Relationship of vitamin D intake and sun exposure with serum 25-hydroxyvitamin-D in schoolchildren with obesity

The obesity worldwide has produced an increase in obesity-related diseases and can be associated with low concentrations of 25-hydroxyvitamin-D. Also obesity and low physical activity can decrease sun exposure, so the aim was to correlate vitamin D intake with serum 25-hydroxyvitamin-D levels and to assess sun exposure habits in schoolchildren with obesity. Materials and methods. A correlational study was performed from January 2017 to January 2018 on 103 children between 6-12 years of age, with a body mass index ≥+2SD for age and sex, according to the World Health Organization. Blood samples were taken to determine the serum concentrations of 25-hydroxyvitamin-D, a nutritional survey to determine the vitamin D intake and a sun exposure questionnaire were applied. A Spearman correlation coefficient analysis was performed. Results. Forty-seven percent of the children were girls. The median years of age was 10. The median serum 25-hydroxyvitamin-D levels were 35.5 ng/mL, 74.8% had sufficient levels, 25.2% had insufficient levels. The median vitamin D intake was 214.7IU in boys and 231.9IU in girls. Regarding sun exposure, most of the children had excessive levels of sun exposure and inadequate sun protection practices. A positive correlation between vitamin D intake and serum 25-hydroxyvitamin-D was identified only in boys (rho=0.276, p=0.041). Conclusion. A positive correlation between vitamin D intake and serum 25-hydroxyvitamin-D levels was found in obese boys and excessive levels of sun exposure with inadequate sun protection practices in boys and girls(AU)

La obesidad se le ha asociado con distintas comorbilidades, bajas concentraciones séricas de 25-hidroxivitamina-D, sedentarismo que a su vez podría comprometer la exposición solar; por tanto, el objetivo fue relacionar la ingesta de vitamina D con los niveles séricos de 25-hidroxivitamina-D y determinar los hábitos de exposición solar en escolares con obesidad. Materiales y métodos. Estudio correlacional realizado de enero 2017 a enero 2018, en 103 niños entre 6 y 12 años, con un índice de masa corporal ≥+2DE para edad y sexo, según la Organización Mundial de la Salud. Se extrajo muestras sanguíneas para determinar las concentraciones séricas de 25-hidroxivitamina-D, se aplicó una encuesta nutricional para determinar la ingesta de vitamina D y un cuestionario de exposición solar. Se realizó un análisis del coeficiente de correlación de Spearman. Resultados. El 47% de los sujetos eran niñas. La mediana de edad fue de 10. La mediana de los niveles séricos de 25-hidroxivitamina-D fue de 35,5 ng/mL, el 74,8% tenía niveles suficientes, el 25,2% tenía niveles insuficientes. La mediana de la ingesta de vitamina D fue de 214,7UI en niños y de 231,9UI en niñas. Con respecto a la exposición solar, la mayoría de los niños presentaban una exposición excesiva y prácticas inadecuadas de protección solar. Se identificó una correlación positiva entre la ingesta de vitamina D y la 25-hidroxivitamina-D sérica en los niños (rho=0,276, p=0,041). Conclusión. Se identificó una correlación positiva entre la ingesta de vitamina D y los niveles séricos de 25-hidroxivitamina-D en niños obesos y exposición excesiva con prácticas inadecuadas de protección solar en niños y niñas(AU)

Serum 25-Hydroxyvitamin D correlates with systolic blood pressure in obese male schoolchildren.

Introduction: Introduction: childhood obesity is associated with an increased risk of chronic diseases. We aimed to examine the relation between serum levels of 25-hydroxyvitamin D (25[OH]D) and blood pressure in obese schoolchildren. Material and methods: a cross-sectional study in school-age children with obesity. The serum levels of 25(OH)D were measured and classified as sufficient or insufficient/deficient. Blood pressure was measured. Normal values were considered < 90th percentile, elevated blood pressure ≥ 90th to < 95th percentiles, and hypertension ≥ 95th percentile, according to blood pressure reference tables specific for age, sex, and height. A Pearson correlation was performed. Results: a total of 256 obese schoolchildren (123 [48.0 %] females and 133 [51.9 %] males) were evaluated. The prevalence rates of vitamin D deficiency, insufficiency, and sufficiency were 23.4 %, 52.3 %, and 24.2 %, respectively. Normal blood pressure was observed in 101 (39.4 %) children; the frequencies of elevated blood pressure and hypertension were 10.9 % and 49.6 %, respectively. A moderate inverse correlation of 25(OH)D levels with systolic blood pressure levels (r = -0.54, p = 0.03) was observed. When analyzed by sex, a significantly high inverse correlation between 25(OH)D levels and systolic blood pressure was observed in males (r = -0.85 and p ≤ 0.001). No significant correlation was found in females (systolic r = -0.16 and p = 0.67; diastolic r = -0.15 and p = 0.812). When performing the multiple regression analysis, the 25(OH)D levels and BMI were the significant predictors for systolic blood pressure. Conclusions: we identified an inverse correlation between 25[OH]D levels and systolic blood pressure in male schoolchildren with obesity.

Introducción: Introducción: la obesidad infantil se asocia con un mayor riesgo de desarrollar enfermedades crónicas. El objetivo fue analizar la relación entre los niveles séricos de 25-hidroxivitamina D (25[OH]D) y la presión arterial (PA) en escolares obesos. Material y métodos: estudio transversal en niños en edad escolar con obesidad. Los niveles séricos de 25(OH)D se clasificaron como suficientes e insuficientes/deficientes. Los valores de PA se clasificaron como normales si < percentil 90, presión elevada entre los percentiles ≥ 90 y < 95, e hipertensión si ≥ percentil 95, de acuerdo con las tablas de referencia de la PA, específicas para cada edad, sexo y altura. Se realizaron una correlación de Pearson y una regresión múltiple. Resultados: se evaluaron 256 escolares obesos (123 [48,0 %] mujeres y 133 [51,9 %] hombres). La frecuencia de la deficiencia, insuficiencia y suficiencia de vitamina D fue del 23,4 %, 52,3 % y 24,2 %, respectivamente. Se observó una PA normal en 101 (39,4 %) niños; las frecuencias de la PA elevada y la hipertensión fueron del 10,9 % y 49,6 %, respectivamente. Se observó una correlación inversa moderada de los niveles de 25(OH)D con los niveles de presión arterial sistólica (PAS) (r = -0,54; p = 0,03). Cuando se analizó por sexos, se observó una correlación inversa entre los niveles de 25(OH)D y la PAS en los niños (r = -0,85; p ≤ 0,001). No se encontró ninguna correlación significativa en las niñas (sistólica, r = -0,16; p = 0,67; diastólica, r = -0,15; p = 0,812). Al realizar el análisis de regresión múltiple, los niveles de 25(OH)D y el IMC fueron predictores significativos de la PAS. Conclusiones: identificamos una correlación inversa entre los niveles de 25[OH]D y la PAS en niños escolares con obesidad.

Vitamin D status and its relation to insulin resistance in a Mexican pediatric population.

Background Obesity in children and adolescents has increased alarmingly, placing them at a higher risk for impaired glucose tolerance and type 2 diabetes. The prevalence of vitamin D deficiency has increased as well. Vitamin D is critical for glucose homeostasis and insulin secretion. Studies on adults have reported an inverse association between vitamin D levels and insulin resistance (IR), but the results in children are inconsistent. The aim of our study was to determine the association between IR and serum vitamin D levels in obese Mexican children and adolescents. Methods A cross-sectional study was performed on 227 children and adolescents between 6 and 19 years of age. Obesity was diagnosed through body mass index (BMI) for age, according to the World Health Organization (WHO) criteria (2007). 25-Hydroxyvitamin D (25[OH]D) was measured using an immunoassay technique and the homeostatic model assessment of insulin resistance (HOMA-IR) was calculated using the Matthews equation. Student's t-test was carried out. Results The mean serum 25(OH)D level was 35.80 ng/mL, and 55.1% of the subjects had levels classified as sufficient, 33.5% as insufficient, and 11.5% as deficient. The mean level of HOMA-IR was 3.16, and 70% of the subjects were diagnosed with IR. Fasting insulin levels and HOMA-IR were significantly different in adolescents with hypovitaminosis, compared with adolescents in the vitamin D sufficiency group (p = 0.01 and p = 0.03, respectively). Conclusions The insulin levels and HOMA-IR were higher in adolescents with hypovitaminosis. The girls presented higher levels of insulin and HOMA-IR than the boys.

Higher levels of C-reactive protein associated with higher adiposity in mexican schoolchildren.

INTRODUCTION: The development of chronic-degenerative diseases secondary to obesity in early infancy has alerted health providers to the importance of identifying the risk factors for obesity and assessing preventive treatment to reduce risks. Studies performed on a pediatric population have examined the role of inflammatory biomarkers (specifically CRP and TNF-α) and adiposity with inconsistent results. OBJECTIVE: To assess the relationship between the serum levels of C-reactive protein and tumor necrosis factor-alfa with adiposity measured by bioimpedance analysis in schoolchildren. METHODS: Cross sectional design. Data were collected from 74 schoolchildren randomly selected in a local primary school in the city of Colima, Mexico. The mean age was 9.4 years (1.5, SD); 33 (44.6%) were girls. The adiposity (percentage of fat mass) was measured using bioimpedance analysis and anthropometric measurements. Serum C-reactive protein and tumor necrosis factor alpha were determined with enzyme-linked immunosorbent assay. The association between adiposity and serum inflammatory biomarkers was assessed with non parametric tests (Mann Whitney and Kruskall Wallis tests), and parametric tests (Pearson's correlation). RESULTS: Children with obesity had a significantly higher level of C-reactive protein [2.90 mg/L (0.07-9.37)] compared with children with a normal percentage of fat mass [0.71 mg/L (0.07-5.75)] (p < 0.001). No differences between groups were identified regarding serum levels of tumor necrosis factor-alfa. Modest correlations were identified between serum levels of C-reactive protein, adiposity determined by bioimpedance analysis (r = 0.453, p < 0.001); body mass index (r = 0.398, p = 0.001); triceps skinfold (r = 0.369, p = 0.002); and subescapular skinfold (r = 0.405, p < 0.001). No correlation was found between adiposity and serum tumor necrosis factor-alfa. CONCLUSION: Subclinical inflammation manifested by higher serum levels of C-reactive protein was identified in schoolchildren with higher percentage of fat mass as determined by bioimpedance analysis and other anthropometric measurements.

Introducción: Las enfermedades crónico-degenerativas, secundarias a la obesidad en niños, ha alertado a los profesionales de la salud sobre la importancia de identificar los factores de riesgo asociados a obesidad y establecer un enfoque preventivo para reducir el riesgo de complicaciones. Algunos estudios realizados en población pediátrica han estudiado el papel de los biomarcadores inflamatorios [específicamente proteína C-reactiva (PCR) y factor de necrosis tumoral alfa (TNF-)] asociado a adiposidad con resultados inconsistentes. Objetivo: Evaluar la relación entre los niveles séricos de PCR y TNF-con adiposidad determinada mediante impedancia bioeléctrica en niños en edad escolar. Métodos: Diseño transversal analítico. Se recopilaron los datos de 74 alumnos seleccionados al azar en una escuela primaria local en la ciudad de Colima, México. La edad media fue de 9,4 años (1.5 DE), treinta y tres (44.6%) fueron niñas. La adiposidad (porcentaje de grasa) se midió mediante impedancia bioeléctrica y antropometría. La PCR y TNF-séricos se determinaron con el ensayo por inmunoabsorción ligado a enzimas (ELISA). Las comparaciones de las variables entre los grupos se analizaron con pruebas no paramétricas (U de Mann Whitney y Kruskall Wallis) y la correlación de Pearson. Resultados: Los niños con obesidad presentaron un nivel sérico [2,90 mg/L (0,07-9,37)] significativamente más alto de PCR en comparación con los niños con un porcentaje normal de grasa [0,71 mg/L (0,07-5,75)] (p < 0,001). Con respecto a los niveles séricos de TNF-no se identificaron diferencias entre los grupos estudiados. Se obtuvieron correlaciones modestas entre los niveles séricos de PCR con la adiposidad determinado por impedancia bioeléctrica (r = 0,453, p < 0,001); índice de masa corporal (r = 0,398, p = 0,001); pliegue cutáneo tricipital (r = 0,369, p = 0,002), y pliegue cutáneo subescapular (r = 0,405, p < 0,001). No se encontró correlación entre la adiposidad y el nivel sérico de TNF-. Conclusión: La inflamación subclínica determinada por elevación de los niveles séricos de proteína C-reactiva fue identificada en niños en edad escolar con mayor porcentaje de grasa determinado por impedancia bioeléctrica y antropometría.

Correlation between percentage of body fat measured by the Slaughter equation and bio impedance analysis technique in Mexican schoolchildren.

INTRODUCTION: Obesity is considered one of the most serious public health problems of the 21st century in children and adolescents. The percentile or Z-score of the body mass index is widely used in children and adolescents to define and assess overweight and obesity, but it does not determine the percentage of total body fat. Other anthropometric measurements that determine total body fat are skinfold thickness and methods of body composition assessment such as bio impedance analysis, both of which are rapid and inexpensive. OBJECTIVE: The aim of the study was to correlate the percentage of body fat determined by the Slaughter equation with the percentage of body fat determined by the bio impedance analysis technique, and the body mass index in schoolchildren. METHODS: The design of the study is cross-sectional and it was performed on a random selection of 74 children (9.47 ± 1.55 years old) attending a primary school in Colima, Mexico during 2011. The percentage of body fat was measured by the Slaughter equation and bio impedance analysis technique. Body mass index was calculated. Inferential statistics were performed with the non-paired Student's t test, Pearson's correlation for quantitative variables (percentage of body fat by the Slaughter equation and bio impedance analysis) and the Fisher exact test for qualitative variables. RESULTS: A significant correlation (r = 0.74; p < 0.001) was identified between the percentage of fat measured by the Slaughter equation and bio impedance analysis. We also identified a significant correlation between the percentage of fat measured by the Slaughter equation and body mass index (r = 0.85; p < 0.001) and the percentage of fat measured by bio impedance analysis and body mass index (r = 0.78; p < 0.001). CONCLUSION: Given that we identified a significant positive correlation between BIA and STE, we conclude that both are adequate alternatives for measuring the percentage of body fat among schoolchildren in our population.

Correlation between percentage of body fat measured by the Slaughterequation and bio impedance analysis technique in Mexican schoolchildren / Correlación entre el porcentaje de grasa determinado mediante la ecuación de Slaughter e impedancia bioeléctrica en niños mexicanos en edad escolar

Introduction: Obesity is considered one of the most serious public health problems of the 21st century in children and adolescents. The percentile or Z-score of the body mass index is widely used in children and adolescents to define and assess overweight and obesity, but it does not determine the percentage of total body fat. Other anthropometric measurements that determine total body fat are skinfold thickness and methods of body composition assessment such as bio impedance analysis, both of which are rapid and inexpensive. Objetive: The aim of the study was to correlate the percentage of body fat determined by the Slaughter equation with the percentage of body fat determined by the bio impedance analysis technique, and the body mass index in schoolchildren. Methods: The design of the study is cross-sectional and it was performed on a random selection of 74 children (9.47 ± 1.55 years old) attending a primary school in Colima, Mexico during 2011. The percentage of body fat was measured by the Slaughter equation and bio impedance analysis technique. Body mass index was calculated. Inferential statistics were performed with the non-paired Student's t test, Pearson's correlation for quantitative variables (percentage of body fat by the Slaughter equation and bio impedance analysis) and the Fisher exact test for qualitative variables. Results: A significant correlation (r = 0.74; p < 0.001) was identified between the percentage of fat measured by the Slaughter equation and bio impedance analysis. We also identified a significant correlation between the percentage of fat measured by the Slaughter equation and body mass index (r = 0. 85; p < 0.001) and the percentage of fat measured by bio impedance analysis and body mass index (r = 0.78; p < 0.001). Conclusion: Given that we identified a significant positive correlation between BIA and STE, we conclude that both are adequate alternatives for measuring the percentage of body fat among schoolchildren in our population (AU)

Introducción: La obesidad en el siglo XXI es considerado ya como un problema serio de salud pública, tanto en niños como adolescentes. El puntaje Z del indicador índice de masa corporal para la edad es ampliamente utilizado en el área de pediatría para definir sobrepeso y obesidad, sin embargo, dicho indicador no permite determinar el porcentaje de grasa total en el cuerpo. Existen otros métodos antropométricos que permiten determinar el porcentaje de masa grasa, como son los pliegues cutáneos o métodos que determinan la composición corporal, como es la impedancia bioeléctrica, ambos rápidos de realizar y a un bajo costo. Objetivo: Correlacionar el porcentaje de grasa corporal determinado mediante la ecuación de Slaughter con el porcentaje de grasa determinado por impedancia bioeléctrica y con el indicador índice de masa corporal en niños en edad escolar. Material y método: El diseño del estudio fue transversal analítico y se realizó en una muestra de 74 niños seleccionados al azar (9,47 ± 1,55 años de edad) que asisten a una escuela primaria en Colima, México en el 2011. El porcentaje de grasa se realizó con la ecuación de Slaughter, impedancia bioeléctrica y además se calculó el índice de masa corporal. El análisis estadístico inferencial se realizó con la prueba T de Student, correlación de Pearson para establecer relación entre el porcentaje de grasa determinado por la ecuación de Slaughter e impedancia bioeléctrica así como prueba exacta de Fisher para variables cualitativas. Resultados: Se identificó una correlación significativa (r = 0,74; p < 0,001) entre el porcentaje de grasa determinado por la ecuación de Slaughter y la impedancia bioeléctrica. Así mismo, se identificó una correlación significativa entre el porcentaje de grasa determinado por la ecuación de Slaughter y el índice de masa corporal (r = 0,85; p < 0,001) y el porcentaje de grasa determinado por impedancia bioeléctrica y el índice de masa corporal (r = 0,78; p < 0,001). Conclusión: Dada la correlación positiva y significativa del porcentaje de grasa determinado mediante la ecuación de Slaughter y la impedancia bioeléctrica, se concluye que son alternativas adecuadas para determinar el porcentaje de grasa corporal en niños escolares mexicanos (AU)

Higher levels of C-reactive protein associated with higher adiposity in Mexican schoolchildren / Los niveles elevados de proteína C reactiva se asocian a una mayor adiposidad en escolares mexicanos

Introduction: The development of chronic-degenerative diseases secondary to obesity in early infancy has alerted health providers to the importance of identifying the risk factors for obesity and assessing preventive treatment to reduce risks. Studies performed on a pediatric population have examined the role of inflammatory biomarkers (specifically CRP and TNF-α) and adiposity with inconsistent results. Objective: To assess the relationship between the serum levels of C-reactive protein and tumor necrosis factoralfa with adiposity measured by bioimpedance analysis in schoolchildren. Methods: Cross sectional design. Data were collected from 74 schoolchildren randomly selected in a local primary school in the city of Colima, Mexico. The mean age was 9.4 years (1.5, SD); 33 (44.6%) were girls. The adiposity (percentage of fat mass) was measured using bioimpedance analysis and anthropometric measurements. Serum C-reactive protein and tumor necrosis factor alpha were determined with enzyme-linked immunosorbent assay. The association between adiposity and serum inflammatory biomarkers was assessed with non parametric tests (Mann Whitney and Kruskall Wallis tests), and parametric tests (Pearson's correlation). Results: Children with obesity had a significantly higher level of C-reactive protein [2.90 mg/L (0.07-9.37)] compared with children with a normal percentage of fat mass [0.71 mg/L (0.07-5.75)] (p < 0.001). No differences between groups were identified regarding serum levels of tumor necrosis factoralfa. Modest correlations were identified between serum levels of C-reactive protein, adiposity determined by bioimpedance analysis (r = 0.453, p < 0.001); body mass index (r = 0.398, p = 0.001); triceps skinfold (r = 0.369, p = 0.002); and subescapular skinfold (r = 0.405, p < 0.001). No correlation was found between adiposity and serum tumor necrosis factor-alfa. Conclusion: Subclinical inflammation manifested by higher serum levels of C-reactive protein was identified in schoolchildren with higher percentage of fat mass as determined by bioimpedance analysis and other anthropometric measurements (AU)

Introducción: Las enfermedades crónico-degenerativas, secundarias a la obesidad en niños, ha alertado a los profesionales de la salud sobre la importancia de identificar los factores de riesgo asociados a obesidad y establecer un enfoque preventivo para reducir el riesgo de complicaciones. Algunos estudios realizados en población pediátrica han estudiado el papel de los biomarcadores inflamatorios [específicamente proteína C-reactiva (PCR) y factor de necrosis tumoral alfa (TNF-α)] asociado a adiposidad con resultados inconsistentes. Objetivo: Evaluar la relación entre los niveles séricos de PCR y TNF-α con adiposidad determinada mediante impedancia bioeléctrica en niños en edad escolar. Métodos: Diseño transversal analítico. Se recopilaron los datos de 74 alumnos seleccionados al azar en una escuela primaria local en la ciudad de Colima, México. La edad media fue de 9,4 años (1.5 DE), treinta y tres (44.6%) fueron niñas. La adiposidad (porcentaje de grasa) se midió mediante impe-dancia bioeléctrica y antropometría. La PCR y TNF-α séricos se determinaron con el ensayo por inmunoabsorción ligado a enzimas (ELISA). Las comparaciones de las variables entre los grupos se analizaron con pruebas no paramétricas (U de Mann Whitney y Kruskall Wallis) y la correlación de Pearson. Resultados: Los niños con obesidad presentaron un nivel sérico [2,90 mg/L (0,07-9,37)] significativamente más alto de PCR en comparación con los niños con un porcentaje normal de grasa [0,71 mg/L (0,07-5,75)] (p < 0,001). Con respecto a los niveles séricos de TNF-α no se identificaron diferencias entre los grupos estudiados. Se obtuvieron correlaciones modestas entre los niveles séricos de PCR con la adiposidad determinado por impedancia bioeléctrica (r = 0,453, p < 0,001); índice de masa corporal (r = 0,398, p = 0,001); pliegue cutáneo tricipital (r = 0,369, p = 0,002), y pliegue cutáneo subescapular (r = 0,405, p < 0,001). No se encontró correlación entre la adiposidad y el nivel sérico de TNF-α. Conclusión: La inflamación subclínica determinada por elevación de los niveles séricos de proteína C-reactiva fue identificada en niños en edad escolar con mayor porcentaje de grasa determinado por impedancia bioeléctrica y antropometría (AU)