title: National report on the association of serum vitamin D with cardiometabolic risk factors in the pediatric population of the Middle East and North Africa (MENA): the CASPIAN-III Study.
abstract: OBJECTIVE
  As the first, to our knowledge, nationwide study in the Middle East and North Africa (MENA), this study aimed to investigate the association of serum 25 hydroxy vitamin D [25(OH)D] levels with cardiometabolic risk factors in a nationally representative sample of the pediatric population in Iran. The second objective was to provide the prevalence of hypovitaminosis D and the percentiles of serum 25(OH)D in the study population.
  
  
  METHODS
  This national population-based study was conducted among 1100 Iranian students living in 27 provinces in Iran. The association of 25(OH)D with each cardiometabolic risk factor was determined after adjustment for age, gender, body mass index, and waist circumference.
  
  
  RESULTS
  Participants consisted of 1095 students (52% boys) with a mean age of 14.74 ± 2.61 y. The median 25(OH)D level corresponded to a vitamin D insufficiency level: 12.70 ng/mL in boys and 13.20 ng/mL in girls. Overall, 40% of participants were vitamin D deficient, and 39% had vitamin D insufficiency. There were no significant differences in these findings between boys and girls. Adjusted regression analysis revealed a significant weak inverse association of 25(OH)D with systolic blood pressure, diastolic blood pressure, total cholesterol, and low-density lipoprotein cholesterol. This association was significantly positive with high-density lipoprotein cholesterol, but not with fasting plasma glucose and metabolic syndrome.
  
  
  CONCLUSIONS
  We found a considerably high prevalence of hypovitaminosis D in the pediatric population of a sunny region. Our findings also revealed an association of hypovitaminosis D with many cardiometabolic risk factors from childhood; these associations were independent of obesity indexes. It is of special concern that the highly prevalent disorders of low 25(OH)D and low high-density lipoprotein cholesterol in children and adolescents of the MENA region had significant association. The clinical importance of our findings needs to be confirmed in longitudinal studies.
authors.affiliation: Pediatrics Department, Child Growth and Development Research Center, and Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Electronic address: kelishadi@med.mui.ac.ir.
authors.forename: Roya
authors.initials: R
authors.lastname: Kelishadi
authors.forename: Gelayol
authors.initials: G
authors.lastname: Ardalan
authors.forename: Mohammad Esmail
authors.initials: ME
authors.lastname: Motlagh
authors.forename: Keyvan
authors.initials: K
authors.lastname: Shariatinejad
authors.forename: Ramin
authors.initials: R
authors.lastname: Heshmat
authors.forename: Parinaz
authors.initials: P
authors.lastname: Poursafa
authors.forename: Maryam
authors.initials: M
authors.lastname: Fakhri
authors.forename: Mohamadhasan
authors.initials: M
authors.lastname: Tajadini
authors.forename: Mahnaz
authors.initials: M
authors.lastname: Taslimi
mesh_terms: D000293:Adolescent; D000352:Africa, Northern / Q000453:epidemiology; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D014807:Vitamin D / Q000097:blood*; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D055105:Waist Circumference
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014807:Vitamin D
keywords: Adolescents; Cardiometabolic risk factors; Vitamin D