Vitamin D Status Is Associated with Early Markers of Cardiovascular Disease in Children and Adolescents with Overweight and Obesity

Presentation Number: SUN 342
Date of Presentation: April 2nd, 2017

Marisa Censani*1, Tiffany Schumaker1, Hoda T. Hammad2 and Paul J. Christos2
1Weill Cornell Medicine New York Presbyterian, New York, NY, 2Weill Cornell Medicine, New York, NY

Abstract

Background: Adults with high lipoprotein ratios have been found to have increased risk of cardiovascular disease (CVD), and elevated non-high density lipoprotein (HDL) cholesterol in childhood has been documented to be related to cardiovascular risk in adulthood. Studies in adults have reported associations of low 25 hydroxyvitamin D (25OHD) with dyslipidemia and CVD. However, there is scarce pediatric data regarding the relationship between vitamin D status and specific lipid markers impacting cardiovascular risk during childhood. The study objective was to investigate the associations of vitamin D status and cardiovascular risk, specifically serum lipid markers, during childhood and adolescence.

Methods: A cross-sectional study of children and adolescents, ages 6-17 years, evaluated at the pediatric endocrinology outpatient clinics at Weill Cornell Medical between 4/2013 and 5/2015 with vitamin D levels obtained at time of visit. Age, sex, pubertal status, 25OHD levels, and cardiometabolic labwork with fasting lipid parameters: total cholesterol (TC), triglycerides (TG), HDL, low density lipoprotein (LDL), and non-HDL-C were collected. Total cholesterol (TC)/HDL and TG/HDL ratios were calculated. Vitamin D deficiency was defined as 25OHD <20 ng/ml.

Results: 178 of 332 patients (61 males and 117 females; age:12.1±3.3 years) met criteria for overweight and obesity (BMI>85th percentile). 60 of 178 patients with BMI >85th percentile had fasting lipid parameters available. When laboratory results were analyzed according to vitamin D status, patients with 25OHD <20ng/ml were found to have significantly higher non-HDL-C (134.76± 47.32 vs.108.85± 31.14, p<0.03), TG/HDL ratio (3.09± 2.26 vs. 1.82± 1.18, p=0.03), TC/HDL ratio (4.23± 1.23 vs. 3.40± 1.05, p<0.01), TC (184.15± 40.19 vs. 158.89± 30.10, p<0.01), and TG (134.76± 47.32 vs.78.93± 37.46, p<0.03), compared to patients with 25OHD>20mg/dl. When laboratory results were analyzed according to pubertal status, pubertal children with vitamin D deficiency showed significantly higher TC/HDL levels 4.26±1.18 vs. 3.42 ±0.8, p<0.02) than those with vitamin D status >20ng/mL; TC (p=0.06), non-HDL-C (p=0.07), and TG/HDL (p=0.09) approached significance.

Conclusions: Vitamin D deficiency was significantly associated with an increase in atherogenic lipids and markers of early cardiovascular disease with non-HDL-C, TC/HDL, TG/HDL, TC, and TG levels higher in vitamin D deficient patients compared to patients with insufficient or normal values. Findings suggest that vitamin D deficiency may have negative effects on lipid parameters with increase in cardiovascular risk among individuals with low vitamin D concentrations. This study highlights the role of monitoring 25OHD levels in children and adolescents with overweight and obesity and the potential benefits of improving vitamin D status to reduce cardiometabolic risk.

 

Nothing to Disclose: MC, TS, HTH, PJC