras ES. Vitamin D deficiency associated with risk of prediabetes among older adults: Data from the National Health and Nutrition Examination Survey (NHANES), 2007-2012. Diabetes Metab Res Rev 2022; 38:e3499. [PMID: 34590783 DOI: 10.1002/dmrr.3499] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 09/07/2021] [Indexed: 12/18/2022]
Abstract
AIM To examine the association between vitamin D (25(OH)D) deficiency and risk of prediabetes in Americans 50+ years of age. MATERIALS AND METHODS This was a cross-sectional analysis of NHANES (2007-2012) subjects aged 50+ years, free of kidney/liver diseases and diabetes. Prediabetes was defined as: HbA1c level 5.7%-6.4%, or fasting plasma glucose level 100-125 mg/dL, or Oral Glucose Tolerance Test result 140-199 mg/dL, with no laboratory value in the diabetic range. The comparison group had normal glucose tolerance (NGT) with no marker in the prediabetes/diabetes range. Total serum 25(OH)D levels were deficient at <50 nmol/L, insufficient 50-75 nmol/L, and sufficient >75 nmol/L. Logistic regression included strata, cluster and weight variables. Models were adjusted for body mass index (BMI), ethnicity, age and gender. RESULTS The final sample was 2286 adults, predominantly White (80.4%) and female (56.6%), with a mean age of 62.3 years. Within the sample, 1387 had prediabetes (59.1%) and 899 were NGT (40.9%). Individuals classified within a lower serum vitamin D category were more likely to have prediabetes (p = 0.03). Those with 25(OH)D deficiency were more likely to have prediabetes compared to 25(OH)D sufficient individuals (crude OR = 1.48, 95% CI 1.15-1.91), and this association remained significant after adjustment for ethnicity, BMI, age and gender (aOR = 1.39, 95% CI 1.02-1.89). There was no effect modification by BMI, gender or ethnicity. CONCLUSIONS Vitamin D status was associated with risk of prediabetes in this sample of Americans 50+ years of age. Future research should seek to understand the potential mechanistic relationship between vitamin D and prediabetes.
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Affiliation(s)
- Rachele M Pojednic
- Simmons University, Boston, Massachusetts, USA
- Norwich University, Northfield, Vermont, USA
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Vitamin D Deficiency Is Inversely Associated with Homeostatic Model Assessment of Insulin Resistance. Nutrients 2021; 13:nu13124358. [PMID: 34959910 PMCID: PMC8705502 DOI: 10.3390/nu13124358] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/24/2021] [Accepted: 11/25/2021] [Indexed: 01/08/2023] Open
Abstract
The study was conducted to comprehensively assess the association of the concentration of vitamin D in the blood and insulin resistance in non-diabetic subjects. The objective was to pool the results from all observational studies from the beginning of 1980 to August 2021. PubMed, Medline and Embase were systematically searched for the observational studies. Filters were used for more focused results. A total of 2248 articles were found after raw search which were narrowed down to 32 articles by the systematic selection of related articles. Homeostatic Model Assessment of Insulin Resistance (HOMAIR) was used as the measure of insulin resistance and correlation coefficient was used as a measure of the relationship between vitamin D levels and the insulin resistance. Risk of bias tables and summary plots were built using Revman software version 5.3 while Comprehensive meta-analysis version 3 was used for the construction of forest plot. The results showed an inverse association between the status of vitamin D and insulin resistance (r = -0.217; 95% CI = -0.161 to -0.272; p = 0.000). A supplement of vitamin D can help reduce the risk of insulin resistance; however further studies, like randomized controlled trials are needed to confirm the results.
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Kang M, Choi SY, Jung M. Dietary intake and nutritional status of Korean children and adolescents: a review of national survey data. Clin Exp Pediatr 2021; 64:443-458. [PMID: 33445834 PMCID: PMC8426097 DOI: 10.3345/cep.2020.01655] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 12/07/2020] [Indexed: 12/11/2022] Open
Abstract
In Korea, several national cross-sectional surveys monitor the diet, nutritional status, and health status of children. This continual dedicated national surveillance system contributes to the identification of nutritional and health issues, establishment of public health policies, and development of nutrition recommendations. This paper provides recent information about the Korea National Health and Nutrition Examination Survey and the Korean Youth Risk Behavior Web-based Survey and describes key nationwide survey findings published in the last 5 years on infant feeding practices and the dietary intake and nutritional status of Korean infants, children, and adolescents. There have been increasing trends in children, and teenagers who skip breakfast, eat fast food, consume sugary drinks, have vitamin D deficiency, and are obese. This review will inform pediatricians, nutritionists, and other health care practitioners who track children's growth and development. It may also help researchers and policymakers identify diet-related policies and strategies for chronic disease prevention in Korean infants, children, and adolescents.
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Affiliation(s)
- Minji Kang
- BK21 FOUR Education and Research Team for Sustainable Food & Nutrition, Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul, Korea
| | - So Yoon Choi
- Department of Pediatrics, Kosin University Gospel Hospital, Kosin University School of Medicine, Busan, Korea
| | - Minyoung Jung
- Department of Pediatrics, Kosin University Gospel Hospital, Kosin University School of Medicine, Busan, Korea
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Rafiq S, Jeppesen PB. Insulin Resistance Is Inversely Associated with the Status of Vitamin D in Both Diabetic and Non-Diabetic Populations. Nutrients 2021; 13:1742. [PMID: 34063822 PMCID: PMC8224049 DOI: 10.3390/nu13061742] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/11/2021] [Accepted: 05/17/2021] [Indexed: 02/06/2023] Open
Abstract
Vitamin D has been implicated in the regulation of glucose metabolism and insulin resistance. We designed this study to provide evidence that insulin resistance is dependent on the concentration of vitamin D in the body. Forty observational studies of both type 2 diabetes mellitus patients and healthy subjects were included in this meta-analysis. Related articles were searched from Embase, PubMed, and Medline through January 2021. Filters for search were used to obtain more focused results. We used Comprehensive Meta-Analysis Version 3 for the construction of forest plots. RevMan software version 5.3 was used to build the risk of bias tables and summary plots. The observational studies included in this systematic review and meta-analysis showed an inverse relationship of insulin resistance with the status of vitamin D both in non-diabetic (r = -0.188; 95% CI = -0.141 to -0.234; p = 0.000) and diabetic (r = -0.255; 95% CI = -0.392 to -0.107, p = 0.001) populations. From the meta-analysis we concluded that hypovitaminosis D is related to increased levels of insulin resistance in both type 2 diabetes patients and the healthy population all over the world.
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Affiliation(s)
- Shamaila Rafiq
- Department of Clinical Medicine, Aarhus University, Aarhus N, 8200 Aarhus, Denmark;
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Tran Huu TT, Tran HD, Tran TN, Hoang BB. Relationship Between Vitamin D Status and the Relevant Parameters of Glucose in Patients with Type 2 Diabetes. Diabetes Metab Syndr Obes 2021; 14:2489-2494. [PMID: 34113140 PMCID: PMC8184150 DOI: 10.2147/dmso.s314416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 05/22/2021] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION Clarifying the prevalence of vitamin D deficiency in diabetic patients, and the relationship between vitamin D concentration and insulin resistance, fasting plasma glucose, and HbA1C in patients in Hue City, Vietnam. METHODS A cross-sectional study on 110 diabetic patients examined at Hue Central Hospital and Hue University of Medicine and Pharmacy Hospital. These patients were collected venous blood sampling, and the 25(OH)D test, fasting plasma glucose test, fasting insulin test, HOMA-IR and QUICKI calculation. RESULTS Vitamin D deficiency and insufficiency prevalence were 51.8%. The average concentration of 25(OH)D (ng/mL) was 30.67 ± 8.55; this concentration in fasting glucose level ≤8 mmol/l group and >8 mmol/l group was 32.08 ± 9.26 and 28.55±6.91 (p = 0.033); it was 32.95 ± 8.58 and 28.97 ± 8.17 in HOMA-IR ≤3.5 and HOMA-IR >3.5 group, (p = 0.015); in QUICKI ≤0.32 group, it was 29.16 ± 8.12; in QUICKI >0.32 group, it was 32.85 ± 8.76 (p = 0.025). Patients with an ideal exercise level have higher average levels of 25(OH)D (32.11±8.62 vs 26.83±7.16, p=0.003). The average levels of 25(OH)D in male patients are higher than in female patients (33.47±0.08 vs 29.01±8.43, p=0.008). Vitamin D deficiency and insufficiency prevalence in patients with HOMA-IR ≤3.5 and QUICKI >0.32 were 36.2% and 37.8%, whereas in those with HOMA-IR >3.5 and QUICKI ≤0.32 they were 63.5% and 61.5% (p = 0.007 and 0.02, respectively). 25(OH)D is negative correlation with fasting glucose level and HOMA-IR, with r = -0.229 and -0.192, respectively (p = 0.016 and 0.045); 25(OH)D was positively correlated with QUICKI, with r = 0.235, p = 0.008. CONCLUSION Patients who have better glucose-related parameters, such as fasting blood sugar, HOMA-IR and QUICKI, have a better vitamin D status. Some blood sugar-related factors, such as exercise level and sex, are related to vitamin D status.
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Affiliation(s)
| | - Huu Dang Tran
- Department of Internal Medicine, Hue University of Medicine and Pharmacy, Hue City, Vietnam
| | - Thua Nguyen Tran
- Department of General Internal Medicine and Geriatrics, Hue Central Hospital, Hue City, Vietnam
- Correspondence: Thua Nguyen Tran Department of General Internal Medicine and Geriatrics, Hue Central Hospital, Hue City, VietnamTel +84903597695 Email
| | - Bui Bao Hoang
- Department of Internal Medicine, Hue University of Medicine and Pharmacy, Hue City, Vietnam
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Kwak JH, Choi YH, Paik JK. Vitamin D Status, Fiber Intake, and Type 2 Diabetes in U.S. Adults. J Med Food 2020; 23:711-718. [PMID: 32392443 DOI: 10.1089/jmf.2019.4528] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Vitamin D and fiber intake are nutritional factors that could affect the development of type 2 diabetes (T2D), potentially by reducing insulin resistance. Therefore, we hypothesized that the influence of vitamin D on T2D might depend on fiber intake. This study investigated the association between vitamin D status and T2D according to fiber intake. The present study analyzed data from 9,656 American adults (≥20 years old) who participated in the National Health and Nutrition Examination Survey (NHANES) 2007-2010. The serum concentration of 25-hydroxyvitamin D [25(OH)D] was used as a biomarker for vitamin D status. The T2D classification was based on two criteria: T2Da was identified using only self-reported questionnaire data and T2Db was identified based on both survey and laboratory data. The deficient vitamin D status (<50 nmol/L) was used as the reference group. After controlling for sociodemographic, behavioral, and dietary factors, the odds ratios (ORs) were 0.72 (95% confidence interval [CI]: 0.58, 0.90) for T2Da and 0.60 (0.50, 0.80) for T2Db in the sufficient vitamin D status (≥75 nmol/L). Furthermore, the total vitamin D concentration exhibited dose-dependent associations with lower OR values for T2Da (P for trend = .005) and T2Db (P for trend <.001). Among participants with high-fiber intake, the OR values for T2Db were 0.60 (95% CI: 0.42, 0.90) at suboptimal vitamin D status and 0.49 (95% CI: 0.31, 0.77) at sufficient vitamin D status. Moreover, the significant dose-dependent association persisted in the high-fiber-intake subgroup (P for trend = .004). Therefore, combining vitamin D plus high-fiber intake would help reduce the prevalence of diabetes, although the interaction analysis results were not statistically significant.
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Affiliation(s)
- Jung Hyun Kwak
- Department of Food and Nutrition, Eulji University, Seongnam, Republic of Korea
| | - Yoon-Hyeong Choi
- Department of Preventive Medicine, Gachon University College of Medicine, Incheon, Republic of Korea.,Gachon Advanced Institute for Health Sciences and Technology, Incheon, Republic of Korea
| | - Jean Kyung Paik
- Department of Food and Nutrition, Eulji University, Seongnam, Republic of Korea
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Milagres LC, Filgueiras MDS, Rocha NP, Suhett LG, de Albuquerque FM, Juvanhol LL, Franceschini SDCC, de Novaes JF. Cutoff point estimation for serum vitamin D concentrations to predict cardiometabolic risk in Brazilian children. Eur J Clin Nutr 2020; 74:1698-1706. [PMID: 32341487 DOI: 10.1038/s41430-020-0624-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 03/20/2020] [Accepted: 03/25/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND/OBJECTIVES To evaluate serum 25(OH)D concentrations and determine a cutoff point for cardiometabolic risk in children. SUBJECT/METHODS This is a cross-sectional study with a representative sample of 378 8-9-year-old children from all urban schools in the city of Viçosa, MG, Brazil. Sociodemographic data and information on lifestyle, and food consumption were collected. Biochemical evaluation included glucose, triglycerides, leptin, calcidiol [25(OH)D], and parathormone. Body composition was assessed by dual energy X-ray absorptiometry. Cardiometabolic risk was considered when nontraditional risk markers were detected, including triglyceride × glycemia index (TyG index), hyperleptinemia, and hypertriglyceridemic waist phenotype (HWP). The receiver operating characteristic curve (ROC) was used to define the cutoff point for serum 25(OH)D to predict cardiometabolic risk. RESULTS 25(OH)D showed better predictive capacity for grouping of cardiometabolic risk markers than for either single or paired markers. The area under the curve for grouping of risk markers was 0.636 (95% CI: 0.585, 0.685, P < 0.001). The cutoff point to predict cardiometabolic risk was defined as 32.0 ng/mL. CONCLUSION 25(OH)D presented good predictive capacity for cardiometabolic risk and 25(OH)D concentration higher than 32 ng/mL was associated with a 49% reduction of cardiometabolic risk prevalence in prepubertal Brazilian children.
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Affiliation(s)
- Luana Cupertino Milagres
- Department of Nutrition and Health, Biological Sciences Center, Federal University of Viçosa, Viçosa, Minas Gerais, 36570-900, Brazil.
| | - Mariana De Santis Filgueiras
- Department of Nutrition and Health, Biological Sciences Center, Federal University of Viçosa, Viçosa, Minas Gerais, 36570-900, Brazil
| | - Naruna Pereira Rocha
- Department of Nutrition and Health, Biological Sciences Center, Federal University of Viçosa, Viçosa, Minas Gerais, 36570-900, Brazil
| | - Lara Gomes Suhett
- Department of Nutrition and Health, Biological Sciences Center, Federal University of Viçosa, Viçosa, Minas Gerais, 36570-900, Brazil
| | - Fernanda Martins de Albuquerque
- Department of Nutrition and Health, Biological Sciences Center, Federal University of Viçosa, Viçosa, Minas Gerais, 36570-900, Brazil
| | - Leidjaira Lopes Juvanhol
- Department of Nutrition and Health, Biological Sciences Center, Federal University of Viçosa, Viçosa, Minas Gerais, 36570-900, Brazil
| | | | - Juliana Farias de Novaes
- Department of Nutrition and Health, Biological Sciences Center, Federal University of Viçosa, Viçosa, Minas Gerais, 36570-900, Brazil
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Clarke CL, Bell LM, Gies P, Henderson S, Siafarikas A, Gorman S. Season, Terrestrial Ultraviolet Radiation, and Markers of Glucose Metabolism in Children Living in Perth, Western Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193734. [PMID: 31623384 PMCID: PMC6801873 DOI: 10.3390/ijerph16193734] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 09/20/2019] [Accepted: 09/24/2019] [Indexed: 11/16/2022]
Abstract
Seasonality in glucose metabolism has been observed in adult populations; however, little is known of the associations between season and glucose metabolism in children. In this study, we examined whether markers of glucose metabolism (fasting glucose, insulin and HbA1c) varied by season in a paediatric population (6-13 years of age) located in Perth (Western Australia, n = 262) with data categorised by weight. Linear regression was used to analyse the nature of the relationships between mean daily levels of terrestrial ultraviolet radiation (UVR) (prior to the day of the blood test) and measures of glucose metabolism. Fasting blood glucose was significantly lower in autumn compared to spring, for children in combined, normal and obese weight categories. Fasting insulin was significantly lower in autumn and summer compared to winter for individuals of normal weight. HbA1c was significantly higher in summer (compared with winter and spring) in overweight children, which was in the opposite direction to other published findings in adults. In children with obesity, a strong inverse relationship (r = -0.67, p = 0.002) was observed for fasting glucose, and daily terrestrial UVR levels measured in the previous 6 months. Increased safe sun exposure in winter therefore represents a plausible means of reducing fasting blood sugar in children with obesity. However, further studies, using larger paediatric cohorts are required to confirm these relationships.
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Affiliation(s)
- Catherine L Clarke
- Telethon Kids Institute, University of Western Australia, Perth 6872, Australia.
| | - Lana M Bell
- Department of Paediatric Endocrinology and Diabetes, Perth Children's Hospital, Nedlands 6009, Australia.
| | - Peter Gies
- Australian Radiation Protection and Nuclear Safety Agency (ARPANSA), Yallambie 3085, Victoria, Australia.
| | - Stuart Henderson
- Australian Radiation Protection and Nuclear Safety Agency (ARPANSA), Yallambie 3085, Victoria, Australia.
| | - Aris Siafarikas
- Telethon Kids Institute, University of Western Australia, Perth 6872, Australia.
- Department of Paediatric Endocrinology and Diabetes, Perth Children's Hospital, Nedlands 6009, Australia.
- Medical School, Division of Paediatrics, University of Western Australia, Crawley 6009, Australia.
- Institute for Health Research, University of Notre Dame, Fremantle 6160, Australia.
| | - Shelley Gorman
- Telethon Kids Institute, University of Western Australia, Perth 6872, Australia.
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Denova-Gutiérrez E, Muñoz-Aguirre P, López D, Flores M, Medeiros M, Tamborrel N, Clark P. Low Serum Vitamin D Concentrations Are Associated with Insulin Resistance in Mexican Children and Adolescents. Nutrients 2019; 11:E2109. [PMID: 31491877 PMCID: PMC6770751 DOI: 10.3390/nu11092109] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 08/28/2019] [Accepted: 08/30/2019] [Indexed: 12/24/2022] Open
Abstract
Previous studies in the Mexican adult population have suggested a relationship between low levels of serum concentrations of serum vitamin D with impaired glucose tolerance, metabolic syndrome, and diabetes, regardless of the presence of obesity. The aim of this study is to investigate the relationship between serum vitamin D levels and the factors linked to insulin resistance. A total of 533 children and adolescents from the "Reference Values of Body Composition in the Pediatric Population of Mexico City" study are assessed. Body composition, dietary, and lifestyle data are obtained. Serum vitamin D, insulin, and glucose are also measured. Associations are tested using multiple linear and logistic regression models. Approximately 90% of children and adolescents in this study have sub-optimal vitamin D levels (<30 ng/mL). An inverse relationship between insulin resistance and serum vitamin D is observed (OR (odds ratios) = 2.9; 95% CI (95% confidence intervals): 1.1, 7.2; p-trend 0.03). Low serum vitamin D levels are associated with insulin resistance in the pediatric population. The present study provides additional evidence for the role of vitamin D in insulin resistance. Our findings suggest the supplementation of vitamin D may be helpful in preventing insulin resistance and subsequent diabetes.
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Affiliation(s)
- Edgar Denova-Gutiérrez
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Morelos 62100, Mexico.
| | - Paloma Muñoz-Aguirre
- CONACYT-Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos 62100, Mexico.
| | - Desiree López
- Clinical Epidemiology Research Unit, Hospital Infantil de México Federico Gómez, Mexico City 06720, Mexico.
| | - Mario Flores
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca, Morelos 62100, Mexico.
| | - Mara Medeiros
- Nephrology and Bone Mineral Metabolism Research Unit, Hospital Infantil de México Federico Gómez, Mexico City 06720, Mexico.
| | - Natalia Tamborrel
- School of Medicine, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico.
| | - Patricia Clark
- Clinical Epidemiology Research Unit, Hospital Infantil de México Federico Gómez, Mexico City 06720, Mexico.
- School of Medicine, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico.
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Migliaccio S, Di Nisio A, Mele C, Scappaticcio L, Savastano S, Colao A. Obesity and hypovitaminosis D: causality or casualty? INTERNATIONAL JOURNAL OF OBESITY SUPPLEMENTS 2019; 9:20-31. [PMID: 31391922 DOI: 10.1038/s41367-019-0010-8] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Epidemiological studies reported that vitamin D deficiency represents an increasingly widespread phenomenon in various populations. Vitamin D deficiency is considered a clinical syndrome determined by low circulating levels of 25-hydroxyvitamin D (25(OH)D), which is the biologically-inactive intermediate and represents the predominant circulating form. Different mechanisms have been hypothesized to explain the association between hypovitaminosis D and obesity, including lower dietary intake of vitamin D, lesser skin exposure to sunlight, due to less outdoor physical activity, decreased intestinal absorption, impaired hydroxylation in adipose tissue and 25(OH)D accumulation in fat. However, several studies speculated that vitamin D deficiency itself could cause obesity or prevent weight loss. The fat-solubility of vitamin D leads to the hypothesis that a sequestration process occurs in body fat depots, resulting in a lower bioavailability in the obese state. After investigating the clinical aspects of vitamin D deficiency and the proposed mechanisms for low 25(OH)D in obesity, in this manuscript we discuss the possible role of vitamin D replacement treatment, with different formulations, to restore normal levels in individuals affected by obesity, and evaluate potential positive effects on obesity itself and its metabolic consequences. Food-based prevention strategies for enhancement of vitamin D status and, therefore, lowering skeletal and extra-skeletal diseases risk have been widely proposed in the past decades; however pharmacological supplementation, namely cholecalciferol and calcifediol, is required in the treatment of vitamin D insufficiency and its comorbidities. In individuals affected by obesity, high doses of vitamin D are required to normalize serum vitamin D levels, but the different liposolubility of different supplements should be taken into account. Although the results are inconsistent, some studies reported that vitamin D supplementation may have some beneficial effects in people with obesity.
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Affiliation(s)
- Silvia Migliaccio
- Department of Movement, Human and Health Sciences, Unit Endocrinology, University Foro Italico, Roma, Italy
| | - Andrea Di Nisio
- 2Department of Medicine, Operative Unit of Andrology and Medicine of Human Reproduction, University of Padova, Padova, Italy
| | - Chiara Mele
- 3Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.,4Division of General Medicine, S. Giuseppe Hospital, Istituto Auxologico Italiano, Piancavallo, Verbania, Italy
| | - Lorenzo Scappaticcio
- Division of Endocrinology and Metabolic Diseases, Dept of Medical, Surgical, Neurological, Metabolic Sciences and Aging, University of Campania L. Vanvitelli, Naples, Italy
| | - Silvia Savastano
- 6Department of Medicine and Surgery, Unit of Endocrinology, Federico II University Medical School of Naples, Roma, Italy
| | - Annamaria Colao
- 6Department of Medicine and Surgery, Unit of Endocrinology, Federico II University Medical School of Naples, Roma, Italy
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Grunwald T, Fadia S, Bernstein B, Naliborski M, Wu S, Luca FD. Vitamin D supplementation, the metabolic syndrome and oxidative stress in obese children. J Pediatr Endocrinol Metab 2017; 30:383-388. [PMID: 27977406 DOI: 10.1515/jpem-2016-0211] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 11/04/2016] [Indexed: 12/17/2022]
Abstract
BACKGROUND Previous studies suggest that vitamin D may play a role in cardiovascular and metabolic health. Oxidative stress has also been implicated in the development of cardiovascular disease. Evidence suggests that vitamin D deficiency may contribute to the occurrence of oxidative stress. This study aimed to determine whether treatment and correction of vitamin D deficiency in obese children led to changes in their metabolic profile, independent of changes in adiposity. In addition, we aimed to determine whether vitamin D deficiency and oxidative stress are causally related in obese children. METHODS In the retrospective arm, chart review identified 32 obese children who experienced normalization of vitamin D deficiency or insufficiency with vitamin D supplementation. We then correlated laboratory and anthropometric data with vitamin D levels. In the prospective arm of the study, urinary 8-isoprostane and hydrogen peroxide were measured before and after correction of vitamin D deficiency/insufficiency and correlated to vitamin D levels in seven patients. RESULTS In our predominantly Hispanic population of obese children in an urban setting, we demonstrated a cause-effect relationship between vitamin D deficiency and oxidative stress. In contrast, we found no association between vitamin D status, adiposity, and markers of insulin sensitivity, nor any effect of vitamin D treatment on the same parameters. CONCLUSIONS These discordant findings suggest a differential effect of vitamin D on cardiovascular risk factors such as oxidative stress and insulin resistance. To confirm these findings, further prospective studies with larger sample size and longer follow-up are warranted.
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Affiliation(s)
- Tal Grunwald
- Department of Pediatrics, Section of Endocrinology and Diabetes, St. Christopher's Hospital for Children, Drexel University College of Medicine, Philadelphia, PA
| | - Shruti Fadia
- Department of Pediatrics, Section of Endocrinology and Diabetes, St. Christopher's Hospital for Children, Drexel University College of Medicine, Philadelphia, PA
| | - Bruce Bernstein
- Department of Pediatrics, Section of General Pediatrics, St. Christopher's Hospital for Children, Drexel University College of Medicine, Philadelphia, PA
| | - Matthew Naliborski
- Department of Pediatrics, Section of Endocrinology and Diabetes, St. Christopher's Hospital for Children, Drexel University College of Medicine, Philadelphia, PA
| | - Shufang Wu
- Department of Pediatrics, Section of Endocrinology and Diabetes, St. Christopher's Hospital for Children, Drexel University College of Medicine, Philadelphia, PA
| | - Francesco De Luca
- Department of Pediatrics, Section of Endocrinology and Diabetes, St. Christopher's Hospital for Children, Drexel University College of Medicine, Philadelphia, PA
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Wright CS, Weinheimer-Haus EM, Fleet JC, Peacock M, Campbell WW. The Apparent Relation between Plasma 25-Hydroxyvitamin D and Insulin Resistance is Largely Attributable to Central Adiposity in Overweight and Obese Adults. J Nutr 2015; 145:2683-9. [PMID: 26446485 PMCID: PMC4656909 DOI: 10.3945/jn.115.220541] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 09/10/2015] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Research indicates that plasma 25-hydroxyvitamin D [25(OH)D] is associated with insulin resistance, but whether regional adiposity confounds this association is unclear. OBJECTIVE This study assessed the potential influence of adiposity and its anatomical distribution on the relation between plasma 25(OH)D and insulin resistance. METHODS A secondary analysis of data from middle-aged overweight and obese healthy adults [n = 336: 213 women and 123 men; mean ± SD (range); age: 48 ± 8 y (35-65 y); body mass index (BMI; in kg/m2): 30.3 ± 2.7 (26-35)] from West Lafayette, Indiana (40.4 °N), were used for this cross-sectional analysis. Multiple linear regression analyses that controlled for multiple covariates were used as the primary statistical model. RESULTS Of all participants, 8.6% and 20.5% displayed moderate [20.1-37.5 nmol/L plasma 25(OH)D] to mild (37.6-49.9 nmol/L) vitamin D insufficiency, respectively. A regression analysis controlling for age, sex, race, plasma parathyroid hormone concentration, season of year, and supplement use showed that 25(OH)D was negatively associated with fasting insulin (P = 0.021). Additional regression analyses showed that total and central adiposity but not peripheral adiposity predicted low plasma 25(OH)D [total fat mass index (FMI): P = 0.018; android FMI: P = 0.052; gynoid FMI: P = 0.15; appendicular FMI: P = 0.07) and insulin resistance (homeostasis model assessment of insulin resistance: total and android FMI, P <0.0001; gynoid FMI, P = 0.94; appendicular FMI, P = 0.86). The associations of total and central adiposity with insulin resistance remained significant after adjusting for plasma 25(OH)D. However, adjusting for central adiposity but not other anatomical measures of fat distribution eliminated the association between plasma 25(OH)D and insulin resistance. CONCLUSION Central adiposity drives the association between plasma 25(OH)D and insulin resistance in overweight and obese adults. The trial was registered at clinicaltrials.gov as NCT00812409.
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Affiliation(s)
- Christian S Wright
- Department of Nutrition Science, Purdue University, West Lafayette, IN; and
| | | | - James C Fleet
- Department of Nutrition Science, Purdue University, West Lafayette, IN; and
| | - Munro Peacock
- Department of Medicine, Indiana University, Indianapolis, IN
| | - Wayne W Campbell
- Department of Nutrition Science, Purdue University, West Lafayette, IN; and
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Funtikova AN, Navarro E, Bawaked RA, Fíto M, Schröder H. Impact of diet on cardiometabolic health in children and adolescents. Nutr J 2015; 14:118. [PMID: 26574072 PMCID: PMC4647337 DOI: 10.1186/s12937-015-0107-z] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 11/05/2015] [Indexed: 01/10/2023] Open
Abstract
The manifestation of cardiovascular risk factors, such as hypertension, diabetes, and particularly obesity begins in children and adolescents, with deleterious effects for cardiometabolic health at adulthood. Although the impact of diet on cardiovascular risk factors has been studied extensively in adults, showing that their cardiometabolic health is strongly lifestyle-dependent, less is known about this impact in children and adolescents. In particular, little is known about the relationship between their dietary patterns, especially when derived a posteriori, and cardiovascular risk. An adverse association of cardiovascular health and increased intake of sodium, saturated fat, meat, fast food and soft drinks has been reported in this population. In contrast, vitamin D, fiber, mono-and poly-unsaturated fatty acids, dairy, fruits and vegetables were positively linked to cardiovascular health. The aim of this review was to summarize current epidemiological and experimental evidence on the impact of nutrients, foods, and dietary pattern on cardiometabolic health in children and adolescents. A comprehensive review of the literature available in English and related to diet and cardiometabolic health in this population was undertaken via the electronic databases PubMed, Cochrane Library, and Medline.
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Affiliation(s)
- Anna N Funtikova
- Cardiovascular Risk and Nutrition Research Group (CARIN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,CIBER Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Barcelona, Spain.,Food and Nutrition PhD program, University of Barcelona, Barcelona, Spain
| | - Estanislau Navarro
- Molecular Oncology Laboratory, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Rowaedh Ahmed Bawaked
- Cardiovascular Risk and Nutrition Research Group (CARIN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Biomedicine PhD program, University of Pompeu Fabra, Barcelona, Spain
| | - Montserrat Fíto
- Cardiovascular Risk and Nutrition Research Group (CARIN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Barcelona, Spain
| | - Helmut Schröder
- Cardiovascular Risk and Nutrition Research Group (CARIN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain. .,CIBER Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Barcelona, Spain.
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The Role of Vitamin D in Diabetes and Cardiovascular Disease: An Updated Review of the Literature. DISEASE MARKERS 2015; 2015:580474. [PMID: 26576069 PMCID: PMC4630385 DOI: 10.1155/2015/580474] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Revised: 09/22/2015] [Accepted: 09/29/2015] [Indexed: 02/06/2023]
Abstract
The dietary reference values for Vitamin D were set primarily considering its role in bone health, but with the discovery of Vitamin D receptors throughout body tissues, new links with other health conditions are now studied, such as for diabetes and cardiovascular diseases (CVD). This paper shall analyze and examine all new research studies carried out, especially in 2013–2015 regarding diabetes mellitus (DM) and cardiovascular diseases (CVD). Vast research has been carried out to establish strong relationship between Vitamin D serum levels, supplementation, diabetes, and CVD. However, the results from researches identified in this paper are disputable. Benefits of Vitamin D adequate levels were recognized from gestational period until later in disease development such as diabetes and/or CVD, but since not all studies are in agreement further investigation is suggested. Researches conducting large randomized controlled trials, exploring range of supplement doses, with variable baseline serum Vitamin D levels, and inclusion of array of associated parameters, are still required to conduct large-scale analysis and draw conclusion as a risk factor. Until then it is possible to conclude that maintenance of serum Vitamin D levels holds advantageous aspects in diabetic and cardiovascular conditions, and people should strive to attain them.
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20
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Peterson CA, Tosh AK, Belenchia AM. Vitamin D insufficiency and insulin resistance in obese adolescents. Ther Adv Endocrinol Metab 2014; 5:166-89. [PMID: 25489472 PMCID: PMC4257980 DOI: 10.1177/2042018814547205] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Obese adolescents represent a particularly vulnerable group for vitamin D deficiency which appears to have negative consequences on insulin resistance and glucose homeostasis. Poor vitamin D status is also associated with future risk of type 2 diabetes and metabolic syndrome in the obese. The biological mechanisms by which vitamin D influences glycemic control in obesity are not well understood, but are thought to involve enhancement of peripheral/hepatic uptake of glucose, attenuation of inflammation and/or regulation of insulin synthesis/secretion by pancreatic β cells. Related to the latter, recent data suggest that the active form of vitamin, 1,25-dihydroxyvitamin D, does not impact insulin release in healthy pancreatic islets; instead they require an environmental stressor such as inflammation or vitamin D deficiency to see an effect. To date, a number of observational studies exploring the relationship between the vitamin D status of obese adolescents and markers of glucose homeostasis have been published. Most, although not all, show significant associations between circulating 25-hydroxyvitamn D concentrations and insulin sensitivity/resistance indices. In interpreting the collective findings of these reports, significant considerations surface including the effects of pubertal status, vitamin D status, influence of parathyroid hormone status and the presence of nonalcoholic fatty liver disease. The few published clinical trials using vitamin D supplementation to improve insulin resistance and impaired glucose tolerance in obese adolescents have yielded beneficial effects. However, there is a need for more randomized controlled trials. Future investigations should involve larger sample sizes of obese adolescents with documented vitamin D deficiency, and careful selection of the dose, dosing regimen and achievement of target 25-hydroxyvitamn D serum concentrations. These trials should also include clamp-derived measures of in vivo sensitivity and β-cell function to more fully characterize the effects of vitamin D replenishment on insulin resistance.
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Affiliation(s)
- Catherine A Peterson
- University of Missouri, Department of Nutrition and Exercise Physiology, 204 Gwynn Hall, Columbia, MO 65211, USA
| | - Aneesh K Tosh
- Department of Child Health, University of Missouri School of Medicine, University of Missouri, Columbia, MO, USA
| | - Anthony M Belenchia
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, USA
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