Vitamin D Deficiency in Obese Children and Its Relationship to Glucose Homeostasis.

J Clin Endocrinol Metab. 2011 Nov 9.
Olson ML, Maalouf NM, Oden JD, White PC, Hutchison MR. michele.hutchison at utsouthwestern.edu
Departments of Pediatrics (M.L.O., J.D.O., P.C.W., M.R.H.) and Internal Medicine (N.M.M.), University of Texas Southwestern Medical Center, Dallas, Texas.

Objectives:The aim of the study was to compare the prevalence of vitamin D deficiency in obese and non-overweight children in North Texas, to examine relationships between dietary habits and 25-hydroxyvitamin D [25(OH)D] level in obese children, and to examine the relationship between 25(OH)D level and markers of abnormal glucose metabolism and blood pressure.

Patients and Methods:Using a cross-sectional design, systolic and diastolic blood pressure, dietary information, serum 25(OH)D, fasting glucose and insulin, 2-h glucose from oral glucose tolerance test, hemoglobin A1c, and homeostasis model assessment of insulin resistance were recorded for 411 obese subjects (6-16 yr old) at an obesity referral clinic. 25(OH)D was also obtained from 87 control non-overweight subjects (6-16 yr old).

Results:Ninety-two percent of obese subjects had a 25(OH)D level below 75 nmol/liter, and 50% were below 50 nmol/liter.
Among non-overweight subjects, these frequencies were 68 and 22%, respectively (both P < 0.01 compared with obese subjects).
25(OH)D was negatively associated with

• soda intake (P < 0.001), (see Cola Soft Drinks reduce Calcium and vitamin D)
• juice intake (P = 0.009), and
• skipping breakfast (P < 0.001).

25(OH)D was negatively correlated with

• homeostasis model assessment of insulin resistance (r = -0.19; P = 0.001) and
• 2-h glucose (r = -0.12; P = 0.04)

after adjustment for body mass index and age but was not correlated with hemoglobin A1c, systolic blood pressure Z score, or diastolic blood pressure Z score.

Conclusions:Vitamin D deficiency is common in children in this southern United States location and is significantly more prevalent in obese children.
Lower 25(OH)D level is associated with risk factors for type 2 diabetes in obese children.

PMID: 22072738
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Clipped from review by MedPageToday

And half of the obese children had vitamin D deficiency, compared with 22% of thinner kids, Hutchison and colleagues reported in the January issue of the Journal of Clinical Endocrinology & Metabolism.

They were compared with 87 children — matched to the obese group by season when the data was acquired, age, and race/ethnicity — who were below the 85th percentile of BMI for age. They were a convenience sample of otherwise healthy patients being treated for congenital hypothyroidism, acquired primary hypothyroidism, or isolated growth hormone deficiency.

On average, the obese children had a serum 25(OH)D concentration of 49 nmol/L, compared with 67.5 nmol/L for the slimmer cohort. The difference was significant at P<0.0001.

"Our study found that obese children with lower vitamin D levels had higher degrees of insulin resistance," said lead author Micah Olson, MD, also of the University of Texas Southwestern Medical Center.
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See also Vitamin D Life

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• All items in Obesity and Vitamin D 351 items
• Overview Diabetes and Vitamin D
• Overview Obesity and Vitamin D
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• Pre-diabetes and hypertension 2.4X more common when less than 30 ng of vitamin D – Jan 2011
• All items which have "Metabolic Syndrome" 235 items as of Aug 2012
• 70 percent increased chance of Metabolic Syndrome if low on vitamin D – May 2011
• Metabolic Syndrome and vitamin D - view of many papers - Aug 2010
• Metabolic Syndrome 50 percent more likely if under 20 ng of vitamin D – May 2011
• Dark skinned teens use media much more - June 2011 good graphic
• Vitamin D and Obstetrics Improving Pregnancy and Childbirth - presentations May 2011 has the following

7X less diabetes for children with> 2,000 IU of vitamin D daily

Vitamin D Recommendations has the following graph by Endocrine Society - which published this paper

Note that the Endocrine Society recommends up to 2000 IU for children

Following graph shows the decrease in vitamin D with increasing BMI

2 nanograms/ml less vitamin D for every in 5 kg/m**2 increase in BMI

Overview Deficiency of vitamin D has the following graphic