Association Between Vitamin D Status and Insulin Resistance in Adolescents: A Cross-sectional Observational Study

Xiaoyuan GUO; Yutong WANG; Zhibo ZHOU; Shi CHEN; Mei ZHANG; Bo BAN; Ping LI; Xinran ZHANG; Qiuping ZHANG; Kai YANG; Hongbo YANG; Hanze DU; Hui PAN

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Association Between Vitamin D Status and Insulin Resistance in Adolescents: A Cross-sectional Observational Study

VernacularTitle:青春期青少年维生素D营养状况与胰岛素抵抗的相关性: 横断面观察性研究
Author: Xiaoyuan GUO ^{1
,

2} ; Yutong WANG ^{1
,

2} ; Zhibo ZHOU ^{1
,

2} ; Shi CHEN ^{1
,

2} ; Mei ZHANG ³ ; Bo BAN ³ ; Ping LI ³ ; Xinran ZHANG ³ ; Qiuping ZHANG ³ ; Kai YANG ³ ; Hongbo YANG ^{1
,

2} ; Hanze DU ^{1
,

2} ; Hui PAN ^{1
,

2}
Author Information

1. Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
2. Key Laboratory of Endocrinology of National Health Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
3. Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining, Shandong 272000, China
Publication Type:Journal Article
Keywords: vitamin D; insulin resistance; adolescents; puberty
From: Medical Journal of Peking Union Medical College Hospital 2025;16(3):577-583
CountryChina
Language:Chinese
Abstract: Objective
To investigate the correlation between vitamin D nutritional status and insulin resistance in pubertal adolescents.
Methods
This cross-sectional observational study employed convenience sampling to recruit 2021-grade(8th grade) students from Jining No.7 Middle School in Shandong Province on June 5, 2023. Data collection included questionnaires, physical examinations, and imaging assessments to obtain general information, secondary sexual characteristics development, and bone age. Venous blood samples were collected to measure fasting blood glucose(FBG), fasting insulin(FINS), homeostasis model assessment of insulin resistance(HOMA-IR), and 25-hydroxyvitamin D[25(OH)D] levels. Spearman correlation analysis and multivariate linear regression models were used to examine the associations between serum vitamin D levels and FBG, FINS, and HOMA-IR.
Results
The study included 168 pubertal adolescents[69 females(41.1%), 99 males(58.9%); mean age(13.27±0.46) years]. All participants had entered puberty based on sexual development assessment. Vitamin D deficiency was observed in 41 participants(24.4%), insufficiency in 109(64.9%), and sufficiency in 18(10.7%). The median HOMA-IR was 3.49(2.57, 5.14).Significant differences were found across vitamin D status groups for HOMA-IR [4.45(2.54, 6.62) vs. 3.58(2.74, 5.13) vs. 2.25(1.62, 3.40), P=0.003] and FINS[21.5(13.4, 30.1) mU/L vs. 16.5(13.0, 23.9) mU/L vs. 11.2(8.3, 17.8) mU/L, P=0.006], showing decreasing trends with improving vitamin D status. Spearman analysis revealed significant inverse correlations between serum 25(OH)D levels and FBG(r=-0.171, P=0.027), FINS(r=-0.234, P=0.002), and HOMA-IR(r=-0.250, P=0.001).After adjusting for age, sex, body mass index, and daily outdoor activity time, multivariate linear regression demonstrated that log-transformed 25(OH)D levels were independently and inversely associated with FBG(β=-0.324, P=0.022), lnFINS(β=-0.241, P=0.048), and lnHOMA-IR(β=-0.312, P=0.017).
Conclusions
Vitamin D deficiency/insufficiency is prevalent among pubertal adolescents, and serum vitamin D levels show a significant inverse association with insulin resistance. These findings suggest the potential importance of vitamin D status in metabolic health during puberty.