The role of obesity in the development of vitamin D deficiency rickets in children

Abstract

Vitamin D deficiency rickets is one of the most common diseases among children of the first years of life in many countries around the world. It is very important to understand the aforementioned nosological unit as a metabolism disorder, and not just as a D-deficiency state. In modern conditions, the risk factors for vitamin D deficiency rickets have undergone further study. The results of the research indicate that obesity is one of the risk factors for vitamin D deficiency in children. Thus, vitamin D metabolism, deposition, bioavailability and its biological role are dependent on the size of adipose tissue. The pathogenetic interaction between obesity andМvitamin D deficiency is probably predetermined by several mechanisms. Firstly, in case of obesity, vitamin D,Мwhich is a fat-soluble substance, is distributed in a considerable amount of adipose tissue, which leads to a decrease in its concentration in the blood plasma. Secondly, with excessive body weight there is a limitation of vitamin D bioavailability, caused by vitamin D capture with adipocytes and depositing in adipose tissue. Thirdly, there is a genetic proof that the increase in BMI leads to a decrease in vitamin D levels in blood serum. Recent studies have shown that adipose tissue may be the direct target of vitamin D physiological actions. It has been proved that vitamin D can affect obesity through numerous mechanisms, including protein expression, oxidative stress, inflammation and cellular metabolism. Currently, recommendations for treatment and prevention of vitamin D deficiency can be found in international foreign guidebooks whose authors state that obese children need a higher dosage of vitamin D compared to those whose physical development is consistent with age. Understanding the influence of adipose mass on bone tissue during its growth and development is a very important aspect for further health and pharmacotherapy strategies to prevent bone disorders.