Vitamin D status and cardiometabolic risk factors in Greek adolescents with obesity – the effect of vitamin D supplementation: a pilot study

INTRODUCTION: Obesity is associated with cardiovascular disease (CVD) risk factors as well as decreased 25(OH) vitamin D serum levels. We aimed to study 25(OH) vitamin D levels in adolescents with obesity compared with normal weight controls in association with CVD risk factors, and the possible effect of vitamin D supplementation. MATERIAL AND METHODS: In a cross-sectional study, 69 obese and 34 normal-weight adolescents were included. In an interventional study 15 adolescents with obesity and vitamin D insufficiency were given 2000 IU vitamin D per os daily for 3 months. RESULTS: Adolescents with obesity had significantly lower 25(OH) vitamin D levels compared with normal-weight controls (12.0 (3.0–36.0) vs. 34.0 (10.0–69.0) ng/ml, respectively, p < 0.001). In adolescents with obesity, 25(OH) vitamin D was inversely associated with leptin even after adjustment for body mass index (BMI) (r = –0.340, p = 0.009). Conversely, 25(OH) vitamin D was not related with other parameters, such as BMI, blood pressure, lipids, glucose, insulin, homeostasis model assessment (HOMA) index, adiponectin, leptin/adiponectin ratio, and visfatin levels. Following supplementation in 15 vitamin D insufficient adolescents with obesity, 25(OH) vitamin D significantly increased (from 17.3 (12.5–27.8) to 32.6 (14.3–68.0) ng/ml, p = 0.005) and so did low-density lipoprotein cholesterol (LDL-C) (from 85.4 ±9.5 to 92.1 ±15.8 mg/dl, p = 0.022), while there were reductions in glycated haemoglobin (HbA(1c)) (from 5.8 ±0.2 to 5.5 ±0.1%, p = 0.03) and leptin (from 19.7 (7.8–45.5) to 15.1 (4.3–37.3) ng/ml, p = 0.03). Oxidised LDL, paraoxonase, arylesterase, and urine isoprostanes remained unchanged. CONCLUSIONS: Adolescents with obesity had lower 25(OH) vitamin D, which may be associated with higher leptin levels. Vitamin D supplementation may lead to HbA(1c) and leptin reductions, but also to an increase in LDL-C.