Evaluation of micronutrient levels in children and adolescents with obesity and their correlation with the components of metabolic syndrome

Background. Obesity is a significant public health problem worldwide. Vitamin deficiencies, developing due to monotype nutrition, are more likely to be observed in patients than healthy children. The present study evaluates vitamin and micronutrient levels in children and adolescents with obesity and metabolic syndrome compared to healthy controls. Methods. The study included 73 patients with obesity, 64 patients with metabolic syndrome and 71 healthy children (control group) aged 10 to 16 years. Physical examinations were performed, and waist circumference and systolic blood pressure measurements were recorded. Fasting blood glucose, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, total cholesterol, insulin, vitamin A, vitamin E, vitamin B1, vitamin B2, vitamin B6, vitamin B12, folic acid and free carnitine levels were analyzed. The homeostatic model of assessment-insulin resistance (HOMA-IR) index was calculated and recorded. Results. The mean age of all patients was 11.9±2.6 years. The serum insulin level and HOMA-IR index were found to be significantly higher in the obesity and metabolic syndrome groups. No significant difference was found between the groups in terms of vitamin A, vitamin B6 and free carnitine levels. Significantly decreased vitamin E, vitamin B2, vitamin B12 and folic acid and increased vitamin B1 levels were observed in the obesity and metabolic syndrome groups. Conclusions. Compared to healthy children, children with obesity and metabolic syndrome may have varying degrees of micronutrient and vitamin deficiency due to poor and unbalanced eating habits. These deficiencies should also be considered in the treatment and follow-up of obesity and metabolic syndrome

___

1. Rosende A, Pellegrini C, Iglesias R. Obesity and metabolic syndrome in children and adolescents. Medicina (B Aires) 2013; 73: 470-481.

2. Poyrazoğlu Ş, Baş F, Darendeliler F. Metabolic syndrome in young people. Curr Opin Endocrinol Diabetes Obes 2014; 21: 56-63.

3. World Health Organization. Nutrition. Double burden of malnutrition. 2020. from http://www. who.int/nutrition/double-burden-malnutrition/en/. (Retrieved at April 10,2020)

4. Swinburn BA, Sacks G, Hall KD, et al. The global obesity pandemic: shaped by global drivers and local environments. Lancet 2011; 378: 804-814.

5. Cutler DM, Glaeser EL, Shapiro JM. Why have Americans become more obese? J Econ Perspect 2003; 17: 93-118.

6. Via M. The malnutrition of obesity: micronutrient deficiencies that promote diabetes. ISRN Endocrinol 2012; 2012:103472.

7. Agarwal S, Reider C, Brooks JR, Fulgoni VL 3rd. Comparison of prevalence of inadequate nutrient intake based on body weight status of adults in the United States: an analysis of NHANES 2001-2008. J Am Coll Nutr 2015; 34: 126-34

8. Wei X, Peng R, Cao J, et al. Serum vitamin A status is associated with obesity and the metabolic syndrome among school-age children in Chongqing, China. Asia Pac J Clin Nutr 2016; 25: 563-570.

9. Decsi T, Molnar D, Koletzko B. Reduced plasma concentrations of alpha-tocopherol and betacarotene in obese boys. J Pediatr 1997; 130: 653-655.

10. Saccardo Sarni RO, Suano de Souza FI, Ramalho RA, et al. Serum retinol and total carotene concentrations in obese pre-school children. Med Sci Monit 2005; 11: CR510-CR514.

11. Burrows TL, Warren JM, Colyvas K, Garg ML, Collins CE. Validation of overweight children’s fruit and vegetable intake using plasma carotenoids. Obesity (Silver Spring) 2008; 17: 162-168.

12. Odum EP, Wakwe VC. Plasma concentrations of water-soluble vitamins in metabolic syndrome subjects. Niger J Clin Pract 2012; 15: 442-447.

13. Gunanti IR, Marks GC, Al-Mamun, A, Long KZ. Low serum vitamin B-12 and folate concentrations and low thiamin and riboflavin intakes are inversely associated with greater adiposity in Mexican American children. J Nutr 2014; 144: 2027-2033.

14. MacFarlane AJ, Greene-Finestone LS, Shi Y. Vitamin B-12 and homocysteine status in a folate-replete population: results from the Canadian Health Measures Survey. Am J Clin Nutr 2011; 94: 1079- 1087.

15. Ringseis R, Keller J, Eder K. Role of carnitine in the regulation of glucose homeostasis and insulin sensitivity: evidence from in vivo and in vitro studies with carnitine supplementation and carnitine deficiency. Eur J Nutr 2012; 51: 1-18.

16. Neyzi O, Bundak R, Gokcay G, et al. Reference values for weight, height, head circumference, and body mass index in Turkish children. J Clin Res Pediatr Endocrinol 2015; 7: 280-293.

17. de Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of WHO growht reference for school-aged children and adolescents. Bull World Health Organ 2007; 85: 660-667.

18. Zimmet P, Alberti KG, Kaufman F, et al. The metabolic syndrome in children and adolescents-an IDF concensus report. Pediatr Diabetes 2007; 8: 299- 306.

19. Abdullah A. The double burden of undernutrition and overnutrition in developing countries: an Update. Curr Obes Rep 2015; 4: 337-349.

20. Zuckerman M, Greller HA, Babu KM.A Review of the Toxicologic implications of obesity. J Med Toxicol 2015; 11: 342-354.

21. Blouin RA, Kolpek JH, Mann HJ. Influence of obesity on drug disposition. Clin Pharm 1987; 6: 706-714.

22. Zwiauer KF. Prevention and treatment of overweight and obesity in children and adolescents. Eur J Pediatr 2000; 159(Suppl 1): 56-68.

23. García OP, Ronquill, D, del Carmen Caamano M. Zinc, iron and vitamins A, C and E are associated with obesity, inflammation, lipid profile and insulin resistance in Mexican school-aged children. Nutrients 2013; 5: 5012-5030.

24. Shin MJ, Park E. Contribution of insulin resistance to reduced antioxidant enzymes and vitamins in nonobese Korean children. Clin Chim Acta 2006; 365: 200-205.

25. Canas JA, Damaso L, Altomare A, Killen K, Hossain J, Balagopal PB. Insulin resistance and adiposity in relation to serum β-carotene levels. J Pediatr 2012; 161: 58-64.e2

26. Viroonudomphol D, Pongpaew P, Tungtrongchitr R, et al. The relationships between anthropometric measurements, serum vitamin A and E concentrations and lipid profiles in overweight and obese subjects. Asia Pac J Clin Nutr 2003; 12: 73-79.

27. Molnar D, Decsi T, Koletzko BV. Reduced antioxidant status in obese children with multimetabolics yndrome. Int J Obes (Lond) 2004; 28: 1197-1202.

28. Velázquez-López L, Santiago-Díaz G, NavaHernández J, Muñoz-Torres AV, Medina-Bravo P, Torres-Tamayo M. Mediterranean-style diet reduces metabolic syndrome components in obese children and adolescents with obesity. BMC Pediatr 2014; 14: 175.

29. Densupsoontorn N, Srisawat C, Chotipanang K, et al. Prevalence of and factors associated with thiamin deficiency in obese Thai children. Asia Pac J Clin Nutr 2019; 28: 116-121.

30. Ortega RM, López-Sobaler AM, Andrés P, RodríguezRodríguez E, Aparicio A, Bermejo LM. Increasing consumption of breakfast cereal improves thiamine status in overweight/obese women following a hypocaloric diet. Int J Food Sci Nutr 2009; 60: 69-79.

31. Zhou SS, Zhou Y. Excess vitamin intake: an unrecognized risk factor for obesity. World J Diabetes 2014; 5: 1-13.

32. Zhou SS, Li D, Zhou YM, Sun WP, Liu QG. B-vitamin consumption and the prevalence of diabetes and obesity among the US adults: population based ecological study. BMC Public Health 2010; 10: 746.

33. Yu Y, Song Y. Three clustering patterns among metabolic syndrome risk factors and their associations with dietary factors in Korean adolescents: based on the Korea National Health and Nutrition Examination Survey of 2007-2010. Nutr Res Pract 2015; 9: 199-206.

34. Mazur-Bialy AI, Pocheć E.Vitamin B2 deficiency enhances the pro-inflammatory activity of adipocyte, consequences for insulin resistance and metabolic syndrome development. Life Sci 2017; 178: 9-16.

35. Liu Z, Li P, Zhao ZH, Zhang Y, Ma ZM, Wang SX. Vitamin B6 prevents endothelial dysfunction, insulin resistance, and hepatic lipid accumulation in apoe (-/-) mice fed with high-fat diet. J Diabetes Res 2016; 2016: 1748065.

36. Pinhas-Hamiel O, Doron-Panush N, Reichman B, Nitzan-Kaluski D, Shalitin S, Geva-Lerner L. Obese children and adolescents: a risk group for low vitamin B12 concentration. Arch Pediatr Adolesc Med 2006; 160: 933-936.

37. Narang M, Singh M, Dange, S. Serum homocysteine, vitamin B12 and folic acid levels in patients with metabolic syndrome. J Assoc Physicians India 2016; 64: 22-26.

38. Kozioł-Kozakowska A, Kozłowska M, Jagielski P. Assessment of diet quality, nutrient intake, and dietary behaviours in obese children compared to healthy children. Pediatr Endocrinol Diabetes Metab 2020; 26: 27-38.

39. Askarpour M, Hadi A, Miraghajani M, Symonds ME, Sheikhi A, Ghaedi E. Beneficial effects of l-carnitine supplementation for weight management in overweight and obese adults: an updated systematic review and dose-response meta-analysis of randomized controlled trials. Pharmacol Res 2020; 151: 104554.

40. Sun Y, Sun M, Liu B, et al. Inverse association between serum vitamin B12 concentration and obesity among adults in the united states. Front Endocrinol (Lausanne) 2019; 10: 414
Turkish Journal of Pediatrics-Cover
  • ISSN: 0041-4301
  • Yayın Aralığı: Yılda 6 Sayı
  • Başlangıç: 1958
  • Yayıncı: Hacettepe Üniversitesi Çocuk Sağlığı Enstitüsü Müdürlüğü
Sayıdaki Diğer Makaleler

Acute hemorrhagic edema of infancy – is it really a mild, benign disease?

Rasa MEDOVIC, Marija MEDOVIC, Zoran IGRUTINOVIC, Gordana KOSTIC, Biljana VULETIC, Slavica MARKOVIC, Aleksandar VLAHOVIC, Gordana RISTIC

Evaluation of micronutrient levels in children and adolescents with obesity and their correlation with the components of metabolic syndrome

Fatih KARDAŞ, Arife Derda YÜCEL, Mustafa KENDİRCİ, Selim KURTOĞLU, Nihal HATİPOĞLU, Leyla AKIN, Ülkü GÜL, Songül GÖKAY, Pembe ÜSTKOYUNCU

Mucormycosis in a pediatric population: a review of 20 cases from southern Turkey

Derya ALABAZ, Gülsüm YILMAZ, Aysun UĞUZ, Süleyman ÖZDEMİR, Hatice Ilgen ŞAŞMAZ, İbrahim BAYRAM

Complicated pneumonia due to exogenous toxic substances in children

Ercan AYAZ, Berna OĞUZ, Mithat HALİLOĞLU, Dilber ADEMHAN TURAL, Ebru YALÇIN, Uğur ÖZÇELİK, Kübra YÜKSEL

Evaluation of injury-related under-five mortality in Turkey between 2014-2017

Nilgün ÇAYLAN, Sıdıka Songül YALÇIN, Başak TEZEL, Şirin AYDIN, Önder ÖZEN, Meltem ŞENGELEN, Banu ÇAKIR

Ophthalmologic approach to babies with cerebral visual impairment

Aysun İDİL, Deniz ALTINBAY, ESRA ŞAHLI, Pınar Bingöl KIZILTUNÇ, Hatice Semrin Timlioğlu İPER, Kadriye ERKAN TURAN, Damla ERGİNTÜRK ACAR, Fatma Merve BEKTAŞ

Characteristics and outcomes of critically ill children transported by ambulance in a Turkish prehospital system: a multicenter prospective cohort study

Eylem ULAŞ SAZ, Caner TURAN, Murat ANIL, ALKAN BAL, GAMZE GÖKALP, Hayri YILMAZ, Sinem SARI GÖKAY, Tuğçe ÇELİK, Nilden TUYGUN, HALİSE AKÇA, Deniz TEKİN, Sinan OĞUZ, Tanju ÇELİK, Özlem TEKŞAM, Ayşe GÜLTEKİNGİL KESER, Gulser Esen BESLI, Murat DUMAN, Ali YURTSEVEN

Oral health status of asthmatic children using inhaled corticosteroids

Münevver DOĞAN, Ümit Murat ŞAHINER, Atilla Stephan ATAÇ, Elif BALLIKAYA, Özge SOYER, BÜLENT ENİS ŞEKEREL

The general movements assessment and effects of an early intervention in an infant with Cri du chat syndrome: a case report

Bilge Nur YARDIMCI LOKMANOĞLU, Akmer MUTLU, Ayşe LİVANELİOĞLU, Göknur HALİLOĞLU

Investigating the risk factors for antibiotic lock therapy failure in pediatric cancer: a single center retrospective analysis

Hatice KARAOĞLU ASRAK, Nurşen BELET, Özlem TÜFEKÇİ, Canan ÖZLÜ, Birsen BAYSAL, DİLEK İNCE