Read article

Biomarkers of vitamin status in obese school children


Inadequate intake of vitamins, noted in children with obesity, reduces the immune system activity, contributes to the metabolic disorders aggravation and may result in comorbidity.

The aim of the work was to study sufficiency with vitamins and carotenoids of children with obesity.

Material and methods. Examination of vitamin D, B2, C, A, E and β-carotene status in 50 children (male 36.0%) aged 11-17 years [median (Me) - 14 years] with obesity [Z-score body mass index (BMI) ≥2.0, Ме=2.86] by determining serum biomarkers has been conducted.

Results and discussion. All of the children had an adequate supply with vitamin C (ascorbic acid level >0.4 mg/dL). Low vitamin A status (retinol <30pg/dl) was revealed in 8% children. Deficiency of vitamin D [25(OH)D<20 ng/ml], vitamin B2 (riboflavin <5 ng/ml) and β-carotene (<10 pg/dl) was detected in 62.0, 38.8 and 74.0% of obese children. The percentage of persons with reduced vitamin E serum level (<0.8 mg/dl) was amounted 54.0%. A severe vitamin D deficit (<10 ng/ml) has been detected in 24.0% of children with Z-score BMI ≥2.86 (median value) and has not been observed in children with lower body weight, whose serum β-carotene median was 1.5 fold higher (p<0.05). No one was adequately supplied with all 5 studied vitamins and β-carotene. The combined deficiency of 3 or more vitamins took place in 54.0% of obese children. Synchronously suboptimal serum level of ascorbic acid (<50 pmol/l), β-carotene (<0.4 pmol/l) and α-tocopherol/cholesterol ratio (<5.0 pmol/mmol) which is a cardiovascular disease risk factor, has been found in 28.0% of children. BMI was inversely associated with 25(OH)D serum concentration (ρ =-0.313, р=0.027). There was a pronounced negative correlation between serum level of β-carotene and atherogenic LDL cholesterol (ρ=-0.514, p<0.001).

Conclusion. The prevalence of combined vitamin D, tocopherol and carotenoids’ inadequacy in obese children indicates the importance of vitamin status correction to reduce the risk of metabolic syndrome.

Keywords:obese children, vitamin deficiency, serum concentration, 25-hydroxy-vitamin D, riboflavin, tocopherols, retinol, beta-carotene, ascorbic acid

For citation: Beketova N.A., Pavlovskaya E.V., Kodentsova V.M., Vrzhesinskaya O.A., Kosheleva O.V., Sokolnikov A.A., Strokova TV. Biomarkers of vitamin status in obese school children. Voprosy pitaniia [Problems of Nutrition]. 2019; 88 (4): 66-74. doi: 10.24411/0042-8833-2019-10043 (in Russian)


1. Tutelyan V.A., Baturin A.K., Kon’ I.Ya. Martinchik A.N.,Uglitskikh A.K., Korosteleva M.M., et al. Prevalence of overweight and obesity in child population of Russia: multicenter study. Pedi-atriya. Zhurnal im. G.N. Speranskogo [Pediatrics Journal named after G.N. Speransky]. 2014; 93 (5): 28-31. (in Russian)

2. Starodubova A.V., Starodubov V.I. Obesity trends and age-related and regional features in the Russian Federation in 1992-2012. Profilakticheskaya meditsina [Preventive Medicine]. 2017; 20 (6): 32-40. doi: 10.17116/profmed201720632-40 (in Russian)

3. Dedov 1.1., Mel’nichenko G.A., Butrova S.A., Savel’eva L.V., Bodaveli O.V., Buydina T.A., et al. Obesity in adolescents in Russia. Ozhirenie i metabolism [Obesity and Metabolism]. 2006; 3 (4): 30-4. doi: 10.14341/2071-8713-5141 (in Russian)

4. Kelsey M.M., Zaepfel A., Bjornstad P., Nadeau K.J. Age-related consequences of childhood obesity. Gerontology. 2014; 60 (3): 222-8. doi: 10.1159/000356023

5. Reyman M., Verrij n Stuart A.A., van Summeren M., Rakhshan-dehroo M., Nuboer R., de Boer F.K., et al. Vitamin D deficiency in childhood obesity is associated with high levels of circulating inflammatory mediators, and low insulin sensitivity. Int J Obes (Lond). 2014; 38 (1): 46-52. doi: 10.1038/ij o.2013.75

6. Torshin I.Y., Gromova O.A., Limanova O.A., Egorova E.Y., Sardaryan I.S., Yudina N.V., et al. Role of micronutrients sufficiency in health maintaining of children and adolescents: analysis of a large scale sample of patients through data mining. Pediatriya. Zhurnal im. G.N. Speranskogo [Pediatrics Journal named after G.N. Speransky]. 2015; 94 (6): 68-78. (in Russian)

7. Todieva A.M., Nikitina I.L., Karonova T.L., Vasil’eva E.Yu., Budanova M.V. Vitamin D and the metabolic status in obese children and adolescent. Voprosy detskoy dietologii [Problems of Pediatric Nutrition]. 2013; 11 (3): 15-21. (in Russian)

8. Gromova O.A., Torshin I.Yu., Limanova O.A., Grishina T.R., Gromov A.N. Vitamin D concentrations and metabolic disorders: systematic analysis of the fundamental and evidence-based studies on the problem of overweight and diabetes mellitus. Farmateka[Pharmateca]. 2014; (20): 27-38. (in Russian)

9. Pereira-Santos M., Costa P.R., Assis A.M., Santos C.A., Santos D.B. Obesity and vitamin D defi ciency: a systematic review and metaanalysis. Obes Rev. 2015; 16 (4): 341-9. doi: 10.1111/obr.12239

10. Strauss R.S. Comparison of serum concentrations of alphatocopherol and beta-carotene in a cross-sectional sample of obese and nonobese children (NHANES III). National Health and Nutrition Examination Survey. J Pediatr. 1999; 134: 160-5.

11. Molnar D., Decsi T., Koletzko B. Reduced antioxidant status in obese children with multimetabolic syndrome. Int J Obes. 2004; 28: 1197-202. doi: 10.1038/sj.ij o.0802719

12. Codoner-Franch P., Tavarez-Alonso S., Simo-Jorda R., Laporta-Martin P., Carratala-Calvo A., Alonso-Iglesias E. Vitamin D status is linked to biomarkers of oxidative stress, infl ammation, and endothelial activation in obese children. J Pediatr. 2012; 161 (5): 848-54. doi: 10.1016/j.jpeds.2012.04.046

13. Gey K.F. Vitamins E plus C and interacting conutrients required for optimal health. A critical and constructive review of epidemiology and supplementation data regarding cardiovascular disease and cancer. Biofactors. 1998; 7 (1-2): 143-74.

14. Aune D., Keum N., Giovannucci E., Fadnes L.T., Boff etta P., Greenwood D.C., et al. Dietary intake and blood concentrations of antioxidants and the risk of cardiovascular disease, total cancer, and all-cause mortality: a systematic review and dose-response meta-analysis of prospective studies. Am J Clin Nutr. 2018; 108 (5): 1069-91. doi: 10.1093/ajcn/nqy097

15. Spirichev V.B. Kodentsova V.M., Vrzhesinskaya O.A., Beketova N.A., Haritonchik L.A., Alekseeva I.A., et al. Methods for evaluation of vitamin status. Moscow: Al’teks, 2001: 68 p. (in Russian)

16. The national program "Vitamin D defi ciency in children and adolescents of the Russian Federation: modern approaches to correction". Moscow: Pediatr, 2018: 96 p. (in Russian)

17. Pavlovskaya Ye.V., Strokova T.V., Surkov A.G., Bagaeva M.E., Kodentsova V.M., Sokol’nikov A.A. Vitamin D status in obese children. Voprosy detskoy dietologii [Problems of Pediatric Nutrition]. 2018; 16 (5): 16-22. doi: 10.20953/1727-5784-2018-5-16-22 (in Russian)

18. Spirichev V.B. Vitamin provision of children in Russia. Voprosy pitaniia [Problems of Nutrition]. 1996; 65 (5): 45-53. (in Russian)

19. Makarova S.G., Vrzhesinskaya O.A., Kodentsova V.M., Pereverzeva O.G., Leonenko S.N., Turti T.V., et al. Urinary excretion of water-soluble vitamins (C, B1, B2, and B6) in healthy children of preschool and school age: a cross-sectional study. Voprosy sovremennoy pediatrii [Problems of Modern Pediatrics]. 2018; 17 (1): 70-5. doi: 10.15690/vsp.v17i1.1857 (in Russian)

20. Kodentsova V.M., Vrzhesinskaya O.A., Spirichev V.B. The alteration of vitamin status of adult population of the Russian Federation in 1987-2009 (To the 40th anniversary of the Laboratory of vitamins and minerals of Institute of Nutrition at Russian Academy of Medical Sciences). Voprosy pitaniia [Problems of Nutrition]. 2010; 79 (3): 68-72. (in Russian)

21. Sommer A., Davidson F.R. Assessment and control of vitamin A deficiency: the Annecy Accords. J Nutr. 2002; 132 (9, suppl): 2845S-50S. doi: 10.1093/jn/132.9.2845S

22. Pavlovskaja E.V., Strokova TV., Surkov A.G., Zubovich A.I., Bagaeva M.Eh., Kutyreva E.N. Characteristic of the actual nutrition of children with overweight and obesity. Voprosy pitaniia [Problems of Nutrition]. 2015; 84 (S5): 58. (in Russian)

23. Yang Q., Graham T.E., Mody N., Preitner F., Peroni O.D., Zabolotny J.M., et al. Serum retinol binding protein 4 contributes to insulin resistance in obesity and type 2 diabetes. Nature. 2005; 436: 356-62. doi: 10.1038/nature03711

24. Peter S., Friedel A., Roos F.F., Wyss A., Eggersdorfer M., Hoffmann K., et al. A systematic review of global alpha-tocopherol status as assessed by nutritional intake levels and blood serum concentrations. Int J Vitam Nutr Res. 2015; 85 (5-6): 261-81. doi: 10.1024/0300-9831/a000281

25. Thurnham D.I., Davies J.A., Crump B.J., Situnayake R.D., Davis M. The use of different lipids to express serum tocopherol: lipid ratios for the measurement of vitamin E status. Ann Clin Biochem. 1986; 23 (5): 514-20. doi: 10.1177/000456328602300505

26. Chai W., Novotny R., Maskarinec G., Le Marchand L., Fran-ke A.A., Cooney RV. Serum coenzyme Q10, a-tocopherol, Y-tocopherol, and C-reactive protein levels and body mass index in adolescent and premenopausal females. J Am Coll Nutr. 2014; 33 (3): 192-7. doi: 10.1080/07315724.2013.862490 Schwartz H., Ilainen V., Piironen V., Lampi A.-M. Tocopherol, tocotrienol and plant sterol contents of vegetable oils and industrial fats. J Food Compos Anal. 2008; 21 (2): 152-61. doi: 10.1016/ jjfca.2007.07.012

28. Kosheleva O.V., Beketova N.A., Kodentsova V.M., Pereverzeva O.G., Sokolnikov A.A., Vorozhko I.V., et al. Assessment of vitamin status in obese patients with arterial hypertension. Voprosy dietologii [Problems of Dietology]. 2016; 6 (2): 22-9. doi: 10.20953/2224-5448-2016-2-22-29 (in Russian)

29. Mathur P., Ding Z., Saldeen T., Mehta J.L. Tocopherols in the prevention and treatment of atherosclerosis and related cardiovascular disease. Clin Cardiol. 2015; 38 (9): 570-6. doi: 10.1002/clc.22422

30. Stenzel A.P., Carvalho R., Jesus P., Bull A., Pereira S., Saboya C., et al. Serum antioxidant associations with metabolic characteristics in metabolically healthy and unhealthy adolescents with severe obesity: an observational study. Nutrients. 2018; 10 (2). pii: E150. doi: 10.3390/nu10020150

31. Palmer A.C., Siamusantu W., Chileshe J., Schulze K.J., Barff our M., Craft N.E., et al. Provitamin A-biofortifi ed maize increases serum β-carotene, but not retinol, in marginally nourished children: a cluster-randomized trial in rural Zambia. Am J Clin Nutr. 2016; 104 (1): 181-90. doi: 10.3945/ajcn.116.132571

32. Wortsman J., Matsuoka L.Y., Chen T.C., Lu Z., Holick M.F. Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr. 2000; 72 (3): 690-3. doi: 10.1093/ajcn/72.3.690

33. Östh M., Öst A., Kjolhede P., Stralfors P. The concentration of β-carotene in human adipocytes, but not the whole-body adipocyte stores, is reduced in obesity. PLoS One. 2014; 9 (1): e85610. doi: 10.1371/journal.pone.0085610

34. Bonet M.L., Canas J.A., Ribot J., Palou A. Carotenoids and their conversion products in the control of adipocyte function, adiposity and obesity. Arch Biochem Biophys. 2015; 572: 112-25. doi: 10.1016/

35. Traber M.G. Vitamin E regulatory mechanisms. Ann Rev Nutr. 2007; 27: 347-62. doi: 10.1146/annurev.nutr.27.061406.093819

36. Kodentsova V.M., Vrzhesinskaya O.A. Vitamin-enriched food products in nutrition of children: background, problems and prospects. Voprosy detskoy dietologii [Problems of Pediatric Nutrition]. 2012; 10 (5): 31-44. (in Russian)

37. Berestovskaya V.S., Laritcheva Y.S., Khlekhlina Yu.V. The off-season vitamin D3 deficiency of in children and adolescents of Moscow. Klinicheskaya laboratornaya diagnostika [Clinical Laboratory Diagnostics]. 2012; (12): 5-7 (in Russian)

38. Zimmermann M.B., Aeberli I. Dietary determinants of subclinical inflammation, dyslipidemia and components of the metabolic syndrome in overweight children: a review. Int J Obes (Lond). 2008; 32 (suppl 6): S11-8. doi: 10.1038/ij o.2008.202

Journals of «GEOTAR-Media»