Association of Serum Retinol Concentrations With Metabolic Syndrome Components in Iranian Children and Adolescents: The CASPIAN-V Study

Abstract

BackgroundAs a fat-soluble vitamin, vitamin A plays a crucial role in adipogenesis, lipolysis, insulin resistance, and obesity. However, it is still unclear whether they are associated with cardiometabolic risk factors in children and adolescents. The current study aimed to determine the association between serum retinol concentration and the cluster of metabolic syndrome components among children and adolescents.MethodsThis nationwide cross-sectional study was performed on 2,518 students aged 7–18 years from the Childhood and Adolescence Surveillance and Prevention of Adult Non- communicable disease (CASPIAN-V) study. Students were selected via multistage cluster sampling method from 30 provinces of Iran in 2015. Multivariable logistic regression was used to assess the association of serum retinol concentration with metabolic syndrome (MetS) components.ResultsOverall, the mean (SD) age of study participants was 12.16 (3.04) years, and 44.9% (n = 1,166) of them were girls. The mean serum retinol concentration was 1.48 ± 1.55 μmol/L and vitamin A deficiency was observed among 19.7% (95% CI: 18.2–21.3) of study subjects. The results of the logistic regression analysis showed that increasing serum retinol concentrations were associated with an increased likelihood of developing obesity (OR: 1.12, 95% CI: 1.04, 1.20), abdominal obesity (OR: 1.07, 95% CI: 1.01, 1.14), low high-density lipoprotein cholesterol (HDL-C) (OR: 1.10, 95% CI: 1.04, 1.16) and high fasting blood glucose (FBG) (OR: 1.21, 95% CI: 1.10, 1.35), whereas it was associated with a decreased odds of developing high blood pressure (OR: 0.82, 95% CI: 0.73, 0.93). Nevertheless, there was no statistically significant association between metabolic syndrome itself and retinol concentration (OR: 1.02, 95% CI: 0.88, 1.18).ConclusionWe found that serum retinol concentration was positively associated with metabolic syndrome components such as obesity, low HDL-C, and high FBG, but not with metabolic syndrome itself.

Association of multiple serum minerals and vitamins with metabolic dysfunction-associated fatty liver disease in US adults: National Health and Nutrition Examination Survey 2017–2018

“…Moreover, trans-β-carotene, as a provitamin A, could decrease children’s body mass index (BMI), truncal fat mass, and total body fat mass, while vitamin A exhibited the opposite effects ( 58 ). Studies have indicated that increasing serum retinol level is positively associated with a higher prevalence of obesity and other metabolic indicators, including lower HDL-C and higher fasting blood glucose levels ( 59 , 60 ). Moreover, in this study, the Qgcomp and RCS models showed that vitamin A was positively associated with the risk of MAFLD.…”

Assessment of Vitamin Concentrations in Patients with Hashimoto’s Thyroiditis and Their Relationships with Thyroid Function, Biochemical Status, and Anthropometric Parameters—A Preliminary Study

“…Qorbani et al also found that retinol concentration was positively associated with metabolic syndrome components, such as obesity, low HDL, and high FBG levels. They also indicated that vitamin A level and its association with metabolic response is influenced by some genetic variations [ 46 ]. We did not observe any significant correlation between vitamin A and thyroid function parameters.…”

Reducing dietary intake of added sugars could affect the nutritional adequacy of vitamin A in adolescents: the Costa Rica case

“…It has been pointed out that the effect of these factors on retinol levels does not necessarily reflect a good vit-A status, but merely that the body's retinol stores have been redistributed from the liver into circulation [ 37 ]. Meanwhile, an inadequate intake of vit-A for four months can lead to the depletion of retinol stores in the liver [ 38 ] and generate a deficiency in serum levels, as evidenced in adolescents in Brazil [ 39 ], China [ 40 ], the Philippines [ 41 ], Iran [ 42 ], and India [ 43 ]. Although it has been suggested that vit-A deficiency is manifested primarily as a subclinical disease in the Americas [ 44 ], it could generate deleterious effects on the health of adolescents through different pathways, such as those mentioned in the introduction [ 33 , 34 ].…”