Vitamin D status is associated with early markers of cardiovascular disease in prepubertal children

Background: The associations of 25-hydroxyvitamin D [ 25(OH) D], non-high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL), and related markers of early cardiovascular disease (CVD) are unclear in prepubertal children. Objective: To investigate the association of 25(OH) D with markers of CVD. The hypothesis was that 25(OH) D would vary inversely with non-HDL-C. Subjects and methods: A prospective cross-sectional study of children (n=45; 26 males, 19 females) of mean age 8.3 +/- 2.5 years to investigate the relationships between 25(OH) D and glucose, insulin, high-sensitivity C-reactive protein, and lipids. Vitamin D deficiency was defined as 25(OH)D <20 ng/mL; overweight as body mass index (BMI) >= 85th but <95th percentile; and obesity as BMI >95th percentile. Results: Twenty subjects (44.4%) had BMI <85%, and 25 had BMI of >= 85%. Eleven participants (24.4%) had 25(OH) D of <20 ng/mL, and 10 (22.2%) had 25(OH) D of >30 ng/mL. Patients with 25(OH) D of <20 ng/mL had significantly elevated non-HDL-C (136.08 +/- 44.66 vs. 109.88 +/- 28.25, p=0.025), total cholesterol (TC)/HDL ratio (3.89 +/- 1.20 vs. 3.21 +/- 0.83, p=0.042), and triglycerides (TG) (117.09 +/- 71.27 vs. 73.39 +/- 46.53, p=0.024), while those with 25(OH) D of >30 ng/mL had significantly lower non-HDL-C, TC/HDL, TG, and LDL (82.40 +/- 18.03 vs. 105.15 +/- 28.38, p=0.006). Multivariate analysis showed significant inverse correlations between 25(OH) D and non-HDL cholesterol (beta=-0.337, p=0.043), and TC/HDL ratio (beta=-0.339, p=0.028), and LDL (beta=-0.359, p=0.016), after adjusting for age, race, sex, BMI, and seasonality. Conclusions: Vitamin D varied inversely with non-HDL, TC/HDL, and LDL. A 25(OH) D level of 30 ng/mL is associated with optimal cardioprotection in children.