Fazla Kilo Riski Olan Çocuklarda Vitamin D Düzeylerinin Değerlendirilmesi

Amaç: Bu çalışmada fazla kilo riski olan beş yaş altı çocuklarda vitamin D düzeylerinin incelenmesi amaçlanmıştır. Yöntem: Başkent Üniversitesi Genel Pediatri Polikliniğ’ine Şubat 2019-Mart 2019tarihleri arasında sağlam çocuk kontrolleri için başvuran ve kontrollerinde serum 25 hidroksi vitamin D [25(OH)D] düzeyi bakılan beş yaş altı 290 çocuk çalışmaya alındı. Yaşa göre beden kitle indeksinin (BAZ) Z skorları hesaplanarak normal ve fazla kilo riski olarak olgular iki gruba ayrıldı. Serum 25 (OH) D düzeyi ≤20 ng/ml olanlar vitamin D eksik, 21-29 ng/ml olanlar vitamin D yetersiz, ≥30 ng/ml olanlar vitamin D yeterli kabul edildi. Serum 25(OH)D düzeyleri her iki grupta karşılaştırıldı. Bulgular: Çalışmamızda serum 25 (OH)D düzeyi (ort±SH) normal kilolu grupta 21.9±0.7 ng/ml iken, fazla kilo riski olan grupta 15.9±1.1ng/ml idi. Serum 25(OH)D düzeyi açısından her iki grup arasında istatistiksel olarak anlamlı fark saptandı (p

Evaluation of Vitamin D levels in Children at Risk of Being Overweight

Objective: This study aimed to assess vitamin D levels among the children, under 5 years of age, having the risk of being overweight. Methods: 290 children under 5 years of age, who visited Baskent University General Pediatrics Outpatient Clinic between February 2019 and March 2019 for well-child check-up and whose serum 25-hydroxy vitamin D [25(OH)D] levels have been examined, were included in the study. The children were divided into two groups according to body mass index (BMI) Z-scores by age: normalweight children and those having the risk of being overweight. The serum 25(OH)D levels of ≤20 ng/ml, 21-29 ng/ml and ≥30 ng/ml were considered vitamin D deficiency, insufficiency and sufficiency, respectively. Serum 25(OH)D levels were compared in both groups. Findings: In our study, the serum 25(OH)D level (mean ± SE) was 21.9±0.7 ng/ml in the normalweight group, while it was 15.9±1.1 ng/ml in the group with the risk of being overweight. There was a statistically significant difference between the two groups in terms of serum 25(OH)D level (p

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  • 1. Holick MF. Vitamin D deficiency. N Engl J Med 2007;357:266-81.
  • 2. Cassim R, Russell MA, Lodge CJ, Lowe AJ, Koplin JJ, Dharmage SC. The role of circulating 25 hydroxyvitamin D in asthma: Asystematicreview. Allergy 2015;70:339-54.
  • 3. Pludowski P, Holick MF, Grant WB, Konstantynowicz J, Mascarenhas MR, Haq A, et al. Vitamin D supplementationguidelines. J SteroidBiochemMolBiol. 2018; 175:125–135. doi: 10. 1016/j. jsbmb. 2017. 01. 021.
  • 4. Reis AF, Hauache OM, Velho G. Vitamin D endocrinesystemandthegeneticsusceptibilitytodiabe tes, obesityandvasculardisease. A review of evidence. DiabetesMetab. 2005;31:318–25. 5) Hyppönen E, Power C. Vitamin D statusandglucosehomeostasis in the 1958 British birthcohort: the role of obesity. DiabetesCare 2006;29:2244–6.
  • 6. VinhquocLu’o’ng K, Nguyen LTH. Thebeneficial role of vitamin D in obesity: possiblegeneticandcellsignalingmechanisms. Nutr J 2013; 12: 89.
  • 7. Mai X. M. ,Chen Y. , Camargo C. A. , Jr. Crosssectionalandprospectivecohortstudy of serum 25- hydroxyvitamin D levelandobesity in adults: The HUNT study. Am. J. Epidemiol. 2012;175:1029– 1036.
  • 8. Plesner JL, Dahl M, Fonvig CE, Nielsen TRH, Kloppenborg JT, Pedersen O, Hansen T, Holm JC. Obesity is associatedwith vitamin D deficiency in Danish children andadolescents. J Pediatr EndocrinolMetab. 2018 Jan 26;31 (1):53-61.
  • 9. Saggese G, Vierucci F, Boot AM, et al. Vitamin D in childhoodandadolescence: an expertpositionstatement. Eur J Pediatr 2015; 174 (5): 565-76.
  • 10. World HealthOrganization. WHO Child GrowthStandards: length/height-for-age, weightfor- length, weight-for-heightand body massindexfor- age: methodsanddevelopment 2006. Geneva: WHO; 2006.
  • 11. WHO MulticentreGrowth Reference StudyGroup. WHO Child GrowthStandardsbased on length/height, weightand age. ActaPaediatrSuppl 2006;450:76-85.
  • 12. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, andprevention of vitamin D deficiency: an EndocrineSocietyclinicalpracticeguideline. J ClinEndocrinolMetab 2011;96:1911-30.
  • 13. Atasoy V, Altunbaş EA, Set T. Fazla kilolu ve obez çocuklarda D vitamini düzeylerinin değerlendirilmesi. Türk Aile HekDerg. 2019;23 (3):102-109.
  • 14. Mengen E. Obez Çocuklarda D Vitamini Du�zeylerininİnsu�lin Direnci ve Hepatosteatoz ile İlişkisi. Türkiye Çocuk Hastalıkları Dergisi 2020;14 (1):36-41.
  • 15. Cediel G, Corvalán C, López de Romaña D, Mericq V, Uauy R. Prepubertaladiposity, vitamin D status, andinsulinresistance. Pediatrics 2016;138 (1):e20160076.
  • 16. Wortsman J. ,Matsuoka L. Y. , Chen T. C. , Lu Z. , Holick M. F. Decreasedbioavailability of vitamin D in obesity. Am. J. Clin. Nutr. 2000;72:690–693. doi: 10. 1093/ajcn/72. 3. 690.
  • 17. Ding C, Gao D, Wilding J, Trayhurn P, Bing C. Vitamin D signalling in adiposetissue. Br J Nutr. 2012;108:1915–23.
  • 18. Kurşun ÖS. Şişman çocuklarda D vitamini düzeyleri ve insülin direnci ile ilişkisinin araştırılması (Uzmanlık Tezi). Edirne: Trakya Üniversitesi; 2008.
  • 19. Florez H, Martinez R, Chacra W, Strickman-Stein N, Levis S. Outdoorexercisereducesthe risk of hypovitaminosis D in theobese. J SteroidBiochemMolBiol. 2007; 103:679–81.
  • 20. Gazi Üniversitesi/Sağlık Bakanlığı (GÜ/SB), Türkiye’de 6-17 Aylık Çocuklarda ve Annelerinde Hemoglobin Ferritin D -Vitamini Düzeyi ve Demir Eksikliği Anemisi Durum Belirleme. Yürütülen Programların Değerlendirilmesi Araştırması Gazi Üniversitesi Tıp Fakültesi, Ankara: 2011: 106.
  • 21.Yuzbashian E, Asghari G, Hedayati M, Zarkesh M, Mirmiran P, Khalaj A. Determinants of vitamin D receptor gene expression in visceralandsubcutaneousadiposetissue in nonobese, obese, andmorbidlyobesesubjects. TheJournal of steroidbiochemistryandmolecularbiology. 2019;187:82–7.
  • 22. Caron-Jobin M, Morisset AS, Tremblay A, Huot C, Légaré D, Tchernof A. Elevated serum 25 (OH)D concentrations, vitamin D, andcalciumintakesareassociatedwithreducedadipocy te size in women. Obesity (Silver Spring) 2011;19:1335-41.
  • 23. Chung IH, Kang YS, Yoo EG. Responseto vitamin D replacement in overweightand normal weightchildrenwith vitamin D deficiency. Annals of PediatricEndocrinology&Metabolism 2019; 24:22- 26.
  • 24. Lecube A. ,Hernández C. , Pelegrí D. , Simó R. Factorsaccountingforhighferritinlevels in obesity. International Journal of Obesity. 2008;32 (11):1665–1669. doi: 10. 1038/ijo. 2008. 154.
  • 25. Gammon CS, vonHurst PR, Coad J, Kruger R, Stonehouse W. Vegetarianism, vitamin B12 status, andinsulinresistance in a group of predominantlyoverweight/obese South Asianwomen. Nutrition. 2012; 28: 20-4.
  • 26. Gunanti IR, Marks GC, Al-Mamun A, Long KZ. Low serum vitamin B- 12,andfolateconcentrationsandlowthiaminandribofl avinintakesareinverselyassociatedwithgreateradiposi ty in MexicanAmericanchildren. J Nutr. 2014; 144: 2027-33.
  • 27. Okubo Y, Nochioka K, Testa M. Theimpact of pediatricobesity on hospitalizedchildrenwithlowerrespiratorytractinfecti ons in the United States. TheClin. Respiratory J. 2018;12:4.