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2 . 2021

Vitamin D status and calcium-phosphoric metabolism in children with excessive body weight and obesity

Abstract

Obesity is a multifactorial disease, the prevalence of which has increased over the past few decades worldwide in all age groups. There is evidence of the pathogenetic role of vitamin D (VD) in the formation of obesity. However, there are few studies concerning the characteristics of calcium-phosphorus metabolism in obese children. Therefore, data on the prevalence of VD deficiency stratified by body mass index categories, characteristics of calcium-phosphorus homeostasis and the relationship between the concentration of parathyroid hormone (PTH) and 25(OH)D in obese children are of scientific and practical interest.

The aim of the study was to assess the VD status of children, to analyze the ratio of individual biochemical markers of bone metabolism [concentration of calcium (Ca), phosphorus (P), PTH, alkaline phosphatase (ALP) activity] depending on body mass index (BMI).

Material and methods. The cross-sectional (one-stage) study included 77 children with different weight and height parameters at the age from 8 to 10 years. All children were divided into 3 groups: 1st - 26 children with normal body weight, 2nd - 29 children with overweight, 3rd - 22 people with obesity. All children underwent determination of the level of 25(OH)D, PTH, alkaline phosphatase, Ca, P in blood serum.

Results. Reduced VD supply occurred in all groups. However, children with normal BMI had a higher concentration of 25(OH)D - 32.65 [15.96; 44.4]ng/ml vs 23.6 [11.3; 34.54] ng/ml (p=0.001) in children with overweight and 12.51 [5.7; 19.1] ng/ml (p=0.014) in children with obesity (p<0.05). With an increase in BMI, a decrease in 25(OH)D level was noted (r=-0.480, p<0.05). Vitamin D deficiency in obese children (86.4%) occurred 2.3 fold more often than in overweight children (p=0.002), and 2.8 fold more often than in children with normal body weight (p=0.001). The concentration of PTH in all children was within the physiological norm, while there was a moderate negative correlation between the levels of PTH and 25(OH)D (r=-0.44, p<0.05). A moderate inverse correlation was also found between the concentration of PTH and total Ca (r=-0.38, p<0.05) and P (r=-0.44, p<0.05). With an increase in the BMI/age Z-score, a decrease in serum Ca level was observed (r=-0.497, p<0.05). The P content and ALP activity in blood serum were within the physiological norm in all children, however, in children with overweight and obesity, these indicators were statistically significantly lower than in healthy peers (p<0.05). Conclusion. In children with overweight and obesity, vitamin D deficit and insufficiency are recorded statistically significantly more often than in healthy children. With an increase in BMI, there is a tendency to a decrease in Ca, P and ALP.

Keywords:children, obesity, vitamin D, calcium-phosphorus metabolism

Funding. The study was not sponsored.

Conflict of interest. The authors declare no conflicts of interest.

For citation: Belykh N.A., Blokhova E.E. Vitamin D status and calcium-phosphoric metabolism in children with excessive body weight and obesity. Voprosy pitaniia [Problems of Nutrition]. 2021; 90 (2): С. 83-90. DOI: https://doi.org/10.33029/0042-8833-2021-90-2-83-90 (in Russian)

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CHIEF EDITOR
CHIEF EDITOR
Viktor A. Tutelyan
Full Member of the Russian Academy of Sciences, Doctor of Medical Sciences, Professor, Scientific Director of the Federal Research Centre of Nutrition, Biotechnology and Food Safety (Moscow, Russia)

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