Insights into Childhood Obesity: Sleep Patterns, Vitamin D, and Metabolic Dynamics

Yıl 2024, Cilt: 24 Sayı: 4, 201 - 206, 24.02.2025

Ekin Zeynep Altun , Pelin Bilir , Ayça Törel Ergür

https://doi.org/10.26650/jchild.2024.1558168

Öz

Objective: The high prevalence of childhood obesity necessitates a deeper understanding of its underlying pathophysiological mechanisms and associated conditions to effectively address this public health concern. This study investigated the association between vitamin D levels, insulin resistance, dyslipidemia, and sleep patterns in the context of childhood obesity.

Methods: This study used data from 115 obese children and adolescents aged 9.9–18 years, identified by body mass index (BMI, kg/m2) >95th percentile for the children receiving care at a Pediatric Endocrinology Outpatient Clinic. We collected sleep-related information, including onset time and duration, through direct parental questioning and compared these sleep patterns with key health indicators, such as vitamin D levels, insulin resistance, and dyslipidemia.

Results: Children who went to bed before 21:30 had the lowest mean HOMA-IR value (4.8±2.6), whereas children who slept between 21:30 and 23:00 (5.4±2.5) and after 23:00 (5.0±2.5) exhibited slightly higher values (p=0.374 and p=0.789, respectively). Similarly, children who went to bed earlier had lower mean levels of TC (158.7 mg/dl vs. 161.2 mg/dl), LDL (92.3 mg/dl vs. 95.6 mg/dl), and TG (84.1 mg/dl vs. 106.3 mg/dl) than those who slept later (p=0.743, p=0.619 and p=0.067, respectively). However, children who went to bed before 21:30 had significantly higher HDL levels (49.7 mg/dl vs. 44.3 mg/ dl, p=0.019). Regarding sleep duration and 25(OH)D levels, 58.0 % of children with 25(OH)D levels <20 µg/L slept ≤7 hours, whereas 42.0 % slept ≥8 hours. In contrast, 73.5 % of children with 25(OH)D levels ≥20 µg/L slept ≥8 hours, whereas only 26.5 % slept ≤7 hours (p=0.003).

Conclusions: Earlier bedtimes and sufficient sleep duration are associated with reduced insulin resistance, more favorable lipid profiles, and higher vitamin D levels in obese children.

Anahtar Kelimeler

Obese children, sleep time, sleep duration, vitamin D, insulin resistance

Kaynakça

• Deckelbaum RJ, Williams CL. Childhood Obesity: The Health Issue. Obes Res. 2001;9(S11):239S-243S. google scholar
• Lobstein T, Baur L, Uauy R. Obesity in children and young people: a crisis in public health. Obes Rev. 2004;5(s1):4-85. google scholar
• Nehus E, Mitsnefes M. Childhood Obesity and the Metabolic Syndrome. Pediatr Clin. 2019 Feb 1;66(1):31-43. google scholar
• Karlsson M, Mârild S, Brandberg J, Lönn L, Friberg P, Strandvik B. Serum Phospholipid Fatty Acids, Adipose Tissue, and Metabolic Markers in Obese Adolescents. Obesity. 2006;14(11):1931-9. google scholar
• Romano F, Muscogiuri G, Di Benedetto E, Zhukouskaya VV, Barrea L, Savastano S, et al. Vitamin D and sleep regulation: is there a role for vitamin D? Curr Pharm Des. 2020;26(21):2492-6. google scholar
• Samuel L, Borrell LN. The effect of body mass index on optimal vitamin D status in US adults: the National Health and Nutrition Examination Survey 2001-2006. Ann Epidemiol. 2013;23(7):409-14. google scholar
• Reis JP, von Mühlen D, Miller ER III, Michos ED, Appel LJ. Vitamin D Status and Cardiometabolic Risk Factors in the United States Adolescent Population. Pediatrics. 2009 Sep 1;124(3):e371-9. google scholar
• Atasoy V, Ateş Altunbaş E. Evaluation of Vitamin D levels among overweight and obese children. Türkiye Aile Hekim Derg. 2019 Sep 25;23(3):102-9. google scholar
• Mengen E. Obez Çocuklarda D Vitamini Düzeylerinin İnsülin Direnci ve Hepatosteatoz ile İlişkisi. Türkiye Çocuk Hastalık Derg. 2020;1-6. google scholar
• Karampela I, Sakelliou A, Vallianou N, Christodoulatos GS, Magkos F, Dalamaga M. Vitamin D and obesity: current evidence and controversies. Curr Obes Rep. 2021;10:162-80. google scholar
• Gominak SC, Stumpf WE. The world epidemic of sleep disorders is linked to vitamin D deficiency. Med Hypotheses. 2012;79(2):132-5. google scholar
• Gao Q, Kou T, Zhuang B, Ren Y, Dong X, Wang Q. The Association between Vitamin D Deficiency and Sleep Disorders: A Systematic Review and Meta-Analysis. Nutrients. 2018 Oct 1;10(10):1395. google scholar
• Mamun AA, Lawlor DA, Cramb S, O’Callaghan M, Williams G, Najman J. Do childhood sleeping problems predict obesity in young adulthood? Evidence from a prospective birth cohort study. Am J Epidemiol. 2007;166(12):1368-73. google scholar
• Gangwisch JE, Malaspina D, Boden-Albala B, Heymsfield SB. Inadequate sleep as a risk factor for obesity: analyses of the NHANES I. Sleep. 2005;28(10):1289-96. google scholar
• Abboud M. Vitamin D Supplementation and Sleep: A Systematic Review and Meta-Analysis of Intervention Studies. Nutrients. 2022 Mar 3;14(5):1076. google scholar
• Munns CF, Shaw N, Kiely M, Specker BL, Thacher TD, Ozono K, et al. Global Consensus Recommendations on Prevention and Management of Nutritional Rickets. J Clin Endocrinol Metab. 2016 Feb 1;101(2):394-415. google scholar
• Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and Ş-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985 Jul 1;28(7):412-9. google scholar
• Kurtoğlu S, Hatipoğlu N, Mazıcıoğlu M, Kendirci M, Keskin M, Kondolot M. Insulin Resistance in Obese Children and Adolescents: HOMA-IR Cut-Off Levels in the Prepubertal and Pubertal Periods - Original Article. J Clin Res Pediatr Endocrinol. 2010 Sep 15;2(3):100-6. google scholar
• Hirshkowitz M, Whiton K, Albert SM, Alessi C, Bruni O, DonCarlos L, et al. National Sleep Foundation’s sleep time duration recommendations: methodology and results summary. Sleep Health. 2015;1(1):40-3. google scholar
• Reutrakul S, Van Cauter E. Interactions between sleep, circadian function, and glucose metabolism: implications for risk and severity of diabetes. Ann N Y Acad Sci. 2014;1311(1):151-73. google scholar
• Morris CJ, Yang JN, Scheer FAJL. The impact of the circadian timing system on cardiovascular and metabolic function. In: Progress in Brain Research [Internet]. Elsevier; 2012 [cited 2023 Aug 25]. p. 337-58. Available from: https://linkinghub.elsevier.com/retrieve/ pii/B9780444594273000198 google scholar
• Simon SL, Behn CD, Cree-Green M, Kaar JL, Pyle L, Hawkins SM, et al. Too late and not enough: school year sleep duration, timing, and circadian misalignment are associated with reduced insulin sensitivity in adolescents with overweight/obesity. J Pediatr. 2019;205:257-64. google scholar
• Nedeltcheva AV, Kessler L, Imperial J, Penev PD. Exposure to Recurrent Sleep Restriction in the Setting of High Caloric Intake and Physical Inactivity Results in Increased Insulin Resistance and Reduced Glucose Tolerance. J Clin Endocrinol Metab. 2009 Sep;94(9):3242-50. google scholar
• Potter GD, Skene DJ, Arendt J, Cade JE, Grant PJ, Hardie LJ. Circadian rhythm and sleep disruption: causes, metabolic consequences, and countermeasures. Endocr Rev. 2016;37(6):584-608. google scholar
• Zhu R, Yang J, Zhai Z, Zhao H, Jiang F, Sun C, et al. The associations between sleep timing and night sleep duration with dyslipidemia in a rural population: The Henan Rural Cohort Study. Chronobiol Int. 2023 Sep 2;40(9):1261-9. google scholar
• Smiley A, King D, Harezlak J, Dinh P, Bidulescu A. The association between sleep duration and lipid profiles: the NHANES 2013-2014. J Diabetes Metab Disord. 2019;18:315-22. google scholar
• Massa J, Stone KL, Wei EK, Harrison SL, Barrett-Connor E, Lane NE, et al. Vitamin D and actigraphic sleep outcomes in older community-dwelling men: the MrOS sleep study. Sleep. 2015;38(2):251-7. google scholar
• Gong QH, Li SX, Li H, Chen Q, Li XY, Xu GZ. 25-Hydroxyvitamin D status and its association with sleep duration in Chinese schoolchildren. Nutrients. 2018;10(8):1013. google scholar
• Al-Shawwa B, Ehsan Z, Ingram DG. Vitamin D and sleep in children. J Clin Sleep Med. 2020 Jul 15;16(7):1119-23. google scholar
• Jean-Louis G, Williams NJ, Sarpong D, Pandey A, Youngstedt S, Zizi F, et al. Associations between inadequate sleep and obesity in the US adult population: analysis of the national health interview survey (1977-2009). BMC Public Health. 2014 Mar 29;14:290. google scholar