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Background <p>Obesity has become a direct factor that severely affects the growth and development of children and adolescents. 25-Hydroxy vitamin D (25-(OH)D) is a fat-soluble vitamin that regulates the maturation of reproductive organs and secondary sexual characteristics in humans. This study aimed to explore the correlations between serum 25(OH)D levels, inflammatory parameters, and metabolism-related parameters and bone age (BA) and bone mineral density (BMD) in obese children and adolescents.</p> Methods <p>A total of 233 children and adolescents aged 3–17&#xa0;years (median age 8&#xa0;years [IQR: 6, 11]) who underwent physical examinations at a tertiary hospital in central and eastern China between July 2022 and June 2024 were included. BA and BMD were measured. Physical activity was evaluated using the International Physical Activity Questionnaire-Short Form (IPAQ-S). Pearson's correlation analysis was used to examine the relationships among 25(OH)D, inflammatory parameters, metabolic parameters, BA, bone density, and obesity across different groups. The diagnostic value of 25(OH)D, BA, and IGF-1 in central precocious puberty was determined by receiver operating characteristic (ROC) curve analysis.</p> Results <p>Among the 233 subjects, 66 (28.33%) were defined as obese based on body mass index (BMI) and the standard deviation&#xa0;(SDS)&#xa0;score&#xa0;(1.645). Compared with nonobese individuals, obese children had significantly lower 25(OH)D levels, higher insulin resistance indices (insulin, HbA1c, and HOMA-IR), higher dyslipidemia (higher TC and LDL levels and lower HDL levels), and higher systemic inflammatory indices (NLR, SII, and SIRI), as well as higher BA levels and lower BMD Z scores (all <i>P</i> &lt; 0.05). In obese children, the 25(OH)D was markedly lower in the advanced BA group than in the normal BA group (<i>P</i> = 0.0003), whereas the glucose, lipid, and inflammatory indices were not significantly different. ROC analysis indicated that 25(OH)D was a reliable predictor of advanced BA in obese children (AUC = 0.7580, <i>P</i> = 0.0005). Compared with the normal BMD group, the abnormal BMD group had significantly higher HDL levels (<i>P</i> = 0.0139), with high-density lipoprotein (HDL) levels presenting a moderate predictive value for abnormal BMD (AUC = 0.6890; <i>P</i> = 0.0128). Subgroup analysis in school-aged obese children yielded consistent findings.</p> Conclusions <p>Obese children present with insulin resistance, dyslipidemia, systemic inflammation, advanced BA and decreased BMD Z scores. Reduced 25(OH)D is associated with advanced BA, whereas elevated HDL is associated with abnormal BMD in obese children.</p>

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Associations of serum 25-hydroxy vitamin D, inflammatory index, and metabolic parameters with bone age and bone mineral density in obese children and adolescents

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  • 发表日期：

    2026年8月5日

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  • Li Li,
  • Mei Liu

摘要

Background

Obesity has become a direct factor that severely affects the growth and development of children and adolescents. 25-Hydroxy vitamin D (25-(OH)D) is a fat-soluble vitamin that regulates the maturation of reproductive organs and secondary sexual characteristics in humans. This study aimed to explore the correlations between serum 25(OH)D levels, inflammatory parameters, and metabolism-related parameters and bone age (BA) and bone mineral density (BMD) in obese children and adolescents.

Methods

A total of 233 children and adolescents aged 3–17 years (median age 8 years [IQR: 6, 11]) who underwent physical examinations at a tertiary hospital in central and eastern China between July 2022 and June 2024 were included. BA and BMD were measured. Physical activity was evaluated using the International Physical Activity Questionnaire-Short Form (IPAQ-S). Pearson's correlation analysis was used to examine the relationships among 25(OH)D, inflammatory parameters, metabolic parameters, BA, bone density, and obesity across different groups. The diagnostic value of 25(OH)D, BA, and IGF-1 in central precocious puberty was determined by receiver operating characteristic (ROC) curve analysis.

Results

Among the 233 subjects, 66 (28.33%) were defined as obese based on body mass index (BMI) and the standard deviation (SDS) score (1.645). Compared with nonobese individuals, obese children had significantly lower 25(OH)D levels, higher insulin resistance indices (insulin, HbA1c, and HOMA-IR), higher dyslipidemia (higher TC and LDL levels and lower HDL levels), and higher systemic inflammatory indices (NLR, SII, and SIRI), as well as higher BA levels and lower BMD Z scores (all P < 0.05). In obese children, the 25(OH)D was markedly lower in the advanced BA group than in the normal BA group (P = 0.0003), whereas the glucose, lipid, and inflammatory indices were not significantly different. ROC analysis indicated that 25(OH)D was a reliable predictor of advanced BA in obese children (AUC = 0.7580, P = 0.0005). Compared with the normal BMD group, the abnormal BMD group had significantly higher HDL levels (P = 0.0139), with high-density lipoprotein (HDL) levels presenting a moderate predictive value for abnormal BMD (AUC = 0.6890; P = 0.0128). Subgroup analysis in school-aged obese children yielded consistent findings.

Conclusions

Obese children present with insulin resistance, dyslipidemia, systemic inflammation, advanced BA and decreased BMD Z scores. Reduced 25(OH)D is associated with advanced BA, whereas elevated HDL is associated with abnormal BMD in obese children.