VITAMIN D, OBESITY AND BONE HEALTH IN CHILDREN: THE ROLE OF METABOLIC SYNDROME AND MASLD
DOI:
https://doi.org/10.32782/health-2025.3.2Keywords:
vitamin D, obesity, children, bone tissue, osteoporosis, metabolic syndrome, MASLDAbstract
This article provides a narrative review of recent scientific literature regarding the complex interrelationship between vitamin D status, obesity, and bone health in the pediatric population. Vitamin D plays a pivotal role in calcium and phosphorus homeostasis, bone mineralization, and the regulation of bone turnover through osteoblast and osteoclast activity. A deficiency in this essential micronutrient during childhood can impair bone development and lead to conditions such as rickets, osteopenia, and osteoporosis. The high prevalence of vitamin D deficiency in children is associated with inadequate sun exposure, poor dietary intake, sedentary lifestyle, and underlying metabolic disturbances.A key focus of the review is the impact of obesity on vitamin D metabolism and skeletal health. Obesity not only reduces vitamin D bioavailability due to its sequestration in adipose tissue but also contributes to chronic low-grade inflammation and metabolic dysregulation, which adversely affect bone structure and function. Emerging evidence highlights that while higher body mass was once considered protective against bone fragility, recent studies suggest that excessive visceral fat, particularly in the presence of metabolic syndrome (MetS), may compromise bone quality and increase fracture risk.The article also explores the implications of metabolic dysfunction-associated steatotic liver disease (MASLD), which is increasingly diagnosed in overweight and obese children. MASLD may disrupt the newly recognized liver-bone axis, thereby contributing to altered bone remodeling and reduced bone mineral density. Furthermore, studies show that vitamin D deficiency is closely associated with the presence and severity of MASLD, suggesting a bidirectional relationship.The authors underscore the potential of vitamin D supplementation and lifestyle interventions, including improved nutrition and physical activity, as viable strategies to mitigate the adverse effects of obesity and MetS on pediatric skeletal health. The need for further clinical and translational research is emphasized to better understand the interactions among vitamin D status, adiposity, liver function, and bone development in children and adolescents.
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