Objective To analyze the characteristics of pulmonary ventilation function in school-age obese children and its correlation with serum 25-hydroxyvitamin D [25-(OH)D], and to explore the mechanism of the effect of vitamin D on the pulmonary function of obese children. Methods Totally 104 obese children aged 6-12 years were recruited from January 2019 to January 2020 to measure their height, body mass, serum 25-(OH)D level and pulmonary ventilation function.Pulmonary ventilation function parameters were compared in obese children with deficient, insufficient and appropriate serum vitamin D level.Multiple linear regression was used to analyze the correlation between serum vitamin D and pulmonary function parameters. Results The lung function parameters in mild to moderate obesity group were higher than those in severe obesity group, and the differences in FEF50% and MMEF between the two groups was significant (t=2.808,2.164, P<0.05).The difference in FEV1, FVC, PEF, FEF25%, FEF50% and FEF75% were significant among obese children with deficient, insufficient and appropriate serum vitamin D level(F=3.988, 4.758, 3.142, 5.186, 3.478, 3.220, P<0.05).Multiple linear regression showed that pulmonary function parameters FEV1, FVC, PEF, FEF25%, FEF50%, FEF75% and MMEF were positively linear correlated with serum 25-(OH)D level (B=0.341, 0.315, 0.371, 0.745, 0.665, 0.715, 0.613, P<0.05).Significant correlation was not found between FEV1/FVC, FEV1/FVC% and serum 25-(OH)D level. Conclusion There is a linear positive correlation between serum 25-(OH)D level and some lung function parameters of school-age obese children, which may be a protective factor of lung function of obese children.
Key words
childhood obesity /
pulmonary function /
vitamin D
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
References
[1] 马冠生,张玉.中国儿童肥胖防控面临的挑战和机遇[J].中国儿童保健杂志, 2020,28(2):117-119.
[2] 马淑婧,张艳青,羊柳,等.1991—2015年中国9个省份儿童青少年超重和肥胖率的变化趋势分析[J].中华预防医学杂志,2020,54(2):133-138.
[3] 叶佩玉,陈芳芳,米杰.儿童期肥胖的健康危害:来自中国人群的证据[J].中华预防医学杂志,2016,50(1):97-100.
[4] Lautenbacher LA,Jariwala SP,Markowitz ME,et al.Vitamin D and pulmonary function in obese asthmatic children[J].Pediatr Pulmonol, 2016,51(12):1276-1283.
[5] 李辉,季成叶,宗心南,等.中国0~18岁儿童、青少年体块指数的生长曲线[J].中华儿科杂志,2009,47(7):493-498.
[6] Styne DM,Arslanian SA,Connor EL,et al.Pediatric obesity-assessment, treatment, and prevention:an endocrine society clinical practice guideline[J].J Clin Endocrinol Metab,2017,102(3):709-757.
[7] 罗飞宏,沈水仙,屠月珍,等.上海市6~18岁儿童青少年体重指数的分布特征[J].中华内分泌代谢杂志,2004,20(6):506-509.
[8] Zhou YP,Zhang Q,Wang T,et al.Prevalence of overweight and obesity in Chinese children and adolescents from 2015[J].Ann Hum Biol,2017,44(7):642-643.
[9] Zhang J,Li XY,Hawley N,et al.Trends in the prevalence of overweight and obesity among chinese school-age children and adolescents from 2010 to 2015[J].Child Obes,2018,14(3):182-188.
[10] Dixon AE,Peters U.The effect of obesity on lung function[J].Expert Rev Respir Med,2018,12(9):755-767.
[11] Lang JE.Obesity and childhood asthma[J].Curr Opin Pulm Med, 2019,25(1):34-43.
[12] Fretzayas A,Moustaki M,Loukou I,et al.Is obesity related to the lung function of non-asthmatic children?[J].World J Clin Pediatr,2018,7(2):67-74.
[13] 董文芳,张磊,邬宇芬,等.肥胖哮喘患儿肺功能改变特点观察[J].中国实用儿科杂志,2015,30(11):864-867.
[14] Park JE,Tirupathi Pichiah PB,Cha YS.Vitamin D and metabolic diseases:growing roles of vitamin D[J].J Obes Metab Syndr,2018,27(4):223-232.
[15] 郭锡熔.维生素D缺乏与儿童肥胖[J].中国儿童保健杂志,2018,26(12):1280-1283,1288.
[16] Chen HL,Lu R,Zhang YG,et al.Vitamin D receptor deletion leads to the destruction of tight and adherens junctions in lungs[J].Tissue Barriers,2018.6(4):1-13.
[17] Bugadze L,Manjavidze N,Jorjoliani L.Asthma control status and lung function in relation to vitamin D level in children with bronchial asthma[J].Georgian Med News,2018,(283):115-118.
[18] 程小秋,邓笑伟.体检人群25羟基-维生素D与肺功能相关的研究[J].临床肺科杂志,2017,22(10):1854-1858.
[19] HyppÖnen E,Boucher BJ.Adiposity,vitamin D requirements,and clinical implications for obesity-related metabolic abnormalities[J].Nutr Rev,2018,76(9):678-692.
[20] Lotfi-Dizaji L,Mahboob S,Aliashrafi S,et al.Effect of vitamin D supplementation along with weight loss diet on meta-inflammation and fat mass in obese subjects with vitamin D deficiency:a double-blind placebo-controlled randomized clinical trial[J].Clin Endocrinol(Oxf),2019,90(1):94-101.
[21] 赵丽平,陈绩,杨婷,等.儿童维生素D缺乏症药物治疗循证指南的系统评价[J].中国循证医学杂志,2015,15(3):270-275.