Vitamin D insufficiency/deficiency is associated with insulin resistance in Brazilian children, regardless of body fat distribution

Public Health Nutr. 2017 Nov;20(16):2878-2886. doi: 10.1017/S136898001700194X. Epub 2017 Aug 22.

Abstract

Objective: To assess the prevalence of vitamin D insufficiency and deficiency and its association with cardiometabolic risk factors, controlled by adiposity, in a representative sample of prepubescent children.

Design: Cross-sectional population-based study. Body composition was evaluated by dual-energy X-ray absorptiometry. Anthropometric measures and blood pressure were performed. Laboratory analyses were performed to determine the levels of vitamin D (25-hydroxyitamin D; 25(OH)D), glucose, insulin, serum lipids and intact parathyroid hormone. Dietary intake was assessed by three 24 h recalls.

Setting: Viçosa, Minas Gerais, Brazil, 2015.

Subjects: Representative sample of 378 children aged 8 and 9 years from urban schools.

Results: Inadequate serum concentrations of 25(OH)D were diagnosed in more than half of the children and none of them met the recommended vitamin D intake. After adjusting for confounding factors in the multiple regression analysis, lower prevalence of insulin resistance and hypertriacylglycerolaemia was found in children with serum 25(OH)D levels ≥75 nmol/l (prevalence ratio=0·25; 95 % CI 0·08, 0·85) and ≥50 nmol/l (prevalence ratio=0·61; 95 % CI 0·37, 0·99), respectively. However, after adjusting for different indicators of adiposity, insulin resistance remained independently associated and the association with hypertriacylglycerolaemia was lost after adjusting for central adiposity. The prevalence of vitamin D insufficiency/deficiency was associated with the number of cardiometabolic alterations in children.

Conclusions: The study results showed that prevalence of vitamin D insufficiency/deficiency was high among the children and insulin resistance was the main cardiometabolic alteration associated with this condition, even in a tropical climate country such as Brazil.

Keywords: Adiposity; Child; Insulin resistance; Nutritional epidemiology; Vitamin D.

MeSH terms

  • 25-Hydroxyvitamin D 2 / blood
  • Adiposity* / ethnology
  • Biomarkers / blood
  • Brazil / epidemiology
  • Calcifediol / blood
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / ethnology
  • Cardiovascular Diseases / etiology*
  • Child
  • Child Nutritional Physiological Phenomena* / ethnology
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / ethnology
  • Diabetes Mellitus, Type 2 / etiology*
  • Female
  • Humans
  • Insulin Resistance* / ethnology
  • Male
  • Nutritional Status / ethnology
  • Poisson Distribution
  • Prevalence
  • Risk Factors
  • Severity of Illness Index
  • Urban Health* / ethnology
  • Vitamin D Deficiency / epidemiology
  • Vitamin D Deficiency / ethnology
  • Vitamin D Deficiency / metabolism
  • Vitamin D Deficiency / physiopathology*

Substances

  • Biomarkers
  • 25-Hydroxyvitamin D 2
  • Calcifediol