Vitamin D Deficiency in Children and Adolescents: Role of Puberty and Obesity on Vitamin D Status

Abstract

Background: Vitamin D deficiency is common among children and adolescents and can be affected by several factors such as puberty and obesity. Objective: The aim of this study was to evaluate vitamin D status in children and adolescents and to analyse the influence of puberty and obesity on its level. Method: A cross-sectional study was carried-out, in which clinical and biochemical data were gathered from 384 healthy children and adolescents between May 2019 to May 2020. Results: 220 females and 164 males were enrolled (aged 7-16 years; mean ± SD: 11 ± 2.5). Vitamin D deficiency was found in 49% of the total cases and was significantly more prevalent in females than males (33.1% in female; 15.9% in male, P < .001). Mean vitamin D level was lower in obese children compared with non-obese ( P < .001). Non-obese group had significantly higher levels of vitamin D in Tanner stage IV of puberty than obese individuals (20.1 ± 17.0 vs 5.4 ± 2.0) ( P = .03). Vitamin D levels were significantly lower in females than males only in Tanner stage II (12.3 ± 9.0 vs 19.6 ± 16.6) ( P = .005). The lowest level of Vitamin D was in Tanner stage Ⅳ-Ⅴ in boys and in Tanner stage Ⅱ-Ⅲ in girls ( P < .001). Conclusion: Puberty is an additional risk factor for vitamin D deficiency especially in girls and obese children. This increased risk, together with the fact that most important time for building a proper skeleton is during childhood and adolescent, makes it essential to monitor vitamin D in these age groups.

Vitamin D, Insulin Resistance and Cytokine Levels in Obese Pubertal Children

“…Hypovitaminosis D is associated with abnormal glucose homeostasis and inflammatory cytokines. 14 In our study, pubertal obese and control groups were compared for age, BMI, 25(OH) D,1,25(OH)2D, PTH, IR, and inflammatory status. Age differences between the control and obese groups 1a and 1b were significant; however, we did not take this into account as they had all entered puberty.…”

The link between vitamin D, chemerin and metabolic profile in overweight and obese children - preliminary results

“…Rusconi et al (62), among a group of more than one hundred obese children with 25(OH)D levels above or below 20 ng/ ml, found higher total cholesterol and LDL-C levels in the group with vitamin D deficit. It should be noted that the stage of puberty also affects the relationship between vitamin D and the components of metabolic syndrome in obese children (53,70,71). Pires et al (53) reported that the significant increase in TG, fasting insulin and HOMA-IR, observed during puberty, was related to a decrease in 25(OH)D levels independent of sex, body mass and pubertal Tanner stage.…”

“…( 62 ), among a group of more than one hundred obese children with 25(OH)D levels above or below 20 ng/ml, found higher total cholesterol and LDL-C levels in the group with vitamin D deficit. It should be noted that the stage of puberty also affects the relationship between vitamin D and the components of metabolic syndrome in obese children ( 53 , 70 , 71 ). Pires et al.…”

Screening Questionnaire for Vitamin D Insufficiency in Children with Obesity

“…Considering that roughly 43 million children are estimated to be affected by obesity throughout the world, anyone could easily predict the size of the risk of vitamin D deficiency in this category of subjects, who are a vulnerable group for poor VitD status, showing a significant decrease in VitD levels in pubertal stages compared to pre-pubertal conditions, supporting the important role of puberty in VitD metabolism. Puberty, indeed, is a crucial time in the development of the bone mineral mass, with increased requirements in this period [ 26 , 27 ].…”