Niveles de calcidiol en pacientes pediátricos con obesidad

espanolObjetivos. Comprobar si la obesidad produce deficit de calcidiol en ninos y si ese deficit repercute originando hiperparatiroidismo secundario. Pacientes y metodos. Comparamos diferentes valores analiticos y antropometricos entre ninos con obesidad seguidos en las consultas de Nutricion (n=63) y pacientes sanos en seguimiento en atencion primaria (n=76). Se clasificaron en tres subgrupos: deficit de vitamina D (32 ng/ml). Estudiamos si los pacientes obesos con deficit de vitamina D presentaban un aumento significativo de la PTH con respecto a los pacientes con niveles de suficiencia. Resultados. Los ninos obesos presentaron alterados significativamente muchos de los valores antropometricos y analiticos estudiados, como tension arterial diastolica, colesterol HDL, glucosa, insulina, vitamina D, trigliceridos y acido urico. No se encontraron diferencias significativas en otros parametros como tension arterial sistolica, colesterol total o LDL. Aunque los niveles de calcidiol fueron inferiores de forma significativa (25,1±7,7 vs. 28,9±7,7 ng/ml, p=0,008), no existieron diferencias significativas en los niveles de PTH intacta. Conclusion: Los pacientes obesos mostraron alteracion en los parametros analiticos asociados al sindrome metabolico desde una edad temprana. El deficit de calcidiol asociado a obesidad no produce hiperparatiroidismo secundario porque la reduccion de sus niveles, aunque significativa, es de poca relevancia. EnglishObjetive: Verify if obesity causes calcidiol deficiency in children and if this deficit causes secondary hyperparathyroidism. Materials and methods: We compare different analytical and anthropometric values among children with obesity followed in the Nutrition consultations (n = 63) and healthy patients in follow-up from primary care (n = 76). They were classified into three subgroups: vitamin D deficiency ( 32 ng / ml). We studied whether obese patients with vitamin D deficiency had a significant increase in PTH compared to patients with sufficiency levels. Results: Obese children had significantly altered many of the anthropometric and analytical values studied, such as diastolic blood pressure, HDL cholesterol, glucose, insulin, vitamin D, triglycerides and uric acid; while they found no significant differences in other parameters such as systolic blood pressure, total cholesterol or LDL. Although calcidiol levels were significantly lower (25.1 ± 7.7 vs. 28.9 ± 7.7 ng / ml, p = 0.008), there were no significant differences with respect to phosphocalcic metabolism. Conclusion: Obese patients showed alteration in the analytical parameters associated with the metabolic syndrome from an early age. The calcidiol deficit associated with obesity does not produce secondary hyperparathyroidism because the reduction of its levels, although significant, is of little relevance.