Effects of vitamin D supplementation on insulin resistance and cardiometabolic risk factors in children with metabolic syndrome: a triple-masked controlled trial

Kelishadi, Roya; Salek, Shadi; Salek, Mehdi; Hashemipour, Mahin; Movahedian, Mahsa

doi:10.1016/j.jpedp.2013.06.005

Informação do artigo

Abstract

This triple-masked controlled trial aimed to assess the effects of vitamin D supple- mentation on insulin resistance and cardiometabolic risk factors in obese children and adolescents.

The study comprised 50 participants, aged 10 to 16 years, who were randomly assigned into two groups of equal number. In this 12-week trial, one group received oral vitamin D (300,000 IU) and the other group received placebo. Cardiometabolic risk factors, insulin resistance, and a continuous value of metabolic syndrome (cMetS) were determined. Statistical analysis was conducted after adjustment for covariate interactions.

Overall, 21 patients in the vitamin D group and 22 in the placebo group completed the trial. No significant difference was observed in the baseline characteristics of the two groups. After the trial, in the vitamin D group, serum insulin and triglyceride concentrations, as well as HOM-IR and C-MetS decreased significantly, both when compared with the baseline and with the placebo group. No significant difference was observed when comparing total cholesterol, LDL-C, HDL-C, fasting blood glucose, and blood pressure.

The present findings support the favorable effects of vitamin D supplementation on reducing insulin resistance and cardiometabolic risk factors in obese children.

Keywords:

Vitamin D

Metabolic syndrome

Insulin resistance

Children and adolescents

Resumo

Este ensaio clínico triplo-cego controlado visa investigar os efeitos da suplementação de vitamina D sobre a resistência à insulina e os fatores de risco cardiometabólico em crianças e adolescentes obesos.

O estudo contou com 50 participantes com idade entre 10 e 16 anos, aleatoriamente divididos em dois grupos de igual número de participantes. Neste ensaio clínico de 12 semanas, um grupo recebeu vitamina D via oral (300000 IU) e o outro grupo recebeu placebo. Foram determinados fatores de risco cardiometabólico, resistência à insulina e valor contínuo da síndrome metabólica (cMetS). A análise estatística foi conduzida após o ajuste das interações covariáveis.

No todo, 21 pacientes no grupo vitamina D e 22 no grupo placebo concluíram o ensaio clí- nico. Nenhuma diferença significativa foi encontrada nas características de base dos dois grupos estudados. Após o ensaio clinico, no grupo vitamina D, as concentrações séricas de insulina e triglicerídeos, bem como HOMA-RI e cMetS caíram significativamente em comparação ao início do estudo; e também em comparação ao grupo placebo. Nenhuma diferença significativa foi vista ao comparar o colesterol total, LDL-C, HDL-C, glicemia de jejum e pressão sanguínea.

Nossas conclusões indicam efeitos favoráveis da suplementação de vitamina D sobre a redução da resistência à insulina e de fatores de risco cardiometabólico em crianças obesas.

Palavras-chave:

Vitamina D

Síndrome metabólica

Resistência à insulina

Crianças e adolescents

O texto completo está disponível em PDF

Referências

[1]

M.E. da Conceição-Machado, L.R. Silva, M.L. Santana, E.J. Pinto, C. Silva Rde, L.T. Moraes, et al.

Hypertriglyceridemic waist phenotype: association with metabolic abnormalities in adolescents.

J Pediatr (Rio J)., 89 (2013), pp. 56-63

[2]

R. Kelishadi.

Childhood overweight, obesity, and the metabolic syndrome in developing countries.

Epidemiol Rev., 29 (2007), pp. 62-76

http://dx.doi.org/10.1093/epirev/mxm003 | Medline

[3]

R. Kelishadi, G. Ardalan, R. Gheiratmand, K. Adeli, A. Delavari, R. Majdzadeh, et al.

Paediatric metabolic syndrome and associated anthropometric indices: the CASPIAN Study.

Acta Paediatr., 95 (2006), pp. 1625-1634

http://dx.doi.org/10.1080/08035250600750072 | Medline

[4]

P. Khashayar, R. Heshmat, M. Qorbani, M.E. Motlagh, T. Aminaee, G. Ardalan, et al.

Metabolic Syndrome and Cardiovascular Risk Factors in a National Sample of Adolescent Population in the Middle East and North Africa: the CASPIAN III Study.

Int J Endocrinol., 2013 (2013), pp. 702095

http://dx.doi.org/10.1155/2013/702095 | Medline

[5]

A. Patel, Y. Zhan.

Vitamin D in cardiovascular disease.

Int J Prev Med., 3 (2012), pp. 664

Medline

[6]

B.J. Boucher.

Vitamin D insufficiency and diabetes risks.

Curr Drug Targets., 12 (2011), pp. 61-87

Medline

[7]

A. Salo, J.V. Logomarsino.

Relationship of vitamin D status and cardiometabolic risk factors in children and adolescents.

Pediatr Endocrinol Rev., 9 (2011), pp. 456-462

Medline

[8]

S.S. Harris, A.G. Pittas, N.J. Palermo.

A randomized, placebo- controlled trial of vitamin D supplementation to improve glycaemia in overweight and obese African Americans.

Diabetes Obes Metab., 14 (2012), pp. 789-794

http://dx.doi.org/10.1111/j.1463-1326.2012.01605.x | Medline

[9]

E. Borghi, M. de Onis, C. Garza, J. Van den Broeck, E.A. Frongillo, L. Grummer-Strawn, et al.

Construction of the World Health Organization child growth standards: selection of methods for attained growth curves.

Stat Med., 25 (2006), pp. 247-265

http://dx.doi.org/10.1002/sim.2227 | Medline

[10]

R. Kahn, J. Buse, E. Ferrannini, M. Stern.

American Diabetes Association; European Association for the Study of Diabetes. The metabolic syndrome: time for a critical appraisal: joint statement from the American Diabetes Association and the European Association for the Study of Diabetes.

Diabetes Care., 28 (2005), pp. 2289-2304

Medline

[11]

G. Shafiee, R. Kelishadi, R. Heshmat, M. Qorbani, M.E. Motlagh, T. Aminaee, et al.

First report on validity of a continuous metabolic syndrome score as an indicator for metabolic syndrome in a national sample of pediatric population: the CASPIAN-III Study.

Endocrynol Polska., (2013),

[12]

R. Kelishadi, N. Mirghaffari, P. Poursafa, S.S. Gidding.

Lifestyle and environmental factors associated with inflammation, oxidative stress and insulin resistance in children.

Atherosclerosis., 203 (2009), pp. 311-319

http://dx.doi.org/10.1016/j.atherosclerosis.2008.06.022 | Medline

[13]

Expert.

Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents; National Heart, Lung, and Blood Institute. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report.

Pediatrics., 128 (2011), pp. S213-S256

http://dx.doi.org/10.1542/peds.2009-2107C | Medline

[14]

M.F. Holick.

Vitamin D deficiency.

N Engl J Med., 357 (2007), pp. 266-281

http://dx.doi.org/10.1056/NEJMra070553 | Medline

[15]

G.E. Nam, D.H. Kim, K.H. Cho, Y.G. Park, K.D. Han, S.M. Kim, et al.

25-Hydroxyvitamin D insufficiency is associated with cardiometabolic risk in Korean adolescents: the 2008-2009 Korea National Health and Nutrition Examination Survey (KNHANES).

Public Health Nutr., (2012), pp. 1-9

http://dx.doi.org/10.1017/S1368980015000385 | Medline

[16]

L. Pacifico, C. Anania, J.F. Osborn, F. Ferraro, E. Bonci, E. Olivero, et al.

Low 25(OH)D3 levels are associated with total adiposity, metabolic syndrome, and hypertension in Caucasian children and adolescents.

Eur J Endocrinol., 165 (2011), pp. 603-611

http://dx.doi.org/10.1530/EJE-11-0545 | Medline

[17]

V. Ganji, X. Zhang, N. Shaikh, V. Tangpricha.

Serum 25-hydroxyvitamin D concentrations are associated with prevalence of metabolic syndrome and various cardiometabolic risk factors in US children and adolescents based on assay- adjusted serum 25-hydroxyvitamin D data from NHANES 2001-2006.

Am J Clin Nutr., 94 (2011), pp. 225-233

http://dx.doi.org/10.3945/ajcn.111.013516 | Medline

[18]

W.G. Petchey, I.J. Hickman, E. Duncan, J.B. Prins, C.M. Hawley, D.W. Johnson, et al.

The role of 25-hydroxyvitamin D deficiency in promoting insulin resistance and inflammation in patients with chronic kidney disease: a randomised controlled trial.

BMC Nephrol., 10 (2009), pp. 41

http://dx.doi.org/10.1186/1471-2369-10-41 | Medline

[19]

H.Y. Park, Y.H. Lim, J.H. Kim, S. Bae, S.Y. Oh, Y.C. Hong.

Association of serum 25-hydroxyvitamin D levels with markers for metabolic syndrome in the elderly: a repeated measure analysis.

J Korean Med Sci., 27 (2012), pp. 653-660

http://dx.doi.org/10.3346/jkms.2012.27.6.653 | Medline

[20]

S. Muldowney, A.J. Lucey, G. Paschos, J.A. Martinez, N. Bandarra, I. Thorsdottir, et al.

Relationships between vitamin D status and cardio-metabolic risk factors in young European adults.

Ann Nutr Metab., 58 (2011), pp. 85-93

http://dx.doi.org/10.1159/000324600 | Medline

[21]

E.E. Delvin.

Importance of vitamin D in insulin resistance.

Bull Acad Natl Med., 195 (2011), pp. 1091-1103

Medline

[22]

S.A. Chacko, Y. Song, J.E. Manson, L. Van Horn, C. Eaton, L.W. Martin, et al.

Serum 25-hydroxyvitamin D concentrations in relation to cardiometabolic risk factors and metabolic syndrome in postmenopausal women.

Am J Clin Nutr., 94 (2011), pp. 209-217

http://dx.doi.org/10.3945/ajcn.110.010272 | Medline

[23]

S. Salekzamani, T.R. Neyestani, H. Alavi-Majd, A. Houshiarrad, A. Kalayi, N. Shariatzadeh, et al.

Is vitamin D status a determining factor for metabolic syndrome?. A case-control study.

Diabetes Metab Syndr Obes., 4 (2011), pp. 205-212

http://dx.doi.org/10.2147/DMSO.S21061 | Medline

[24]

N.M. Al-Daghri, K.M. Alkharfy, Y. Al-Saleh, O.S. Al-Attas, M.S. Alokail, A. Al-Othman, et al.

Modest reversal of metabolic syndrome manifestations with vitamin D status correction: a 12-month prospective study.

Metabolism., 61 (2012), pp. 661-666

http://dx.doi.org/10.1016/j.metabol.2011.09.017 | Medline

[25]

E.S. Ford, U.A. Ajani, L.C. McGuire, S. Liu.

Concentrations of serum vitamin D and the metabolic syndrome among U.S. adults.

Diabetes Care., 28 (2005), pp. 1228-1230

Medline

[26]

D.R. Brenner, P. Arora, B. Garcia-Bailo, T.M. Wolever, H. Morrison, A. El-Sohemy, et al.

Plasma vitamin D levels and risk of metabolic syndrome in Canadians.

Clin Invest Med., 34 (2011), pp. E377

Medline

[27]

M.D. Witham, F.J. Dove, M. Dryburgh, J.A. Sugden, A.D. Morris, A.D. Struthers.

The effect of different doses of vitamin D(3) on markers of vascular health in patients with type 2 diabetes: a randomised controlled trial.

Diabetologia., 53 (2010), pp. 2112-2119

http://dx.doi.org/10.1007/s00125-010-1838-1 | Medline

[28]

M.H. Eftekhari, M. Akbarzadeh, M.H. Dabbaghmanesh, J. Hasanzadeh.

Impact of treatment with oral calcitriol on glucose indices in type 2 diabetes mellitus patients.

Asia Pac J Clin Nutr., 20 (2011), pp. 521-526

Medline

[29]

D. Erdönmez, S. Hatun, F.M. Çizmecioğlu, A. Keser.

No relationship between vitamin D status and insulin resistance in a group of high school students.

J Clin Res Pediatr Endocrinol., 3 (2011), pp. 198-201

http://dx.doi.org/10.4274/jcrpe.507 | Medline

[30]

E. Cavalier, W. Faché, J.C. Souberbielle.

A randomised, double- blinded, placebo-controlled, parallel study of vitamin D3 supplementation with different schemes based on multiples of 25,000 IU doses.

Int J Endocrinol., 2013 (2013), pp. 327265

http://dx.doi.org/10.1155/2013/327265 | Medline

☆

Como citar este artigo: Kelishadi R, Salek S, Salek M, Hashemipour M, Effects of vitamin D supplementation on insulin resistance and cardiometabolic risk factors in children with metabolic syndrome: a triple-masked controlled trial. J Pediatr (Rio J). 2014;90:28-34.

Indexada em:

Siga-nos:

Indexada em:

Siga-nos:

Receba a nossa Newsletter