Yıl: 2023 Cilt: 39 Sayı: 1 Sayfa Aralığı: 6 - 12 Metin Dili: İngilizce DOI: 10.4274/eamr.galenos.2022.61224 İndeks Tarihi: 08-05-2023

The Relationship Between Vitamin D Level and Ambulatory Blood Pressure Parameters and Cardiovascular Risk Factors

Öz:
Objective: It has been reported that the level of vitamin D in obese children is lower and that the low level of vitamin D creates a predisposition to hypertension. In this study, it was aimed to evaluate the relationship between vitamin D level, ambulatory blood pressure parameters, and cardiovascular risk factors in obese children. Methods: Age, gender, and anthropometric measurements, fasting serum glucose, insulin, transaminase levels, lipid profile, 25(OH) vitamin D levels, 24-hour ambulatory blood pressure monitoring data, electrocardiography and echocardiography data of the patients were retrospectively obtained from hospital records. Results: A total of 57 patients between the ages of 8-17 years, 26 females and 31 males, were included in the study. Patients were divided into two groups based on their vitamin D levels below and above 20 ng/mL. A total of 40 patients (70%) were hypertensive, and no correlation was found between blood pressure values and serum vitamin D levels in obese children in the correlation analysis. In the group with a vitamin D level lower than 20 ng/mL, the insulin level and homeostatic model assessment for insulin resistance (HOMA-IR) score were found to be significantly higher than in the other group (p=0.01, p=0.016, respectively). Furthermore, there was a positive correlation between the HOMA-IR score and systolic blood pressure load (r=0.280, p=0.03). Conclusion: Increased insulin resistance in obese children is associated with high blood pressure values. However, no direct relationship could be found between vitamin D levels and blood pressure profile.
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  • 1. James PT, Rigby N, Leach R; International Obesity Task Force. The obesity epidemic, metabolic syndrome and future prevention strategies. Eur J Cardiovasc Prev Rehabil 2004;11:3-8.
  • 2. Abrha S, Shiferaw S, Ahmed KY. Overweight and obesity and its sociodemographic correlates among urban Ethiopian women: evidence from the 2011 EDHS. BMC Public Health 2016;16:636.
  • 3. Kremer R, Campbell PP, Reinhardt T, Gilsanz V. Vitamin D status and its relationship to body fat, final height, and peak bone mass in young women. J Clin Endocrinol Metab 2009;94:67-73.
  • 4. Colak R, Anil M, Yasar F, Rahmi Bakiler A, Pirgon O, Helvaci M, et al. Metabolic disturbances and cardiovascular risk factors in obese children with vitamin D deficiency. Arch Pediatr 2020;27:140-5.
  • 5. Mengen E, Kocaay P. The relation of vitamin D levels to insulin resistance and hepatosteatosis in obese children. Turk J Pediatr Dis 2020;14:36-41.
  • 6. Bilici ME, Erdeve ŞS, Çetinkaya S, Aycan Z. The effect of 2000 ıu/day vitamin D supplementation on insulin resistance and cardiovascular risk parameters in vitamin D deficient obese adolescents. Turk J Pediatr 2019;61:723-32.
  • 7. Rusconi RE, De Cosmi V, Gianluca G, Giavoli C, Agostoni C. Vitamin D insufficiency in obese children and relation with lipid profile. Int J Food Sci Nutr 2015;66:132-4.
  • 8. Gul A, Ozer S, Yılmaz R, Sonmezgoz E, Kasap T, Takcı S, et al. Association between vitamin D levels and cardiovascular risk factors in obese children and adolescents. Nutr Hosp 2017;34:323-9.
  • 9. Wortsman J, Matsuoka LY, Chen TC, Lu Z, Holick MF. Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr 2000;72:690-3. Erratum in: Am J Clin Nutr 2003;77:1342.
  • 10. Holick MF. Vitamin D: evolutionary, physiological and health perspectives. Curr Drug Targets 2011;12:4-18.
  • 11. Delvin E, Souberbielle JC, Viard JP, Salle B. Role of vitamin D in acquired immune and autoimmune diseases. Crit Rev Clin Lab Sci 2014;51:232- 47.
  • 12. Maghbooli Z, Hossein-Nezhad A, Karimi F, Shafaei AR, Larijani B. Correlation between vitamin D3 deficiency and insulin resistance in pregnancy. Diabetes Metab Res Rev 2008;24:27-32.
  • 13. Li YC, Kong J, Wei M, Chen ZF, Liu SQ, Cao LP. 1,25-Dihydroxyvitamin D(3) is a negative endocrine regulator of the renin-angiotensin system. J Clin Invest 2002;110:229-38.
  • 14. Skrzypczyk P, Ofiara A, Szyszka M, Dziedzic-Jankowska K, Sołtyski J, Pańczyk-Tomaszewska M. Vitamin D in children with primary hypertension. Arterial Hypertens 2018;22:127-34.
  • 15. Ganji V, Zhang X, Shaikh N, Tangpricha V. 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 2011;94:225-33.
  • 16. Ruiz Pons M, García Nieto V, García MG, García Mérida M, Valenzuela Hdez C, Aguirre-Jaime A. Pérdida de la reducción de la presión arterial sistólica nocturna en el niño obeso [Reduced nocturnal systolic blood pressure dip in obese children]. Nefrologia 2008;28:517-24.
  • 17. Lurbe E, Torro I, Alvarez V, Nawrot T, Paya R, Redon J, et al. Prevalence, persistence, and clinical significance of masked hypertension in youth. Hypertension 2005;45:493-8.
  • 18. Pludowski P, Jaworski M, Niemirska A, Litwin M, Szalecki M, Karczmarewicz E, et al. Vitamin D status, body composition and hypertensive target organ damage in primary hypertension. J Steroid Biochem Mol Biol 2014;144:180-4.
  • 19. Dolinsky DH, Armstrong S, Mangarelli C, Kemper AR. The association between vitamin D and cardiometabolic risk factors in children: a systematic review. Clin Pediatr (Phila) 2013;52:210-23.
  • 20. Kao KT, Abidi N, Ranasinha S, Brown J, Rodda C, McCallum Z, et al. Low vitamin D is associated with hypertension in paediatric obesity. J Paediatr Child Health 2015;51:1207-13.
  • 21. Kelishadi R, Ardalan G, Motlagh ME, Shariatinejad K, Heshmat R, Poursafa P, et al. National report on the association of serum vitamin D with cardiometabolic risk factors in the pediatric population of the Middle East and North Africa (MENA): the CASPIAN-III Study. Nutrition 2014;30:33-8.
  • 22. Banzato C, Maffeis C, Maines E, Cavarzere P, Gaudino R, Fava C, et al. Hypovitaminosis D and nocturnal hypertension in obese children: an interesting link. J Hum Hypertens 2014;28:360-6.
  • 23. Pacifico L, Anania C, Osborn JF, Ferraro F, Bonci E, Olivero E, et al. Low 25(OH)D3 levels are associated with total adiposity, metabolic syndrome, and hypertension in Caucasian children and adolescents. Eur J Endocrinol 2011;165:603-11.
  • 24. Rajakumar K, Moore CG, Khalid AT, Vallejo AN, Virji MA, Holick MF, et al. Effect of vitamin D3 supplementation on vascular and metabolic health of vitamin D-deficient overweight and obese children: a randomized clinical trial. Am J Clin Nutr 2020;111:757-68.
  • 25. Dong Y, Stallmann-Jorgensen IS, Pollock NK, Harris RA, Keeton D, Huang Y, et al. A 16-week randomized clinical trial of 2000 international units daily vitamin D3 supplementation in black youth: 25-hydroxyvitamin D, adiposity, and arterial stiffness. J Clin Endocrinol Metab 2010;95:4584- 91.
  • 26. Khayyatzadeh SS, Mirmoosavi SJ, Fazeli M, Abasalti Z, Avan A, Javandoost A, et al. High-dose vitamin D supplementation is associated with an improvement in several cardio-metabolic risk factors in adolescent girls: a nine-week follow-up study. Ann Clin Biochem 2018;55:227-35.
  • 27. Misra M, Pacaud D, Petryk A, Collett-Solberg PF, Kappy M; Drug and Therapeutics Committee of the Lawson Wilkins Pediatric Endocrine Society. Vitamin D deficiency in children and its management: review of current knowledge and recommendations. Pediatrics 2008;122:398- 417.
  • 28. Gordon CM, DePeter KC, Feldman HA, Grace E, Emans SJ. Prevalence of vitamin D deficiency among healthy adolescents. Arch Pediatr Adolesc Med 2004;158:531-7.
  • 29. Flynn JT, Kaelber DC, Baker-Smith CM, Blowey D, Carroll AE, Daniels SR, et al. Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics 2017;140:e20171904. Erratum in: Pediatrics 2017. Erratum in: Pediatrics 2018;142.
  • 30. Milagres LC, Rocha NP, Filgueiras MS, Albuquerque FM, Castro APP, Pessoa MC, et al. Vitamin D insufficiency/deficiency is associated with insulin resistance in Brazilian children, regardless of body fat distribution. Public Health Nutr 2017;20:2878-86.
  • 31. Moore CE, Liu Y. Elevated systolic blood pressure of children in the United States is associated with low serum 25-hydroxyvitamin D concentrations related to body mass index: National Health and Examination Survey 2007-2010. Nutr Res 2017;38:64-70.
  • 32. Reis JP, von Mühlen D, Miller ER 3rd, Michos ED, Appel LJ. Vitamin D status and cardiometabolic risk factors in the United States adolescent population. Pediatrics 2009;124:e371-e379.
  • 33. Nam GE, Kim DH, Cho KH, Park YG, Han KD, Kim SM, 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 2014;17:186-94.
APA Sulu A, ALTAY E, Kosger P, Kiztanir H, Ucar B (2023). The Relationship Between Vitamin D Level and Ambulatory Blood Pressure Parameters and Cardiovascular Risk Factors. , 6 - 12. 10.4274/eamr.galenos.2022.61224
Chicago Sulu Ayse,ALTAY EMİNE,Kosger Pelin,Kiztanir Hikmet,Ucar Birsen The Relationship Between Vitamin D Level and Ambulatory Blood Pressure Parameters and Cardiovascular Risk Factors. (2023): 6 - 12. 10.4274/eamr.galenos.2022.61224
MLA Sulu Ayse,ALTAY EMİNE,Kosger Pelin,Kiztanir Hikmet,Ucar Birsen The Relationship Between Vitamin D Level and Ambulatory Blood Pressure Parameters and Cardiovascular Risk Factors. , 2023, ss.6 - 12. 10.4274/eamr.galenos.2022.61224
AMA Sulu A,ALTAY E,Kosger P,Kiztanir H,Ucar B The Relationship Between Vitamin D Level and Ambulatory Blood Pressure Parameters and Cardiovascular Risk Factors. . 2023; 6 - 12. 10.4274/eamr.galenos.2022.61224
Vancouver Sulu A,ALTAY E,Kosger P,Kiztanir H,Ucar B The Relationship Between Vitamin D Level and Ambulatory Blood Pressure Parameters and Cardiovascular Risk Factors. . 2023; 6 - 12. 10.4274/eamr.galenos.2022.61224
IEEE Sulu A,ALTAY E,Kosger P,Kiztanir H,Ucar B "The Relationship Between Vitamin D Level and Ambulatory Blood Pressure Parameters and Cardiovascular Risk Factors." , ss.6 - 12, 2023. 10.4274/eamr.galenos.2022.61224
ISNAD Sulu, Ayse vd. "The Relationship Between Vitamin D Level and Ambulatory Blood Pressure Parameters and Cardiovascular Risk Factors". (2023), 6-12. https://doi.org/10.4274/eamr.galenos.2022.61224
APA Sulu A, ALTAY E, Kosger P, Kiztanir H, Ucar B (2023). The Relationship Between Vitamin D Level and Ambulatory Blood Pressure Parameters and Cardiovascular Risk Factors. European Archives of Medical Research, 39(1), 6 - 12. 10.4274/eamr.galenos.2022.61224
Chicago Sulu Ayse,ALTAY EMİNE,Kosger Pelin,Kiztanir Hikmet,Ucar Birsen The Relationship Between Vitamin D Level and Ambulatory Blood Pressure Parameters and Cardiovascular Risk Factors. European Archives of Medical Research 39, no.1 (2023): 6 - 12. 10.4274/eamr.galenos.2022.61224
MLA Sulu Ayse,ALTAY EMİNE,Kosger Pelin,Kiztanir Hikmet,Ucar Birsen The Relationship Between Vitamin D Level and Ambulatory Blood Pressure Parameters and Cardiovascular Risk Factors. European Archives of Medical Research, vol.39, no.1, 2023, ss.6 - 12. 10.4274/eamr.galenos.2022.61224
AMA Sulu A,ALTAY E,Kosger P,Kiztanir H,Ucar B The Relationship Between Vitamin D Level and Ambulatory Blood Pressure Parameters and Cardiovascular Risk Factors. European Archives of Medical Research. 2023; 39(1): 6 - 12. 10.4274/eamr.galenos.2022.61224
Vancouver Sulu A,ALTAY E,Kosger P,Kiztanir H,Ucar B The Relationship Between Vitamin D Level and Ambulatory Blood Pressure Parameters and Cardiovascular Risk Factors. European Archives of Medical Research. 2023; 39(1): 6 - 12. 10.4274/eamr.galenos.2022.61224
IEEE Sulu A,ALTAY E,Kosger P,Kiztanir H,Ucar B "The Relationship Between Vitamin D Level and Ambulatory Blood Pressure Parameters and Cardiovascular Risk Factors." European Archives of Medical Research, 39, ss.6 - 12, 2023. 10.4274/eamr.galenos.2022.61224
ISNAD Sulu, Ayse vd. "The Relationship Between Vitamin D Level and Ambulatory Blood Pressure Parameters and Cardiovascular Risk Factors". European Archives of Medical Research 39/1 (2023), 6-12. https://doi.org/10.4274/eamr.galenos.2022.61224