Vitamin D status associated with early CVD markers in children with obesity

ORLANDO, Fla. — In children with overweight or obesity, low levels of serum 25-hydroxyvitamin D are associated with markers for cardiovascular disease, including elevated non-HDL cholesterol, total cholesterol and triglycerides, according to study findings presented here.

“Vitamin D deficiency was significantly associated with an increase in atherogenic lipids and markers of early cardiovascular disease,” Marisa Censani, MD, a pediatric endocrinologist and director of the pediatric obesity program at New York Presbyterian Hospital/Weill Cornell Medical Center, said during a press conference discussing the findings. “Our data suggest that all children and adolescents who are overweight or obese should be screened for vitamin D deficiency and the potential benefits of improving vitamin D status to reduce cardiometabolic risk.”

Marisa Censani

Censani and colleagues analyzed data from 178 children aged 6 to 17 years with overweight or obesity (61 boys; mean age, 12 years; mean BMI, 31.3 kg/m²) and available serum 25(OH)D levels who were evaluated at the pediatric endocrinology outpatient clinics at Weill Cornell Medical between April 2013 and May 2015. Researchers had fasting lipid data for 60 children and calculated total cholesterol/HDL ratio and triglyceride/HDL ratio. Vitamin D deficiency was defined as a serum 25(OH)D level of 20 ng/mL or less.

Within the cohort, 55% of children were considered vitamin D deficient (n = 33), Censani said; mean vitamin D level among deficient children was 15.2 ng/mL, vs. 27.5 ng/mL in the non-deficient group. There were no between-group differences in BMI.

The researchers found that, compared with children who were not vitamin D deficient, those with a serum 25(OH)D level of 20 ng/mL or less had higher mean non-HDL cholesterol (134.76 mg/dL vs. 108.85 mg/dL; P < .03), higher triglyceride/HDL ratio (3.09 vs. 1.82; P = .03), higher total cholesterol/HDL ratio (mean 134.76 vs. 78.93; P < .03), higher total cholesterol (mean 184.15 mg/dL vs. 158.99 mg/dL; P< .01) and higher triglycerides (mean 134.76 mg/dL vs. 78.93 mg/dL; P < .03).

When stratified by pubertal status, pubertal children with vitamin D deficiency showed markedly higher total cholesterol/HDL ratio vs. pubertal children who were not vitamin D deficient, according to the researchers (mean 4.26 vs. 3.42).

“These findings suggest that vitamin D deficiency may have a negative effect on lipid markers, with an increase in cardiovascular risk among individuals with low vitamin D levels,” Censani said. “This is one of the first studies to assess the relationship of vitamin D deficiency with both lipoproteins and non-HDL cholesterol, which are specific lipid markers impacting cardiovascular risk during childhood. These findings are particularly important in children with obesity, because they are at higher risk for medical conditions, including dyslipidemia, insulin resistance, metabolic syndrome and hypertension.” – by Regina Schaffer

Reference:

Censani M, et al. SUN-342. Presented at: The Endocrine Society Annual Meeting; April 1-4, 2017; Orlando, Fla.

Disclosures: Censani reports no relevant financial disclosures.