Adiposity, inflammation and fat-soluble vitamins in adolescents

Paes-Silva, Rebecca Peixoto; Gadelha, Patrícia Calado Ferreira Pinheiro; Lemos, Maria da Conceição Chaves de; Castro, Célia Maria Machado Barbosa de; Arruda, Ilma Kruze Grande de; Diniz, Alcides da Silva

doi:10.1016/j.jped.2018.05.008

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Original articles • J. Pediatr. (Rio J.) 95 (5) • Sep-Oct 2019 • https://doi.org/10.1016/j.jped.2018.05.008 copy

Adiposity, inflammation and fat-soluble vitamins in adolescents^☆ ☆ Please cite this article as: Paes-Silva RP, Gadelha PC, Lemos MC, Castro CM, Arruda IK, Diniz AS. Adiposity, inflammation and fat-soluble vitamins in adolescents. J Pediatr (Rio J). 2019;95:575-83.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

Evaluate the association between inflammatory process, adiposity, and vitamins A, D, and E in adolescents, according to gender.

Methods:

Cross-sectional study with adolescents aged 12-19 years old of both genders attending public schools in Recife. A questionnaire was used to collect data on socioeconomic level, lifestyle, and food intake of adolescents. Then, an anthropometric evaluation and a blood sampling were performed to analyze serum concentrations of α-1-acid glycoprotein, retinol, β-carotene, α-tocopherol, and 25-hydroxy-vitamin D.

Results:

The levels of α-1-acid glycoprotein were higher for abdominal obesity in both genders. Male adolescents with insufficient serum α-tocopherol levels had low levels of α-1-acid glycoprotein (p = 0.03) and an increased risk of 25-hydroxy-vitamin D and β-carotene deficiency in relation to total and abdominal fat; female adolescents had an increased risk of insufficient β-carotene with abdominal obesity (PR: 1.33; 95% CI: 1.2-1.5).

Conclusion:

Abdominal adiposity implies a higher risk of inflammation and causes different changes to the levels of fat-soluble vitamins according to gender.

KEYWORDS
Obesity; Inflammation; Adolescents; Vitamins

Variables	n	%	95% CI
Gender
Male	160	38.9	34.1-43.8
Female	251	61.1	56.1-65.8
BMI/age
With excess weight	114	27.9	23.6-32.6
Without excess weight	294	72.1	67.4-76.4
WC
Normal	342	83.2	79.2-86.7
Elevated	69	16.8	13.3-20.8
WHtR
Normal	352	85.6	81.9-88.9
Elevated	59	14.4	11.1-18.1
Serum levels
Retinol
Adequate	265	67.9	63.1-72.6
Insufficient	125	32.1	27.4-36.9
β-carotene
Adequate	84	25.9	21.2-31.0
Insufficient	240	74.1	68.9-78.7
α-tocopherol
Adequate	47	11.9	8.9-15.5
Insufficient	347	88.1	84.4-91.1
25(OH)D
Adequate	202	49.1	44.2-54.1
Insufficient	209	50.9	45.9-55.8
Dietary intake Vitamin A
Adequate	285	71.3	66.5-75.6
Inadequate	115	28.8	24.3-33.4
Vitamin E
Adequate	14	16.3	2.2-6.6
Inadequate	335	83.8	93.4-97.8
Vitamin D
Adequate	3	0.7	0.1-2.1
Inadequate	408	99.3	97.9-99.8

		alpha-1-acid glycoprotein (g/L)
		Male gender			Female gender
	N	n	Mean ± SD	p^a a Student's t-test.BMI, body mass index; WC, waist circumference; WHtR, waist-to-height ratio; adequate serum retinol: >0.7 µmol/L, adequate β-carotene: >0.9 µmol/L; adequate α-tocopherol: >12 µmol/L; adequate 25(OH)D: >72.4 nmol/L. Estimated average requirement (EAR) of vitamin A for boys: >630 µg/day (9-13 years), >485 mg/day (14-18 years), vitamin A for girls: >625 mg/day (9-13 years), >500 µg/day (14-18 years); vitamin E >12 mg/day; vitamin D >10 µg/day.	n	Mean ± SD	p^a a Student's t-test.BMI, body mass index; WC, waist circumference; WHtR, waist-to-height ratio; adequate serum retinol: >0.7 µmol/L, adequate β-carotene: >0.9 µmol/L; adequate α-tocopherol: >12 µmol/L; adequate 25(OH)D: >72.4 nmol/L. Estimated average requirement (EAR) of vitamin A for boys: >630 µg/day (9-13 years), >485 mg/day (14-18 years), vitamin A for girls: >625 mg/day (9-13 years), >500 µg/day (14-18 years); vitamin E >12 mg/day; vitamin D >10 µg/day.
Nutritional status
BMI/age
Without excess weight	294	107	0.73 ± 0.19	0.09	187	0.75 ± 0.17	0.33
With excess weight	114	53	0.78 ± 0.17			0.78 ± 0.16
WC
Normal	342	121	0.73 ± 0.19	0.04	221	0.75 ± 0.17	< 0.01
Elevated	69	39	0.80 ± 0.17		30	0.83 ± 0.16
WHtR
Normal	352	130	0.73 ± 0.19	0.03	222	0.75 ± 0.17	0.06
Elevated	59	30	0.81 ± 0.17		29	0.81 ± 0.16
Serum levels
Retinol
Adequate	265	44	0.72 ± 0.20	0.26	81	0.78 ± 0.16	0.10
Insufficient	125	109	0.76 ± 0.19		156	0.75 ± 0.17
α-tocopherol
Adequate	47	27	0.82 ± 0.16	0.03	20	0.77 ± 0.13	0.88
Insufficient	347	126	0.73 ± 0.19		221	0.76 ± 0.17
25(OH)D
Adequate	202	96	0.73 ± 0.18	0.27	106	0.75 ± 0.16	0.58
Insufficient	209	64	0.77 ± 0.19		145	0.76 ± 0.18
β-carotene
Adequate	84	33	0.76 ± 0.23	0.82	51	0.77 ± 0.17	0.75
Insufficient	240	89	0.77 ± 0.17		151	0.76 ± 0.16
Dietary intake
Vitamin A
Adequate	199	09	0.73 ± 0.19	0.68	176	0.77 ± 0.17	0.11
Inadequate	201	46	0.77 ± 0.19		69	0.73 ± 0.15
Vitamin E
Adequate	24	24	0.71 ± 0.16	0.31	41	0.73 ± 0.16	0.29
Inadequate	376	131	0.75 ± 0.18		204	0.76 ± 0.17
Vitamin D
Adequate	1	2	0.73 ± 0.32	0.93	1	-	0.15
Inadequate	410	158	0.74 ± 0.18		250	0.75 ± 0.17

	Retinol (µmol/L)			α-tocopherol (µmol/L)			β-carotene (µmol/L)			25(OH)D (nmol/L)
	n	Mean ± SD	p ^a a Unpaired Student's t-test.	n	Median (IQR)	p ^b b Mann-Whitney test.	n	Median (IQR)	p ^b b Mann-Whitney test.	n	Median (IQR)	p ^b b Mann-Whitney test.
Male gender
BMI/age
With excess weight	53	0.97 ± 0.35	0.02	51	7.94 (6.33-12.35)	0.02	44	0.8969 (0.8967-0.8975)	< 0.001	53	68.25 (58.44-85.41)	0.001
Without excess weight	102	0.84 ± 0.32		102	6.75 (5.63-8.75)		78	0.8977 (0.8968-0.9249)		107	82.21 (67.42-101.14)
WC
Elevated	39	1.02 ± 0.37	0.03	37	8.56 (6.93-13.83)	0.003	35	0.8969 (0.8967-0.8976)	0.006	69	67.83 (58.34-80.89)	0.002
Normal	116	0.84 ± 0.31		116	6.59 (5.51-8.64)		87	0.8975 (0.8967-0.9206)		121	81.12 (65.52-101.14)
WHtR
Elevated	30	1.05 ± 0.31	0.02	30	10.67 (7.24-17.12)	< 0.001	28	0.8971 (0.8967-0.8978)	0.14	30	66.76 (58.99-75.69)	< 0.001
Normal	125	0.85 ± 0.33		123	6.64 (5.45-8.37)		94	0.8973 (0.8967-0.9159)		130	81.00 (64.97-102.05)
Female gender
BMI/age
With excess weight	60	0.85 ± 0.40	0.23	60	7.26 (6.34-8.45)	0.03	52	0.8971 (0.8968-0.8985)	0.08	61	66.30 (57.12-78.67)	0.35
Without excess weight	180	0.79 ± 0.32		179	6.51 (4.65-8.21)		148	0.89780 (0.8970-0.9024)		187	68.72 (59.02-82.21)
WC
Elevated	29	0.87 ± 0.46	0.26	29	7.42 (6.60-8.89)	0.02	24	0.8971 (0.8969-0.8979)	0.09	30	65.41 (55.82-78.57)	0.26
Normal	213	0.80 ± 0.32		212	6.62 (4.74-8.19)		178	0.8977 (0.8969-0.9022)		221	68.51 (59.12-83.33)
WHtR
Elevated	28	0.82 ± 0.39	0.86	28	7.41 (6.85-8.34)	0.03	24	0.8971 (0.8969-0.8979)	0.10	29	66.53 (56.08-78.67)	0.58
Normal	214	0.81 ± 0.33		213	6.61 (4.70-8.23)		178	0.8977 (0.8969-0.9022)		222	68.38 (58.49-82.54)

	Retinol (µmol/L)					α-tocopherol (µmol/L)					β-carotene (µmol/L)					25(OH)D (nmol/L)
		Insufficient					Insufficient					Insufficient					Insufficient
	N	n	%	PR (95% CI)	p ^a a Chi-squared test.	N	n	%	PR (95% CI)	p ^a a Chi-squared test.	N	n	%	PR (95% CI)	p ^a a Chi-squared test.	N	n	%	PR (95% CI)	p ^a a Chi-squared test.
Male gender
BMI/age
With excess weight	52	11	21.2	1.00		51	37	72.5	1.00		44	40	90.9	1.46 (1.2-1.8)	< 0.01	53	29	54.7	1.67 (1.2-2.41)	0.01
Without excess weight	101	33	32.7	1.54 (0.8-2.8)	0.19	102	89	87.3	1.20 (1.0-1.4)	0.04	78	49	62.8	1.00		107	35	32.7	1.00
WC
Elevated	38	6	15.8	1.00		37	25	67.6	1.00		35	32	91.4	1.40 (1.2-1.7)	< 0.01	39	22	56.4	1.63 (1.1-2.3)	0.02
Normal	115	38	33.0	6.33 (2.8-14.4)	0.06	116	101	87.1	1.29 (1.02-1.6)	0.01	87	57	65.5	1.00		121	42	34.7	1.00
WHtR
Elevated	29	3	10.3	1.00		30	18	60.0	1.00		28	24	85.7	1. 24 (1.0-1.5)	0.09^b b Fisher's exact test.	30	19	63.3	1.83 (1.3-2.6)	< 0.01
Normal	124	41	33.1	6.47 (2.2-19.9)	0.02	123	108	87.8	1.46 (1.1-1.9)	< 0.01	94	65	69.1	1.00		130	45	34.6	1.00
Female gender
BMI/age
With excess weight	57	20	35.1	1.64 (0.7-1.6)	0.87	60	52	86.7	1.00		52	44	84.6	1.19 (1.0-1.4)	0.06	61	38	62.3	1.09 (0.9-1.4)	0.55
Without excess weight	178	60	33.7	1.00		179	167	93.3	1.08 (0.97-1.2)	0.11	148	105	70.9	1.00		187	107	57.2	1.00
WC
Elevated	27	9	33.3	1.00		29	24	82.8	1.00		24	23	95.8	1.33 (1.2-1.5)	0.01	30	19	63.3	1.11 (0.8-1.5)	0.56
Normal	210	72	34.3	1.03 (0.6-1.8)	1.00	212	197	92.9	1.12 (0.95-1.3)	0.07^b b Fisher's exact test.	178	128	71.9	1.00		221	126	57.0	1.00
WHtR
Elevated	25	8	32.0	1.00		28	25	89.3	1.00		24	23	95.8	1.33 (1.2-1.5)	0.01	29	19	65.5	1.15 (0.9-1.5)	0.43
Normal	212	73	34.4	1.08 (0.6-1.9)	1.00	213	196	92.0	1.03 (0.9-1.2)	0.71^b b Fisher's exact test.	178	128	71.9	1.00		222	126	56.8	1.00

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[1] * Corresponding author. E-mail:rebecca.peixoto@gmail.com (R.P. Paes-Silva).

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Adiposity, inflammation and fat-soluble vitamins in adolescents☆ ☆ Please cite this article as: Paes-Silva RP, Gadelha PC, Lemos MC, Castro CM, Arruda IK, Diniz AS. Adiposity, inflammation and fat-soluble vitamins in adolescents. J Pediatr (Rio J). 2019;95:575-83.

Abstract

Objective:

Methods:

Results:

Conclusion:

Adiposity, inflammation and fat-soluble vitamins in adolescents^☆ ☆ Please cite this article as: Paes-Silva RP, Gadelha PC, Lemos MC, Castro CM, Arruda IK, Diniz AS. Adiposity, inflammation and fat-soluble vitamins in adolescents. J Pediatr (Rio J). 2019;95:575-83.