Table 2 Characteristics and results of non-prospective cohort studies
First author, year- country | Study population | Outcomes evaluated and evaluation method | Adjusted variables for statistical analysis | Key findings |
|---|---|---|---|---|
Cross-sectional | ||||
Al Daghri, 2010- Riyadh, Saudi Arabia [28] | 118 children and adolescents, non-obese, without chronic disease, not taking vitamin D supplements, recruited from primary health care centers Mean BMI (SD) in kg/m2: 118 children and adolescents, non-obese, without chronic disease, not taking vitamin D supplements, recruited from primary health care centers Mean BMI (SD) in kg/m2: Boys: 19.8 (5.7); Girls: 18.9 (4.3) % Male: 44.9% Age in years: Range: 5–17; Mean(SD): Boys: 12.4 (3.7); Girls: 11.6 (3.7) | Serum 25(OH)D: ELISA SBP and DBP: average of 2 readings (not detailed) | None | Inverse correlation between vitamin D with SBP and DBP in the total sample and in girls, but not in boys |
Al Daghri, 2015- Riyadh, Saudi Arabia [29] | 259 children, healthy, not taking medications or supplements known to affect body weight, recruited from primary health care centers Mean BMI(SD) in kg/m2: Boys: 23.38 (6.23); Girls: 22.95 (4.97) % Male: 39.8% Age in years: Range: NR; Mean(SD): Boys 14.9 (1.6); Girls 14.8 (1.6) | Serum 25(OH)D: COBAS e-411 automated analyzer SBP and DBP: NR | None | ● Inverse correlation between vitamin D with SBP in boys only ● Inverse correlation between vitamin D with DBP in the total sample |
Al Daghri, 2015- Riyadh, Saudi Arabia [31] | 2225 adolescents, healthy, without acute or chronic medical conditions, recruited from private and public schools Mean BMI(SD) in kg/m2: Boys: 22.9 (0.17); Girls: 23 (0.16) % Male: 53.3% Age in years: Range: 13–17; Mean(SD): Boys: 15.1 (0.06); Girls: 15.1 (0.06) | Serum 25(OH)D: COBAS e-411 automated analyzer SBP and DBP: average of 2 readings, 15 min apart, by a standardized mercury sphygmomanometer | None | Inverse correlation between vitamin D with SBP and DBP in boys only |
Al Daghri, 2016- Riyadh, Saudi Arabia [30] | 4183 children, without acute medical condition, with information collected from a biomarkers research program Mean BMI(SD) in kg/m2: Boys: 21.4 (5.1); Girls: 22 (4.8) % Male: 45.6% Age in years: Range: 12–18; Mean(SD): Boys: 14.3 (1.9); Girls: 14.3 (2.1) | Serum 25(OH)D: COBAS e-411 automated analyzer SBP and DBP: NR | None | Inverse correlation between vitamin D with SBP and DBP in boys only |
Al Daghri, 2018- Riyadh, Saudi Arabia [32] | 740 adolescents, without serious medical conditions, not taking medications or vitamin D supplements, recruited from primary schools Mean BMI(SD) in kg/m2: 21.9 (4.8) % Male: 33.1% Age in years: Range: 10–17; Mean(SD): All: 14.2 (1.6); Boys:14.1 (1.2); Girls: 14.3 (1.8) | Serum 25(OH)D: COBAS e-411 automated analyzer Vitamin D status groups: Deficient: 50–75 nmol/L; Insufficient: < 50 nmol/L; Sufficient: ≥ 75 nmol/L SBP and DBP: NR | None | ● No difference in SBP across vitamin D status groups ● Lower DBP in vitamin D sufficiency |
Al Saleh, 2013-Riyadh, Saudi Arabia [35] | 22 children with vitamin D deficiency, free of chronic diseases, not taking vitamin D supplements, recruited from primary health care centers Mean BMI(SD) in kg/m2: NR % Male: 43.4% Age in years: Range: NR; Mean(SD): NR | Serum 1,25(OH)2D: ELISA SBP and DBP: average of 2 readings (not detailed) | Gender and BMI | Inverse association between vitamin D with SBP only |
Alemzadeh, 2012-Wisconsin, USA [33] | 133 Caucasian, Hispanic and African adolescents, obese (BMI > 95th p for age), medically stable, not taking medications or multivitamin supplement, recruited from an endocrine clinic Mean BMI(SD) in kg/m2: NR % Male: 41.4% Age in years: Range: 13.1–17.9; Mean(SD): 14.9 (1.4) | Serum 25(OH)D: radioimmunoassay Vitamin D status groups: Deficient: < 50 nmol/L; Sufficient: ≥ 50 nmol/L SBP and DBP: average of 2 readings, in sitting position | None | ● No differences in SBP and DBP across vitamin D status groups ● No correlation between vitamin D with SBP and DBP |
Alemzadeh, 2016-Wisconsin, USA [34] | 152 Caucasian, Hispanic and African adolescents, obese (BMI > 95th p for age), without chronic medical conditions, not taking supplements, recruited from a children hospital Mean BMI(SD) in kg/m2: NR % Male: 42.8% Age in years: Range: 13.2-17.8; Mean(SD): 14.7 (1.3) | Serum 25(OH)D: radioimmunoassay Vitamin D status groups: Deficient: < 50 nmol/L; Insufficient: 50–74.9 nmol/L; Sufficient: ≥ 75 nmol/L SBP and DBP: average of 2 readings, in sitting position | None | No differences in SBP and DBP across vitamin D status groups |
Ashraf, 2011- Birmingham, USA [37] | 80 Caucasian American and African American post-menarchal adolescents, obese (BMI > 95th p for age and gender), without chronic disease, not taking supplements, recruited from weight management clinics Mean BMI(SD) in kg/m2: NR % Male: 0% Age in years: Range: NR; Mean(SD): African American: 14.3 (2.3), Caucasian American: 14.8 (2.3) | Serum 25(OH)D: liquid chromatography-tandem mass spectrometry SBP and DBP: automated BP cuff (not detailed) | BMI; Race | No correlation between vitamin D with SBP and DBP |
Ashraf, 2014- Alabama, USA [36] | 47 European American and African American post-menarchal adolescents, without medical conditions, not taking medications and supplements, recruited from weight management clinics Mean BMI(SD) in kg/m2: 23.3 (4.5) %Male: 0% Age in years: Range: 14-18; Mean(SD): 15.9 (1.4) | Serum 25(OH)D: liquid chromatography mass spectrometry Free 25(OH)D and bioavailable 25(OH)D: calculated using published formulas SBP ad DBP: average of 2 readings, after a 5-min rest, using the auscultatory method, in supine position | Age; Percent body fat; Race; Fasting insulin; Height | No correlation between vitamin D with SBP and DBP |
Atabek, 2014- Konya, Turkey [38] | 247 children and adolescents, obese (BMI > 95 p for age and gender), without chronic disease, not taking medications, recruited from an outpatient endocrinology and diabetes pediatric clinic Mean BMI(SD) in kg/m2: NR %Male: 47.3% Age in years: Range: 8–16; Mean(SD): 11.93 (2.77) | Serum 25(OH)D: mass spectrometry Vitamin D status groups: Deficient:< 50 nmol/L SBP and DBP: after a rest ≥ 10 min, using a standard mercury sphygmomanometer | None | ● No differences in SBP and DBP across vitamin D status groups ● Inverse correlation between vitamin D with SBP only |
Bacha, 2019- Texas, USA [40] | 79 Hispanic, Black and White American adolescents, not engaging in a diet or physical activity program, without medical conditions, not taking medications and supplements, recruited through advertisement in the community and at a children’s hospital Normal weight:22.8%; overweight with normal glucose tolerance:38%; overweight with prediabetes:39.2% %Male: 43% Age in years: Range: NR; Mean(SD): 15.4 (0.2) | Total 25(OH)D: electrochemiluminescence assay SBP and DBP: average of 7 readings, taken 10 min apart, by an automated device | None | No differences in SBP and DBP across tertiles of vitamin D |
Banzato, 2014- Verona, Italy [41] | 32 Caucasian children, overweight and obese (definition: NR), free of chronic disease, not taking medications or supplements, recruited from a pediatric department Mean BMI(SD) in kg/m2: 30.08 (3.18) %Male: 65.6% Age in years: Range: 7–16; Mean(SD): 11.7(2.26) | 25(OH)D: chemiluminescent method SBP and DBP: average of 3 readings, on the left arm over 30 min, in sitting position, using a mercury sphygmomanometer | None | No differences in SBP and DBP across tertiles of vitamin D |
Cabral, 2016- Porto, Portugal [42] | 514 adolescents from the EPITeen, recruited from public and private schools BMI ≥ 95 p for age and gender: 9.3% % Male: 47.5% Age in years: Range: 13; Mean(SD): NR | Serum 25(OH)D: chemiluminescence immunoassay SBP and DBP: average of 2 readings separated by ≥ 5 min, after a 10-min rest, by a mercury sphygmomanometer | BMI; Gender; Parental education; Physical activity; Season | ● No differences in SBP and DBP across quartiles of vitamin D ● No difference in vitamin D level among normotensive and those with high BP |
Cheraghi, 2012- Kansas, USA [43] | 74 white and non-white children with multiple, modifiable atherosclerosis-promoting risk factors, recruited from a preventive cardiology clinic at a children's hospital BMI > 95 p for age and gender: 85% %Male: 44.6% Age in years: Range: NR; Mean(SD): 13.7 (3.1) | Serum 25(OH)D: NR Vitamin D status groups: Deficient: < 49.92 nmol/L; Sufficient: ≥ 49.92 nmol/L SBP: over the right arm, in sitting position, using a dinamap monitor | None | ● No difference in SBP across vitamin D status groups ● No difference in vitamin D level among those with normal and high SBP |
Choi, 2014- South Korea [44] | 260 adolescents, free of diabetes, recruited from a rural high school Mean BMI(SD) in kg/m2: Boys:22.2 (3.2); Girls: 21.2 (2.5) %Male: 51.9% Age in years: Range: 15–16; Mean(SD): 15.9 (0.3) | Serum 25(OH)D: radioimmunoassay SBP and DBP: average of 2 readings, at rest, using a oscillometric device with appropriate cuff size | None | No correlation between vitamin D with SBP and DBP |
De Moraes, 2014- European Countries [45] | 1089 European adolescents from the HELENA study, recruited from different European countries Mean BMI(SD) in kg/m2: Boys:21.4; Girls: 21.3 %Male; 46.7% Age in years: Range: 12.5–17.5; Mean: 14.8 | Plasma 25(OH)D: immunoassay ELISA SBP and DBP: lowest of 2 readings, taken 10 min apart, in sitting position, using an oscillometric monitor device | Contextual variables (seasonality; latitude of residence; school); Potential individual confounders (maternal education; age at menarche (in girls); BMI; waist circumference; physical activity; serum lipid concentrations); Biomarker serum concentrates (blood composition; iron status indicators; multiple vitamins including vitamin D) | No association between vitamin D with SBP and DBP |
De piero Belmont, 2015-Spain [46] | 314 children, free of disease, not taking medications and supplements, recruited from public schools Mean BMI(SD) in kg/m2: 19.4 (3.2) %Male: 50.3% Age in years: Range: 8–13; Mean (SD): 10.7 (1.0) | Plasma 25(OH)D: immunochemiluminescence SBP and DBP: average of 3 reading, taken 5 min apart using the right arm, in sitting position HTN status: Normal BP: SBP or DBP ≤ 90th p; Pre-HTN: SBP or DBP ≥ 90th p and ≤ 95 thp; High BP: SBP or DBP ≥ 95th p | For the OR: Age; gender | ● Lower SBP and DBP with increasing tertiles of vitamin D ● Higher prevalence of HTN in the lowest tertile of vitamin D compared with the highest tertile ● Lower odds of elevated SBP or DBP with increasing tertiles of vitamin D |
Dura-Trave, 2020- Pamplona, Spain [47] | 236 Caucasian adolescents, with severe obesity (BMI z-score > 3.0 or BMI > 99th p), without illness, not taking medication, vitamin D, or calcium supplements Mean BMI z-score(SD): deficiency: 4.3 (1.1); insufficiency: 4.4 (0.9); sufficiency: 3.8 (0.6) %Male: 62.3% Age in years: Range: 10.2–15.8; Mean: 13.4 | Plasma 25(OH)D: high-specific chemiluminescence immunoassay Vitamin D status group: Deficient: < 50 nmol/L; hypovitaminosis D: < 75 nmol/L SBP and DBP: lowest of 3 measurements, in the right arm, in supine position, using a digital BP monitor Arterial HTN: SBP and/or DBP ≥ 95th p for age, sex, and height, according to the American reference charts (SBP > 130 or DBP > 85 mmHg) | None | ● Higher SBP and DBP with vitamin D deficiency ● Higher prevalence of arterial HTN with hypovitaminosis D ● Inverse association between vitamin D with SBP only |
Ganji, 2011-USA [15] | 5867 White, Black and Hispanic children and adolescents, recruited from the NHANES study (2001–2006) Mean BMI(SD) in kg/m2: 23.1 (0.1) %Male: 50.6% Age in years: Range: 12–19; Mean: 15.4 | Serum 25(OH)D: radioimmunoassay SBP and DBP: mercury sphygmomanometer (not detailed) | For SBP: Age; Sex; Race/ethnicity; BMI For DBP: Age; Sex | ● Lower SBP with increasing tertiles of vitamin D ● No association between vitamin D with DBP |
Ghobadi, 2019- Shiraz, Iran [48] | 240 children, without chronic disease, not on special diets, not taking drugs affecting metabolic status, recruited from elementary schools Mean BMI(SD) in kg/m2: 16.05 (2.74) %Males: 52.9% Age in years: Range: 6–9; Mean(SD): 7.8 (1.06) | Serum 25(OH)D: ELISA SBP and DBP: average of 2 readings, by mercury sphygmomanometer | Age; Gender; BMI; Physical activity | Inverse association between vitamin D with SBP and DBP |
Ha, 2013- Suwon, South Korea [50] | 310 children, free of disease not taking medications, recruited from elementary schools. Mean BMI(SD) in kg/m2; serum 25(OH)D Q1: 19.8 (3.7); Q2: 19.4 (3.7); Q3: 19.3 (3.3); Q4: 18.3 (3) %Male: 52% Age in years: Range:10–12; Mean (SD): Q1: 12.2 (1.2); Q2:12.2 (1.3); Q3: 12.3 (1.1); Q4:12.3 (1.1) | Serum 25(OH)D: chemiluminescence immunoassay SBP and DBP: average of 2 readings by an automated BP instrument | Age; Gender; Tanner stage; Body fatness; physical activity | ● No differences in SBP and DBP across quartiles of vitamin D ● No association between vitamin D with SBP and DBP |
Hannesdottir, 2017- Iceland [51] | 159 elementary school children Mean BMI(SD) in kg/m2: NR %Male: 46.5% Age in years: Range:7 | Serum 25(OH)D: radioimmunoassay Vitamin D status groups: Deficient: < 50 nmol/L; Sufficient: > 50 nmol/L SBP and DBP: average of 3 readings in a standard way using the left arm | None | ● No association/correlation between vitamin D with SBP and DBP ● No differences in SBP and DBP across vitamin D status groups |
Hassan, 2015- Egypt [52] | 65 obese (BMI > 95th p for age and sex-specific growth curves) and 30 healthy (BMI between 15 and 85th p for age and sex-specific growth curves) children with no medical conditions, including type I and type II diabetes, not taking any medications that influence physical growth, recruited from primary public schools Mean BMI(SD) in kg/m2: 24.28 (5.95) %Male: 49.5% Age in years: Range: 8–11; Mean(SD): All: 9.99 (1.14); obese:10.1 (1.18) ; control: 10.27 (0.74) | Serum 25(OH) D: NR SBP and DBP: average of 2 readings by a mercury sphygmomanometer after a rest of 20 min | None | No association between vitamin D with SBP and DBP in the total sample, and in obese participants |
Hirschler, 2012- Buenos Aires, Argentine [53] | 116 boys without chronic disease, and not taking medications known to affect bone metabolism, recruited from amateur rugby club Mean BMI (SD) in kg/m2: 22.0 (5.3) %Male: 100% Age in years: Mean(SD): 11.3 (2.4) | Serum 25(OH)D: radioimmunoassay kit SBP and DBP: NR | Tanner stage | No differences in SBP and DBP across quartiles of vitamin D |
Hirschler, 2013- Buenos Aires, Argentine [54] | 290 Indian Koya children, free of chronic disease, recruited from schools Mean BMI in kg/m2: 16.88 (2.99) %Male: 44.5% Age in years: Range: 5–19; Mean(SD): 10.7(2.9) | Serum 25(OH)D: radioimmunoassay kit Vitamin D status groups: Deficient: < 50 nmol/L SBP and DBP: NR | Age (adjustment only for SBP across quartiles) | ● Higher SBP and DBP with vitamin D deficiency ● Lower SBP with increasing quartiles of vitamin D |
Hirschler, 2019- San Antonio de los Cobres and Chicoana, Argentine [55] | 152 indigenous schoolchildren from San Antonio de los Cobres;175 from Chicoana not taking medications affecting BP, lipids, glucose level, with no significant difference in socioeconomic level, age, BMI and waist circumference, recruited from elementary schools Mean BMI(SD): San Antonio de los Cobres in kg/m2: 16.83 (2.69); Chicoana: 19.27 (4.41) %Male: 51.7% Age in years: Mean(SD) San Antonio de los Cobres: 9.37 (2.11); Chicoana: 9.02 (2.14) | Serum 25(OH)D: radioimmunoassay SBP and DBP: average of 2 readings, at a period of 1 to 2 min, by a mercury sphygmomanometer in a sitting position with the child’s right forearm horizontal on the table and cuffs sizes adjusted for differences in arm circumference and height HTN: average of the values of SBP and /or DBP ≥ 95th p based on age , sex and height p | Age; Gender; z-BMI; Milk intake | Inverse association between vitamin D with SBP and DBP |
Hirschler, 2019- Argentine [56] | 152 indigenous schoolchildren from San Antonio de los Cobres;175 from Chicoana not taking medications affecting BP, lipids, glucose level, with no significant difference in socioeconomic level, age, BMI and waist circumference, recruited from elementary schools Mean BMI(SD): San Antonio de los Cobres in kg/m2: 16.83 (2.69); Chicoana: 19.27 (4.41) %Male: 51.7% Age in years: Mean(SD) San Antonio de los Cobres: 9.37 (2.11); Chicoana: 9.02 (2.14) | Serum 25(OH)D: radioimmunoassay SBP and DBP: average of 2 readings at a period of 1 to 2 min by a mercury sphygmomanometer in a sitting position, with the child’s right forearm horizontal on the table and cuffs sizes adjusted for differences in arm circumference and height MAP: (DBP*2 + SBP) / 3 | BMI; Age; Sex; Location; Triglycerides; Insulin; Glucose | No association between vitamin D with SBP, DBP and MAP |
Izadi, 2020- Tehran, Iran [57] | 514 students, without disease, or regular use of medication or supplement, recruited from local schools Mean BMI(SD) in kg/m2: 17.41 (0.19) % Male: 46.69% Age in years: Range: 7–12; Mean(SD): 9.16 (1.53) | Serum 25(OH)D: ELISA SBP and DBP: standard mercury pressure gauge with dimensions suitable for children and standard medical devices in a sitting position after a 5-min rest | Linear regression; Age; BMI; Gender; DBP; Triglycerides; HDL and Total Cholesterol | No association between vitamin D with SBP, in adjusted model |
Jang, 2013- South Korea [58] | 320 adolescents, not taking medications and not having high insulin levels, recruited from schools as part of the Korean Children Adolescent Study Not-overweight: 88.4%; Overweight: 11.5% % Male: 0% Age in years: Range: 12.4–14.5; Mean(SD): NR | Serum 25(OH)D: gamma counter with a radioimmunoassay Vitamin D status: Deficient: < 50 nmol/L SBP and DBP: average of 2 readings by a mercury sphygmomanometer in a sitting position at rest High BP: ≥ 130/85 mmHg | BMI z-score; Physical activity | ● No correlation between vitamin D with SBP and DBP ● Higher SBP with vitamin D deficiency ● No differences in prevalence of HTN and DBP across vitamin D status groups |
Kardas, 2013- Turkey [59] | 114 children and adolescents obese (BMI ≥ 90th p for reference curves for Turkish children) and non-obese recruited from a children hospital Mean BMI(SD) in kg/m2: 24.5 (5.4); Mean BMI (obese): 28.5 (2.7); Mean BMI (non-obese); 19.6 (3.6) % Male: 50.9% Age in years: Mean(SD) obese: 13.5 (1.6); non-obese 13.4 (1.7) | Plasma 25(OH)D: HPLC SBP and DBP: average of 2 readings by a mercury sphygmomanometer, after a 20 min rest | None | Inverse correlation between vitamin D with SBP and DBP in the total sample; no longer significant when assessed among obese and non-obese participants |
Kelishadi, 2014-Iran [61] | 1095 nationally representative sample of Iranian students Mean BMI(SD) in kg/m2: 19.37 (4.58) % Male: 52% Age in years: Range: 10–18; Mean(SD): 14.74 (2.61) | Serum 25(OH)D: chemiluminescence immunoassay SBP and DBP: average of two readings by a standardized mercury sphygmomanometer in a sitting position on the right arm with an appropriate cuff size | Age; Gender; Anthropometric measures | Inverse association between vitamin D with SBP and DBP |
Khadgawat, 2012- New Delhi, India [62] | 62 obese Asian-Indian children and adolescents without any known systemic illness, endocrine or metabolic disorder or symptoms suggesting hypothalamic obesity, not taking any medications. Mean BMI(SD) in kg/m2: 29.3 (4.8) % Male: 56.5% Age in years: Range: 6–17; Mean(SD): 13 (3.1) | Serum 25(OH)D: radioimmunoassay Vitamin D status groups: Deficient:< 50 nmol/L; Severe; Deficiency: < 12.5 nmol/L; Moderate Deficiency: 12.5–25 nmol/L; Mild Deficiency :25–50 nmol/L SBP and DBP: average of 3 readings in a sitting position, after a 5 min rest ,by a mercury sphygmomanometer in the right upper arm with an appropriate size cuff | BMI; Age; Gender; Pubertal stage | No differences in SBP and DBP across vitamin D status groups |
Kim, 2018- South Korea [64] | 2314 adolescents selected from the KNHANES (2010–2014) nationwide survey who were fasting for more than 8 h, and had complete data for 25(OH)D and metabolic syndrome components Mean BMI(SD) in kg/m2: NR % Male: 53.80% Age in years: Range: 12–18; Mean(SD): NR | Serum 25(OH)D: NR Vitamin D status groups: Deficient: < 50 nmol/L; Sufficient: ≥ 50 nmol/L SBP and DBP: average of 3 readings on the right arm after a 5-min rest Elevated BP: SBP ≥ 130 mmHg; DBP ≥ 85 mmHg | Age; Gender; Household income; Residential area; Self-perceived health status; Self-perceived stress status; family history of chronic disease; Sleep habits, and physical activity habits | Similar odds of elevated BP across vitamin D status groups, in adjusted model |
Kumar, 2009-USA [65] | 9757 non-Hispanic white, non-Hispanic black, Hispanics/Mexicans and other race; children and adolescents from the NHANES study (2001–2004) Mean BMI(SD) in kg/m2: NR % Male: NR Age in years: Range: 1–21; Mean(SD): NR | 25(OH)D: diasorin assay Vitamin D status groups: Deficient:< 37.5 nmol/L; Insufficient: 37.5–72.5 nmol/L SBP and DBP: average of 3 readings HTN: SBP or DBP >95th p for the median height of each participant's age and gender or > 140/90 mmHg in those ≥ 17 years of age | Age; Gender; Race/ethnicity; Poverty income ratio; Obesity; Milk intake; Television and computer use; vitamin D supplement use | ● Higher odds of HTN with vitamin D deficiency ● Higher SBP and DBP with poorer vitamin D status |
Lee, 2014-Seoul, South Korea [14] | 1660 children from the KMOSES, no history of cardiovascular disease, diabetes, HTN or endocrine disorders, non-smoking, no alcohol consumption Mean BMI(SD) in kg/m2: Boys: 8.6 (3.4) Girls: 17.4 (3.0) % Male: 54.5% Age in years: Range: 9; Mean(SD): NR | Serum 25(OH)D: chemiluminescent immunoassay SBP and DBP: standard brachial cuff technique. HTN: > 90th p for sex, height and age | BMI | ● No differences in prevalence of high BP, SBP and DBP across quartiles of vitamin D ● No difference in vitamin D level among normotensive and those with high BP |
Lee, 2015- Seoul, South Korea [68] | 2880 children and adolescents from the KNHANES (2008–2010) nationwide survey having data on 25(OH) D levels and blood sample for metabolic syndrome components Mean BMI(SD) in kg/m2: 20.46 (3.57) %Male: 53.4% Age in years: Range:10–18; Mean(SD): 13.74 (2.49) | 25(OH)D: 125I-labelled radioimmunoassay kits SBP and DBP: average of 2 readings in the right arm, within 5 min interval, by a standard mercury sphygmomanometer at rest. | Age; Gender | Lower SBP and DBP with increasing quartiles of vitamin D |
Lee, 2016- USA [69] | 209 non-Hispanic white, non-Hispanic black, other race, overweight or obese patients recruited to participate in the OSCIR if having insulin resistance, depressed fasting glucose to fasting insulin ratio or referral from primary health clinics and free of chronic or acute infectious diseases, not taking glucose or lipid lowering medications. Mean BMI(SD): 35.9 (8.4) %Male: 45% Age in years: Range: 6–18; Mean(SD): 12.6 (2.9) | Plasma total 25(OH)D: in duplicates by Immunodiagnostic Systems enzyme immunoassay SBP and DBP: standard sphygmomanometer in a sitting position with an appropriate size cuff | None | No association between vitamin D with SBP and DBP |
Malyavskaya, 2017- Russia [108] | 319 children and adolescents, without acute and/or chronic diseases, recruited from secondary educational institutions Mean BMI(SD) in kg/m2: Q1: 22.6 (4.2); Q2: 20.8 (4.7); Q3: 20.2 (4.4); Q4: 19.6 (3.4) %Male: 51% Age in years: Range:10–15; Mean(SD): 13.3 (1.6) | Serum 25 (OH)D: ELISA SBP and DBP: NR | None | ● No differences in SBP and DBP across quartiles of vitamin D, except for a higher DBP for Q 1 vs. 4 ● Inverse correlation between vitamin D with DBP only |
Matter, 2016-KSA [72] | 84 healthy adolescents attending an outpatient clinic, without acute or chronic disease or under treatment that could influence 25(OH)D level, and with 25(OH)D levels of < 50 or > 75 nmol/L Mean BMI(SD): NR % Male deficient group: 60%; control group:72% Age in years: Range: 12–16; Mean(SD) deficient group: 14.08 (2.01); control group: 13.93 (1.06) | Serum 25(OH)D: radioimmunoassay Vitamin D status: Deficient: < 50 nmol/L SBP and DBP: NR | None | No differences in SBP and DBP across vitamin D status groups |
Mellati, 2015-Iran [73] | 297 healthy schoolchildren Mean BMI(SD) in kg/m2: 17.81 (3.39) % Male: 45.10% Age in years: Range: 7–11 ; Mean(SD): 7.86 (1.32) | Serum 25(OH)D: ELISA using immunodiagnostic system SBP and DBP: average of 3 readings in 10 min intervals after at least a 15-min rest. For those with higher BP, the measurement was repeated on another day | None | ● Lower SBP and DBP with increasing tertiles of vitamin D ● Inverse correlation between vitamin D with SBP and DBP |
Milagres, 2017-Vicosa, Brazil [74] | 378 children from all public and private schools from the Survey of Health Assessment of Schoolchildren, not taking medications interfering with metabolism of vitamin D, glucose, lipids, and no vitamin mineral supplementation. Mean BMI Z-score: 0·41 (1.4) % Male: 47.8% Age in years: Range: 8–9; Mean(SD): NR | Serum 25(OH)D: architect 25-OH vitamin D assay Vitamin D status group: Deficient: < 50 nmol/L; Insufficient: ≥ 50–< 75 nmol/L; Sufficient: ≥ 75 nmol/L SBP and DBP: average of 3 readings by an automatic inflation BP monitor in a sitting position with at least a 5-min rest Elevated BP: SBP or DBP ≥ 90th p for age, gender and height according to the VI Brazilian guidelines of HTN by the Brazilian Society of Cardiology | Age; Gender; Season Ethnicity; PTH; Per capita income; Maternal schooling; vitamin D intake; Sedentary behavior; Percentage of body fat (or other measures of adiposity) | No difference in prevalence of elevated BP and HTN across vitamin D status groups |
Moore, 2017-USA [75] | 2908 children and adolescents from the NHANES study (2007–2010), not pregnant, and completed 24-h recall Mean BMI(SD) in kg/m2: NR % Male: 51.4% Age in years: Range: 8–18; Mean(SD): NR | Serum 25(OH)D: LC/MS Vitamin D status group: Deficient: < 50 nmol/L; Insufficient: 50–72.5 nmol/L; Sufficient :> 72.5 nmol/L SBP and DBP: average of 3 readings by the auscultatory method in a sitting position for 5 min Normal BP: SBP or DBP < 90th p for age, sex and height; Pre-HTN: SBP: ≥ 90th to < 95th p for age, sex and height; HTN: ≥ 95th p for age, sex and height | Race/ethnicity; Sex; Age; Economic status; BMI z-score | ● No association between vitamin D with SBP and DBP, in adjusted model ● Higher prevalence of HTN with poorer vitamin D status |
Muhairi, 2013- Al Ain, UAE [76] | 315 healthy adolescents (BMI: 5–75th p for age and sex), not using regular medications or have chronic medical conditions that might affect growth, body composition, dietary intake or physical activity and non-smokers, recruited from schools obese:16.5%; Overweight :15.9; Lean: 67.5% % Male: 48% Age in years: Range: 12–18; Mean(SD): NR | Serum 25(OH)D: radioimmunoassay SBP and DBP: average of 2 readings by a standard mercury sphygmomanometer after a 5-min rest in a sitting position with appropriate cuff size | None | No difference in vitamin D level among normotensive and those with high BP |
Nam, 2012- South Korea [77] | 713 adolescents from the KNHANES (2007–2009), nationwide survey not having congenital heart disease or previous diagnosis of epilepsy Mean BMI (SD) in kg/m2: 21.12 (0.16) % Male: 53.01 Age in years: Range: 12–19; Mean(SD): NR | Serum 25(OH)D: radioimmunoassay SBP and DBP: average of 2 measurements in 5-min intervals, by standard mercury sphygmomanometer on the right arm | None | ● No difference in SBP across tertiles of vitamin D ● Lower DBP with increasing tertiles of vitamin D |
Nam, 2014- South Korea [78] | 1504 adolescents from the KNHANES (2008–2009), nationwide survey, not having congenital heart disease or epilepsy Mean BMI(SE): insufficient group: 21.2 (0.1); sufficient group: 20.4 (0.2) % Males: 52.65% Age in years: Range: 12–18; Mean(SD): NR | Serum 25(OH)D: radioimmunoassay Vitamin D status groups: Insufficient: ≤ 50 nmol/L; Sufficient: > 50 nmol/L SBP and DBP: average of 2 measurements in 5-min intervals, by standard mercury sphygmomanometer on the right arm High BP: SBP or DBP ≥ 90th p for age and sex, use of BP-lowering medication or a previous diagnosis of HTN | For the OR between high BP and 25(OH)D: Age; Gender; BMI; Regular physical exercise; Alcohol drinking; Use of multivitamin or mineral supplements | ● Inverse correlation between vitamin D with SBP and DBP ● No difference in SBP across vitamin D status groups; higher DBP with vitamin D insufficiency ● Similar odds of high BP across vitamin D status groups, in adjusted model |
Nsiah-Kumi, 2012- Nebraska, USA [80] | 198 native American healthy youth (without active infection, or illness that could affect weight), recruited from schools, local grocery store, tribal exercise facility, health facilities, community events Mean BMI p: 78 (1.7) % Male: 47% Age in years: Range: 5–19; Mean(SEM): 10.8 (0.3) | 25(OH)D: radioimmunoassay vitamin D status groups: Deficient: < 40 nmol/L; Insufficient: < 75 nmol/L SBP and DBP: after a 5-min rest, using an appropriately sized cuff | BMI p for age and sex | Inverse association between vitamin D with SBP and DBP |
Nwosu, 2013-Central New England, USA [81] | 45 prepubertal healthy children recruited using paper flyers from primary care physician offices Normal weight: 44.4%; Overweight: 55.6% % Male: 58% Age in years: Range: 3–12; Mean(SD): 8.3 (2.5); Males: 9.0 (2.4); Females: 7.28 (2.4) | Serum 25(OH)D: chemiluminescent immunoassay Vitamin D status groups: Deficient:< 50 nmol/L; Sufficient: > 50 nmol/L SBP and DBP: NR | None | No differences in SBP and DBP across vitamin D status groups |
Oliveira, 2014-Juiz de Fora, Brazil [83] | 160 healthy adolescents not using medications or supplements, recruited from schools Normal weight: 48.1%; Overweight: 51.9% (matched for age, gender and type of school) % Male: 55.6% Age in years: Range: 15–17; Mean(SD): 16 (0.9) | Serum 25(OH)D: radioimmunoassay SBP and DBP: average of the second and third measurements, at 5-min intervals, with the right arm at the same level as the heart, by an equipment validated against mercury sphygmomanometers according to the international validation protocol, using an appropriate cuff size, in a sitting position Elevated BP: based on parameters of the Brazilian HTN Society taking into account gender, age and height | None | Lower vitamin D level among hypertensive participants |
Olson, 2012- North Texas, USA [84] | 411 obese (BMI ≥ 95th p for age) children without disease, not using medications or vitamin D supplement > 400 IU/day, recruited from an obesity center at a children’s medical center Mean BMI(SD) in kg/m2: NR % Male: 43% Age in years: Range: 6–16; Mean(SD): 11.7(2.6) | 25(OH)D: chemiluminescent immunoassay SBP and DBP: average of up to 3 measures, by dinamap procare monitor, at rest | BMI z-scores; Age | No correlation between vitamin D with SBP and DBP |
Pacifico, 2011-Rome, Italy [85] | 452 healthy children recruited from outpatient clinics %Male Tertile 1: 49.4%; Tertile 2: 45%; Tertile 3: 45.6% Overweight/obese: 67.25% Age in years: Median(IQR): Tertile 1: 11.5 (4.2); Tertile 2: 11.2 (4.3); Tertile 3: 11.0 (4.0) | Serum 25(OH)D3: electrochemiluminescence immunoassay SBP and DBP: average of 2 measures, at the right arm in the supine position using an automated oscillatory system, after a 10-min rest Elevated BP: SBP or DBP ≥ 90th p for age, gender and height | For correlation: age; gender; Tanner stage For regression: Model 1: age; gender; Tanner stage Model 2: age; gender; Tanner stage; waist circumference Model 3: age; gender; Tanner stage; Standard deviation score-BMI | ● Lower SBP and DBP with increasing tertiles of vitamin D ● Negative correlation between vitamin D with SBP only ● Lower odds of elevated BP with increasing tertiles of vitamin D, in adjusted model |
Parikh, 2012- Augusta area, USA [86] | 701 healthy adolescents, not taking medications, recruited from high schools Mean BMI(SD) in kg/m2: 23.0 (4.7) Age in years: Range: 14–18; Mean(SD): 16.2 (1.2) | Plasma 25(OH)D: liquid chromatography tandem mass spectroscopy SBP and DBP: NR | Age; Gender; Ethnicity; Sexual maturation; Season; Physical activity; Percent body fat | ● Inverse correlation between vitamin D with SBP and DBP ● Lower SBP with increasing tertiles of vitamin D; No difference in DBP |
Petersen, 2015-Denmark [87] | 782 healthy children, not taking medications, recruited from schools Girls: Obese: 2%; Overweight: 13%; Normal weight: 74%; Underweight: 11% Boys: Obese: 2%; Overweight: 11%; Normal weight: 78%; Underweight: 9% Age in years: Range: 8–11; Mean(SD): Boys: 10.1 (0.6); Girls: 9.9 (0.6) | Serum 25(OH)D (including both D2 and D3): automated chemiluminescent immunoassay SBP and DBP: average of 3 readings, after 10-min rest, by an automated device, using two different cuff sizes | Sex; Age; Height; Ethnicity; Whole-blood EPA+ DHA; Entered puberty (yes/no); Parental education | ● No association between vitamin D with SBP ● Inverse association with DBP, in adjusted model |
Pirgon, 2013-Turkey [88] | 87 obese adolescents, recruited from a pediatric endocrinology unit: 45 patients with NAFLD and 42 patients without NAFLD, not taking medications, and free of other diseases Mean BMI(SD) in kg/m2: 2.1 (0.3) % Male: 48.2% Age in years: Range: 11–15; Total: Mean(SD): 12.7 (1.3); NAFLD group:12.8 (0.8); Non-NAFLD group:12.6 (1.7) | Serum 25(OH)D: automated chemiluminescence immunoassay SBP and DBP: mercury-gravity manometer and a cuff appropriate for body size, in a sitting position, after rest for at least 5 min | None | No correlation between vitamin D with SBP and DBP in participants with and without NAFLD |
Prodam, 2016- Novara area, Italy [89] | 575 healthy, overweight or obese, sedentary children and adolescents (according to International Obesity Task Force criteria), not using medications, recruited from a pediatric endocrinology clinic Mean BMI (SD) in kg/m2: 26.7 (4.5) Severely obese: 27.6%; Obese: 44.2%; Overweight: 28.2% % Male: 50.26% Age in years: Range: 6–18; Mean(SD): 10.7(2.8) | Serum 25(OH)D: direct competitive chemiluminescent immunoassay SBP and DBP: average of 3 measurements on the left arm, after a 15-min rest in the supine position and prior to other physical evaluations, using a standard mercury sphygmomanometer | None | Inverse correlation between vitamin D and SBP only |
Rafraf, 2014- Boukan, Iran [90] | 216 healthy adolescents, not using medication or supplements, recruited from high schools Mean BMI(SD) in kg/m2: 21.1 (3.5) % Male: 0% Age in years: Range: 14–17; Mean(SD): 15.9 (1.0) | Serum 25(OH)D: ELISA SBP and DBP: average of 2 measurements, at a 1–2 min interval, in the morning by a mercury sphygmomanometer with an adult cuff on the upper right arm, with the arm horizontally on a table, in the sitting position, after a 5-min rest | BMI; Energy; Physical activity level | No association between vitamin D with SBP and DBP |
Reis, 2009- USA [91] | 3528 adolescents nationally representative sample of white, black, Mexican American and other race (NHANES 2001–2004) not diabetic, not pregnant Mean BMI(SD) in kg/m2: NR % Male: 51.5% Age in years: Range: 12–19; Mean(95%CI): 15.4 (15.3–15.6) | Serum 25(OH)D: radioimmunoassay SBP and DBP: average of up to 4 measures by a mercury-gravity sphygmomanometer using appropriate arm cuff size, in seated position, after a 5-min rest High BP: SBP or DBP ≥ 90th p for age, sex, and height, or use of BP medications | Age; Gender; Ethnicity; BMI Poverty-to-income ratio; Physical activity No adjustment for vitamin D as outcome | ● Lower prevalence of high BP and SBP with increasing quartiles of vitamin D; No difference in DBP ● Lower vitamin D level among participants with high BP |
Simpson, 2020-Connecticut, USA [92] | 203 healthy, urban-dwelling children, not using medications or vitamin D supplements > 400 IU/day, recruited to participate in a vitamin D supplementation study from local medical offices and community site Mean BMI(SD) in kg/m2: NR % Male: 50.24% Age in years: Range: 6 months–10 years; Mean(SD): 5.6 (2.3) | Total serum 25-OHD and 1,25(OH)2D: radioimmunoassay Calculated free 25(OH)D: calculated using serum vitamin D binding protein and albumin concentrations, and their reported dissociation constants Genotype-specific free 25(OH)D: calculated using 25(OH)D/DBP dissociation constants specific for each individual’s haplotype Direct measured free 25(OH)D: ELISA SBP and DBP: NR | None | Inverse correlation between vitamin D with SBP only |
Skrzypczyk, 2018- Poland [93] | 49 children and adolescents with primary HTN, not using vitamin D supplements during last 12 months Obese: 30.6%; Overweight: 28.6% % Male: 69.4% Age in years: Range: 5.58–18; Mean(SD): 14.29 (3.17) | 25(OH)D: chemiluminescence Peripheral BP: using oscillometric device 24-h BP: using a SUNTECH OSCAR 2 device and interpreted according to the American Heart Association guidelines. Monitors were programmed to measure BP every 15 min from 6 AM to 10 PM and every 30 min from 10 PM to 6 AM. SBP, DBP and MAP: measured during 24 h | None | No correlation between vitamin D with SBP and DBP |
Teixeira, 2018- Rio de Janeiro, Brazil [96] | 60 severely obese adolescents (BMI > 99.9th p for age), without chronic disease, not taking medications or vitamin D supplementation, recruited from an obesity clinic Mean BMI(SD) in kg/m2: 46.21 (7.01) % Male: 36.7% Age in years: Range: 10–20; Mean(SD): 17.32 (1.35) | Serum 25(OH)D: HPLC Vitamin D status group: Deficient: ≤50 nmol/L; Insufficient: > 50– < 75 nmol/L; Adequate: 75–247 nmol/L SBP and DBP: average of 2 measures taken 1 min apart, by oscillometric technique semi-automatic digital arm device, after a 5-min rest HTN: according to the VI Brazilian Guidelines for HTN in adolescents | None | No difference in prevalence of HTN across vitamin D status groups |
Tomaino, 2015- Lima and Tumbes, Peru [97] | 1074 adolescents selected from a community census Mean BMI in kg/m2: 21.2 Overweight (based on standard recommendations for age- and sex-specific body mass index cutoffs for international, adolescent populations): 22% % Male:48% Age in years: Range: 13–15; Mean(SD): 14.9 (0.8) | 25(OH)D: in duplicate, using the LIASON 25-OH vitamin D total assay Vitamin D status group: Deficient: < 50 nmol/L; Non-deficient: ≥ 50 nmol/L SBP and DBP: median of 3 measurements, after 5-min rest, using the right arm and in the seated position MAP: 1/3 SBP + 2/3 DBP | Overweight status; Age; Sex; Height; Seasonality; Personal smoking status; Second-hand smoke exposure; Monthly household income; Study site | Higher MAP, SBP, DBP with vitamin D deficiency |
Valle, 2019- Rio de Janeiro, Brazil [98] | 97 overweight (BMI ≥ 85th p) and obese adolescents (BMI ≥ 95th p), cared for in the NESA, free of chronic disease, not taking medications or supplements Mean BMI(SD) in kg/m2: 32.2 (6.3) %Male: 44% Age in years: Range: 12–19; Mean(SD): 14.7 (1.8) | Serum 25(OH)D: HPLC Vitamin D status group: Deficient: < 50 nmol/L SBP and DBP: by an automatic inflation BP monitor (not detailed) High BP: NR | None | ● Inverse association between vitamin D with DBP only ● Higher prevalence of elevated BP with vitamin D deficiency ● Higher SBP with vitamin D deficiency |
Williams, 2011-USA [100] | Nationally representative sample of healthy adolescents (NHANES 2001–2006) [N for 25(OH)D: 6013; SBP: 4807; DBP: 4777] % Male: Quintile 1: 40.7%; Quintile 2: 52.9%; Quintile 3: 53.7%; Quintile 4: 54.6%; Quintile 5: 54.6% Age in years: Range: 12–19; Mean(95%CI): Quintile 1: 15.7 (15.5, 15.9); Quintile 2: 15.1 (14.9, 15.3), Quintile 3: 14.9 (14.7, 15.2); Quintile 4: 15.2 (15.0, 15.5); Quintile 5: 15.6 (15.4, 15.8) | Serum 25(OH)D: radioimmunoassay SBP and DBP: average of up to 4 measurements, at rest | Age; Gender; Ethnicity; Poverty income ratio; Waist circumference; Sampling probability (via weights); Cluster effects | Inverse association between vitamin D and SBP only |
Wojcik, 2017- Krakow, Poland [104] | 30 obese adolescents recruited from a children’s university hospital Mean BMI(SD)in kg/m2: 32.5 (4.85) % Male: 46.66% Age in years: Range: NR; Mean(CI): 13.23 (12.64–13.8) | Serum 25(OH)D: HPLC Vitamin D status group: Deficient: < 50 nmol/L SBP and DBP: average of 3 measurements, every 3 min, using a pneumatic sphygmomanometer Arterial HTN: mean SBP and/or DBP >95th p for age, height and gender | None | Higher prevalence of arterial HTN and DBP with vitamin D deficiency; no difference in SBP |
Xiao, 2020- China [105] | 6091 nationally representative sample of children and adolescents, without any condition, or use of drug affecting cardiovascular health, recruited from schools Mean BMI(SD) in kg/m2: NR % Male:50.2% Age in years: Range: 6–18; Mean(SD): 11.9 (3.7) | Plasma 25(OH)D: chemiluminescent immunoassay Vitamin D status group: Adequacy: < 50 nmol/L; Inadequacy: > 50 nmol/L SBP and DBP: average of last 2 reading out of 3, with 1–2 min intervals, after resting for at least 15 min, in a sitting position from the right arm using a suitable cuff size based on the arm circumference HTN: average SBP and/or DBP ≥ 95th sex, age and height-specific p for Chinese children and adolescents, or taking antihypertensive drugs | Age; Gender; Season of blood collection; Geographical location; Smoking; Drinking; Physical activity; Dietary vitamin D intake; BMI; Fat mass percentage; Muscle mass index | Higher odds of HTN with vitamin D inadequacy, in the total sample and in girls only |
Yousefichaijan, 2019- Arak, Iran [106] | 65 healthy children, without disease, not taking hypertensive drugs, with vitamin D deficiency, recruited from a hospital Mean BMI(SD) in kg/m2: 16 (2.84) % Male: 49.2% Age in years: Range < 11; Mean(SD): 13.9 (3.2) | Serum 25(OH)D: NR Vitamin D status group: Deficient: < 50 nmol/L SBP and DBP: digital monitor citizen Hypertensive status: Normal: BP < 90th p for age, gender and height; Pre-HTN: BP: 90–95th p; Stage 1 HTN: BP: 95–99th p + 5 mmHg; Stage II HTN: BP: >99th pe + 5 mmHg | None | No difference in vitamin D level across BP status groups |
Zhou, 2011- USA [107] | 140 healthy obese (BMI > 95th p for age and gender) children, recruited from a pediatric endocrine clinic Mean BMI(SD) in kg/m2: 34.5 (7.4) % Male: 40.7% Age in years: Range: 6–21; Mean(SD): 13.9 (3.2) | Serum 25(OH)D: chemiluminescent assay SBP and DBP: NR | Age | ● Negative correlation between vitamin D with SBP only ● Higher SBP with vitamin D deficiency |
Retrospective | ||||
Aypak, 2014- Ankara- Turkey [39] | 168 medical records of Turkish children, from outpatient pediatric clinics Obese: 26.2%; Overweight 20.2%; Lean: 53.6% % Male: 51.8% Age in years: Range: 4–16; Median: 11 | 25(OH)D: imunochemiluminescent assay SBP and DBP: NR | None | No correlation between vitamin D with SBP and DBP |
Gul, 2017- Tokat- Turkey [49] | 310 obese children (> 95th p for sex-specific growth curves and cut-off levels for Turkish children), followed up at an obesity clinic Mean BMI(SD) in kg/m2: 29.22 (4.71) % Male: 42.6% Age in years: Range: 6–17; Mean(SD): 12.10 (2.82) | Serum 25(OH)D: chemiluminescence immunoassay Vitamin D status groups: Deficient: < 37.5 nmol/L; Insufficient: 37.5–72.5 nmol/L; Sufficient: ≥ 75 nmol/L SBP and DBP: NR HTN: BP ≥ 95th p for age, sex and height | None | ● No differences in HTN frequency, SBP and DBP according to vitamin D status groups ● No correlation between vitamin D with SBP and DBP ● Lower vitamin D level among hypertensive participants |
Kao, 2015- Australia [16] | 229 obese children and adolescents (BMI ≥ 95th p for age and sex-specific growth curves) without pre-existing disorders of vitamin D synthesis or action, attending obesity outpatient clinics Mean BMI(SD) in kg/m2: 34.8 (94) % Male: 50.7% Age in years: Range: 2–18; Mean(SD): 12.1 (3) | Serum 25(OH)D: electrochemiluminescent immunoassay or direct chemiluminescence competitive immunoassay SBP and DBP: manual sphygmomanometer in a seated position with appropriate cuff size | BMI; Age; Gender; Season | ● Lower SBP and DBP with increasing quintiles of vitamin D ● Higher odds of elevated BP with lower quintiles of vitamin D |
Kumaratne, 2017- California, USA [66] | 234 healthy Hispanic adolescents from pediatric clinics not taking vitamin D supplementation and having no chronic illness by chart review BMI (< 85th p): 44.4%; Overweight(≥ 95th p for age and gender); Obese (BMI > 85th p for age and gender): 55.6% % Male: 53% Age in years: Range: 13–19; Mean(SD): NR | Serum 25(OH)D: NR Vitamin D status groups: Deficient: < 50 nmol/L; Adequate: ≥ 50 nmol/L SBP and DBP: NR | None | No differences in SBP and DBP across vitamin D status groups, among all weight categories |
MacDonald, 2017- Alberta, Canada [71] | 217 overweight (BMI 85–97 p for age and sex)and obese (> 97th p for age and sex) children attending a pediatric weight management clinic, data collected from charts Mean BMI(SD) in kg/m2: Deficient group: 33.0 (8.1); Sufficient group: 30.1 (6.6) % Male: 50% Age in years: Range: 12–18; Mean(SD): 12.0 (2.9) | Serum 25(OH)D: according to standard methodologies Vitamin D status groups: Deficient: < 50 nmol/L; Sufficient: > 50 nmol/L SBP and DBP: by an automatic BP machine with appropriate cuff size | None | No differences in SBP and DBP across vitamin D status groups |
Smotkin-Tangorra, 2007- New York, USA [95] | 217 obese (>95th p for age and sex) children and adolescents, recruited from a pediatric endocrine clinic at an infants and children's hospital Mean BMI(SD) in kg/m2: 32.2 (6.4) % Male: 45.6% Age in years: Range: 7–18; Mean(SD): 12.9 (5.5) | 25(OH)D: NR Vitamin D status groups: Insufficient: < 50 nmol/L SBP: 1 measure in seated position | None | Higher SBP with vitamin D insufficiency |
Williams, 2014- Pennsylvania, USA [103] | 150 obese children and teenagers (≥ 95 p) attending a pediatric weight loss program Mean BMI(SD) in kg/m2: NR % Male: 35% Age in years: Range: 5–19; Mean(SD): Deficient group: 14.5 (3.1); Insufficient group: 13.6 (3.4) | Serum 25(OH)D: NR Vitamin D status groups: Deficient: < 50 nmol/L; Insufficient: < 75 nmol/L SBP and DBP: NR High BP: > 95th p for age and sex | Age; Sex; Race; Location; Season; Insulin level; Hyperlipidemia; Total comorbidities | Higher SBP with poorer vitamin D status; no difference in prevalence of high BP and DBP |
Case-control | ||||
Liang, 2018- China [70] | 164 children from an established cohort recruited from elementary schools divided into: Hypertensive group: children diagnosed with HTN, not under treatment for vitamin deficiency and not taking antihypertensive drugs or other medications, and free of other diseases Non-hypertensive group: children without HTN or any other disease that affect vitamin absorption and metabolism Mean BMI(SD) in kg/m2:19.45 (4.59); hypertensive group: 22.51 (4.39); non-hypertensive group: 16.36 (1.94) % Male: 50.6% Age in years: Range: 6–12; Mean(SD): 9.81 (1.62) | Serum 25(OH)D: HPLC SBP and DBP: average of 3 readings in the sit-down position by electronic sphygmomanometer using an appropriately sized BP cuff placed on the right arm | BMI | Lower vitamin D level among participants with HTN; NS after adjustment |
Interventional (baseline assessment) | ||||
Al Daghri, 2016- Riyadh, Saudi Arabia [109] | 77 children and adolescents, overweight/obese, with fasting blood glucose 5.6–6.9 nmol/L, without acute or chronic medical conditions, not taking vitamin D supplements, recruited from public schools and health centers Mean BMI(SD) in kg/m2: 32.31 (5) % Male: 33.5% Age in years: Range: 12–17; Mean(SD): NR | Serum 25(OH)D: COBAS e-411 automated analyzer SBP and DBP: average of 2 readings, at rest | None | Inverse correlation between vitamin D with DBP only |
Khayyatzadeh, 2018- Iran [63] | 988 healthy adolescents not taking medications or supplements Mean BMI(SD) in kg/m2: 21.07 (4.2) % Male: 0% Age in years: Mean(SD): Deficient group: 14.5 (1.53); Insufficient group: 14.7 (1.51); Sufficient group: 15.2 (1.53) | Serum 25(OH)D: electrochemiluminescence Vitamin D status groups: Deficient: < 50 nmol/L; Insufficient :50–74.9 nmol/L; and Sufficient: > 75 nmol/L SBP and DBP: standard procedure | None | No differences in SBP and DBP across vitamin D status groups |
Ohlund, 2020- Umea and Malmo, Sweden [82] | 206 healthy children recruited for a vitamin D supplementation study Mean BMI(SD) in kg/m2: NR % Male: 46.1% Age in years: Range: 5–7; Mean(SD): NR | Serum 25(OH)D2 and 25(OH)D3: MS on an API 4000 LC/MS/MS system (AB Sciex) SBP and DBP: using an automated oscillometric sphygmomanometer in Umea, and an automatic BP monitor in Malmo | Gender; Skin color; Study site; Mothers’ education | Inverse association between vitamin D with SBP and DBP, in adjusted model |
Smith, 2018- United Kingdom [94] | 110 healthy adolescents, not taking vitamin D supplement or planning a winter sun vacation Obese (≥ 95th p for age): 7%; Overweight (≥ 85– < 95th p for age): 12%; Normal (≥ 2nd– < 85th p for age): 81% % Male: 43% Age in years: Range: 14–18; Mean(SD): 15.9 (1.4) | Serum 25(OH)D: liquid chromatography-tandem mass spectrometry SBP and DBP: average of 3 measurements, 1-min apart, using an automatic BP monitor, in upright position with the arm supported | Sex; Age; BMI z-score; Tanner stage; Physical activity | No association between vitamin D with SBP and DBP |
Cross-sectional baseline assessments from prospective cohort studies | ||||
Kwon, 2015- South Korea [67] | 205 prepubertal children from Ewha Birth and Growth Cohort Study Mean BMI(SD) in kg/m2: NR % Male: 53.2% Age in years: Range: 7–9; Mean(SD):7.89 (0.85) | Serum 25(OH) D: radioimmunoassay SBP and DBP: average of 2 readings, 5 min apart, by an automatic device with the correct cuff size and the arm properly supported | Age; Sex; BMI z-score; Birth order; Fruit/fruit juice intake; Maternal educational level | No association between vitamin D with SBP and DBP, in adjusted model |
Williams, 2012- Avon, Southwest England [101] | 4274 children from the Avon Longitudinal Study of Parents and Children at 9 years of follow-up Mean BMI(SD) in kg/m2: 17.6 (2.7) % Male: NR Age in years: Mean(SD): 9.86 (0.32) | 25(OH)D: HPLC Season-adjusted 25(OH)D3 Total 25(OH)D: sum of 25(OH)D2 and unadjusted 25(OH)D3 SBP and DBP: mean of 2 measurements, using a Vital Signs monitor, at rest, with the arm supported at chest level | Age; Gender; Ethnicity; Socioeconomic position; Waist circumference; PTH; Circulating calcium and phosphate level | No association between vitamin D with SBP and DBP, in adjusted model |
Cross-sectional baseline assessment from a prospective cohort study and cross-sectional | ||||
Nandi-Munshi, 2017- USA [79] NHANES (2001–2006): Cross-sectional SNAS: Prospective cohort (baseline assessment) | NHANES: 8789 children and adolescents Obese: 19.79%; Overweight: 16.48%; Lean: 63.73% % Male: 49.9% Age in years: Range: 6–19 SNAS: 938 youth with type 1 diabetes Obese: 13.02%; Overweight: 21.04%; Lean: 65.94% % Male: 52.2% Age in years: up to 19 | NHANES: Serum 25(OH)D: radioimmunoassay SBP and DBP: average of up to 3 measures, at rest, using a mercury sphygmomanometer BP: normal: SBP and DBP <90th p; pre-HTN: SBP or DBP ≥ 90th–< 95th p; HTN: SBP or DBP ≥ 95th p SNAS: Serum 25(OH)D: chemiluminescence immunoassay based on a linkage between specific vitamin D antibody-coated magnetic particles and an isoluminol derivative SBP and DBP: average of 3 measures, using a mercury sphygmomanometer HTN: BP > 90 p for age, sex, and height, or use of antihypertensive drugs | None | No difference in vitamin D level among normotensive and those with HTN |