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Abstract
Objective Vitamin D deficiency has recently evolved as a major public health issue worldwide. But the relationship between vitamin D and cardiovascular health in children remains unclear. Accordingly, we aimed to examine the associations between 25-hydroxyvitamin D (25(OH)D) concentrations and cardiometabolic risk factors, and to assess the possible effect modification of obesity on the associations in a Chinese pediatric population.
Research design and methods A cross-sectional sample of 6091 children aged 6–18 years was obtained using a cluster sampling method. The 25(OH)D concentrations, and metabolic risk factors, including waist to height ratio, blood pressure, blood lipids, fasting blood glucose (FBG), and insulin were measured. Adjusted ORs and multiplicative or additive interaction were calculated to assess the associations and effect modification, respectively.
Results Triglycerides, FBG, insulin, and homeostasis model assessment of insulin resistance were inversely associated with 25(OH)D concentrations (p<0.05) in both sexes. The OR of hyperglycemia among individuals with insufficient vitamin D was higher than those with adequate vitamin D after adjusting for covariates (OR: 1.47; 95% CI 1.26 to 1.70). Moreover, girls with insufficient vitamin D had significantly higher odds for hypertension and high total cholesterol than those with adequate vitamin D, which was not observed in boys. Thirty-two percent (95% CI 14% to 51%) of the increased odds of hyperglycemia can be explained by the interaction between insufficient vitamin D and obesity.
Conclusions Vitamin D insufficiency is associated with increased odds of various cardiometabolic risk factors in Chinese children and has a synergistic effect on hyperglycemia with obesity.
- hyperglycemia
- population-based interaction
- cardiovascular disease risk
- children
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Footnotes
PX and HD contributed equally.
Contributors JM had full access to all the data in the study and takes responsibility for the integrity of the data, conceptualized and designed the study, reviewed and revised the manuscript. PX and HD conducted all analyses, interpreted the results, drafted and revised the manuscript. HL and YY critically reviewed and revised the manuscript. JL, HC, XZ, and DH were involved in data acquisition. JM had the primary responsibility for the final content.
Funding The study was supported by grants from the National Key Research and Development Program of China (2016YFC0900602), and the Beijing Training Project for the Leading Talents in Science and Technology (2009108 and 2011LJ07).
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval The study protocol conformed to the ethical guidelines of the 1975 Declaration of Helsinki and was approved by Ethical Review Committee of Capital Institute of Pediatrics (approval number: 2012062). Written informed consent forms for all participants were obtained from their parents or legal guardians.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available upon reasonable request. The data sets generated during and/or analyzed during the current study are available from the corresponding author upon reasonable request.