Background/Aims: Vitamin D deficiency is highly prevalent in obese children, and obese children tend to respond poorly to vitamin D supplementation. The objective of the study was to compare the response to vitamin D3 supplementation (2,000 IU once daily for 12 weeks) between obese and non-obese Caucasian adolescents. Methods: The study design was open label non-randomized. It was carried out at a single center. Eighteen obese adolescents (aged 12–18 years) and the same number of age-, gender- and season-matched non-obese adolescents received vitamin D3 (2,000 IU/day) orally for 12 weeks. Total serum 25-hydroxyvitamin D [25(OH)D], parathyroid hormone, calcium and phosphorus were measured at baseline and at the end of the 12-week period. Results: The mean baseline 25(OH)D level was higher in the non-obese compared to the obese subjects (mean 28.9 vs. 25.2 ng/ml; p = 0.029). The increment in 25(OH)D levels following vitamin D supplementation was significantly lower in the obese adolescents (mean change 5.8 vs. 9.8 ng/ml; p = 0.019). Conclusions: Higher doses of vitamin D are required to treat vitamin D deficiency in obese adolescents compared to their non-obese peers.

1.
Rovner AJ, O’Brien KO: Hypovitaminosis D among healthy children in the United States: a review of the current evidence. Arch Pediatr Adolesc Med 2008;162:513–519.
2.
Gordon CM, DePeter KC, Feldman HA, Grace E, Emans SJ: Prevalence of vitamin D deficiency among healthy adolescents. Arch Pediatr Adolesc Med 2004;158:531–537.
3.
Sullivan SS, Rosen CJ, Halteman WA, Chen TC, Holick MF: Adolescent girls in Maine are at risk for vitamin D insufficiency. J Am Diet Assoc 2005;105:971–974.
4.
Kumar J, Muntner P, Kaskel FJ, Hailpern SM, Melamed ML: Prevalence and associations of 25-hydroxyvitamin D deficiency in US children: NHANES 2001–2004. Pediatrics 2009;124:e362–e370.
5.
Ginde AA, Liu MC, Camargo CA Jr: Demographic differences and trends of vitamin D insufficiency in the US population, 1988–2004. Arch Intern Med 2009;169:626–632.
6.
Thomas MK, Lloyd-Jones DM, Thadhani RI, Shaw AC, Deraska DJ, Kitch BT, et al: Hypovitaminosis D in medical inpatients. N Engl J Med 1998;338:777–783.
7.
Holick MF, Siris ES, Binkley N, Beard MK, Khan A, Katzer JT, et al: Prevalence of vitamin D inadequacy among postmenopausal North American women receiving osteoporosis therapy. J Clin Endocrinol Metab 2005;90:3215–3224.
8.
Chapuy MC, Preziosi P, Maamer M, Arnaud S, Galan P, Hercberg S, et al: Prevalence of vitamin D insufficiency in an adult normal population. Osteoporos Int 1997;7:439–443.
9.
Wortsman J, Matsuoka LY, Chen TC, Lu Z, Holick MF: Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr 2000;72:690–693.
10.
Harel Z, Flanagan P, Forcier M, Harel D: Low vitamin D status among obese adolescents: prevalence and response to treatment. J Adolesc Health 2011;48:448–452.
11.
Smotkin-Tangorra M, Purushothaman R, Gupta A, Nejati G, Anhalt H, Ten S: Prevalence of vitamin D insufficiency in obese children and adolescents. J Pediatr Endocrinol Metab 2007;20:817–823.
12.
Rajakumar K, de las Heras J, Chen TC, Lee S, Holick MF, Arslanian SA: Vitamin D status, adiposity, and lipids in black American and Caucasian children. J Clin Endocrinol Metab 2011;96:1560–1567.
13.
Alemzadeh R, Kichler J, Babar G, Calhoun M: Hypovitaminosis D in obese children and adolescents: relationship with adiposity, insulin sensitivity, ethnicity, and season. Metabolism 2008;57:183–191.
14.
Misra M, Pacaud D, Petryk A, Collett-Solberg PF, Kappy M: Vitamin D deficiency in children and its management: review of current knowledge and recommendations. Pediatrics 2008;122:398–417.
15.
Ross AC, Manson JE, Abrams SA, Aloia JF, Brannon PM, Clinton SK, et al: The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab 2011;96:53–58.
16.
Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al: Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2011;96:1911–1930.
17.
Wagner CL, Greer FR: Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics 2008;122:1142–1152.
18.
Rajakumar K, Fernstrom JD, Holick MF, Janosky JE, Greenspan SL: Vitamin D status and response to Vitamin D(3) in obese vs non-obese African American children. Obesity (Silver Spring) 2008;16:90–95.
19.
Ashraf AP, Alvarez JA, Gower BA, Saenz KH, McCormick KL: Associations of serum 25-hydroxyvitamin D and components of the metabolic syndrome in obese adolescent females. Obesity (Silver Spring) 2011;19:2214–2221.
20.
Lensmeyer GL, Wiebe DA, Binkley N, Drezner MK: HPLC method for 25-hydroxyvitamin D measurement: comparison with contemporary assays. Clin Chem 2006;52:1120–1126.
21.
Holick MF: Vitamin D deficiency. N Engl J Med 2007;357:266–281.
22.
Kuczmarski RJ, Ogden CL, Guo SS, Grummer-Strawn LM, Flegal KM, Mei Z, et al: 2000 CDC Growth Charts for the United States: methods and development. Vital Health Stat 11 2002;1–190.
23.
Maalouf J, Nabulsi M, Vieth R, Kimball S, El-Rassi R, Mahfoud Z, et al: Short- and long-term safety of weekly high-dose vitamin D3 supplementation in school children. J Clin Endocrinol Metab 2008;93:2693–2701.
24.
Bell NH, Epstein S, Greene A, Shary J, Oexmann MJ, Shaw S: Evidence for alteration of the vitamin D-endocrine system in obese subjects. J Clin Invest 1985;76:370–373.
25.
Scragg R, Sowers M, Bell C: Serum 25-hydroxyvitamin D, diabetes, and ethnicity in the Third National Health and Nutrition Examination Survey. Diabetes Care 2004;27:2813–2818.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.