title: Association Between Serum 25-Hydroxy Vitamin D Levels and Blood Pressure Among Adolescents in Two Resource-Limited Settings in Peru.
abstract: BACKGROUND
  Serum 25-hydroxyvitamin D (25OHD) deficiency (<50 nmol/l or 20 ng/ml) has been associated with increased blood pressure (BP) in observational studies. A paucity of data on this relationship is available in Latin American or child populations. This study investigates the association between 25OHD levels and BP in adolescents at risk for vitamin D deficiency in 2 Peruvian settings.
  
  
  METHODS
  In a population-based study of 1,441 Peruvian adolescents aged 13-15 years, 1,074 (75%) provided a serum blood sample for 25OHD analysis and BP measurements. Relationships between 25OHD and BP metrics were assessed using multiple linear regressions, adjusted for anthropometrics and sociodemographic factors.
  
  
  RESULTS
  25OHD deficiency was associated with an elevated diastolic BP (DBP) (1.09 mm Hg increase, 95% confidence interval: 0.04 to 2.14; P = 0.04) compared to nondeficient adolescents. Systolic BP (SBP) trended to increase with vitamin D deficiency (1.30 mm Hg increase, 95% confidence interval: -0.13 to 2.72; P = 0.08). Mean arterial pressure (MAP) was also greater in adolescents with 25OHD (1.16 mm Hg increase, 95% confidence interval: 0.10 to 2.22; P = 0.03). SBP was found to demonstrate a U-shaped relationship with 25OHD, while DBP and MAP demonstrated inverse J-shaped relationships with serum 25OHD status. The association between 25OHD deficiency and BP was not different across study sites (all P ≥ 0.19).
  
  
  CONCLUSIONS
  Adolescents deficient in 25OHD demonstrated increased DBP and MAP and a trend toward increased SBP, when compared to nondeficient subjects. 25OHD deficiency early in life was associated with elevated BP metrics, which may predispose risk of hypertension later in adulthood.
authors.affiliation: Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA;
authors.forename: Katherine
authors.initials: K
authors.lastname: Tomaino
authors.affiliation: Biomedical Research Unit, A.B. PRISMA, Lima, Peru;
authors.forename: Karina M
authors.initials: KM
authors.lastname: Romero
authors.affiliation: Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA;
authors.forename: Colin L
authors.initials: CL
authors.lastname: Robinson
authors.affiliation: Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA;
authors.forename: Lauren M
authors.initials: LM
authors.lastname: Baumann
authors.affiliation: Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA;
authors.forename: Nadia N
authors.initials: NN
authors.lastname: Hansel
authors.affiliation: Program in Global Disease Epidemiology and Control, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA;
authors.forename: Suzanne L
authors.initials: SL
authors.lastname: Pollard
authors.affiliation: Program in Global Disease Epidemiology and Control, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA;
authors.forename: Robert H
authors.initials: RH
authors.lastname: Gilman
authors.affiliation: Center for Pharmacogenomics and Translational Research, Nemours Children Clinic, Jacksonville, Florida, USA.
authors.forename: Edward
authors.initials: E
authors.lastname: Mougey
authors.affiliation: Center for Pharmacogenomics and Translational Research, Nemours Children Clinic, Jacksonville, Florida, USA.
authors.forename: John J
authors.initials: JJ
authors.lastname: Lima
authors.affiliation: Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Program in Global Disease Epidemiology and Control, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA; wcheckl1@jhmi.edu.
authors.forename: William
authors.initials: W
authors.lastname: Checkley
mesh_terms: D000293:Adolescent; D062186:Arterial Pressure; D001249:Asthma / Q000453:epidemiology; D001794:Blood Pressure; D003430:Cross-Sectional Studies; D005260:Female; D006295:Health Resources; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D007182:Income / Q000706:statistics & numerical data; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D050177:Overweight / Q000453:epidemiology; D010568:Peru / Q000453:epidemiology; D012907:Smoking / Q000453:epidemiology; D014028:Tobacco Smoke Pollution / Q000706:statistics & numerical data; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000453:epidemiology*
chemical_list: D014028:Tobacco Smoke Pollution; D014807:Vitamin D; C104450:25-hydroxyvitamin D
keywords: 25OHD deficiency; adolescents; blood pressure; cardiovascular disease; diastolic blood pressure; hypertension; mean arterial pressure; systolic blood pressure.