Vitamin D Status and Lipid and Glucose–Insulin Abnormalities in Pediatric Patients with Chronic Diseases

Background: Vitamin D insufficiency and deficiency are common in children and adolescents with chronic diseases and may coexist with lipid and glucose–insulin abnormalities. However, evidence across heterogeneous pediatric chronic conditions remains limited. This study aimed to compare these metabolic abnormalities according to vitamin D status in children and adolescents with chronic diseases. Methods: This retrospective cross-sectional study included 321 patients aged 6–17 years evaluated at a tertiary pediatric center in Mexico City, Mexico, with available serum 25-hydroxyvitamin D [25(OH)D], fasting glucose, lipid profile, and insulin measurements. Participants were classified as vitamin D-sufficient (25[OH]D ≥ 30 ng/mL) or -insufficient/deficient (<30 ng/mL). An exploratory multivariable logistic regression analysis was performed to evaluate factors associated with hypertriglyceridemia. Results: The median age was 13 years, 58.3% were female, and 65.8% had overweight or obesity. Vitamin D insufficiency/deficiency was present in 69.7% of participants. Hypertriglyceridemia was more frequent in patients with vitamin D insufficiency/deficiency than in those with sufficient vitamin D concentrations (37.5% vs. 21.6%; p = 0.005). Cholecalciferol supplementation differed markedly between groups, with all patients in the sufficient group receiving supplementation compared with 36.6% of those with insufficiency/deficiency. After adjustment for measured covariates, vitamin D insufficiency/deficiency remained associated with higher odds of hypertriglyceridemia (OR, 2.05; 95% CI, 1.02–4.09), while overweight/obesity showed a stronger association (OR, 2.70; 95% CI, 1.44–5.08). Conclusions: Vitamin D insufficiency/deficiency was common in this clinically selected cohort of children and adolescents with chronic diseases and remained associated with hypertriglyceridemia after adjustment for measured covariates. Overweight/obesity showed an even stronger association. These findings should be interpreted as exploratory and warrant confirmation in prospective studies.