{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T18:31:23Z","timestamp":1788546683971,"version":"build-2803163510"},"reference-count":151,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:p>\n                    Childhood obesity and vitamin D deficiency (VDD) are intertwined global health threats that amplify each other beyond their individual skeletal or metabolic consequences. This review synthesises a decade of clinical, translational and Mendelian-randomisation evidence to show that obesity drives VDD through volume dilution, adipose-tissue sequestration and metabolic associated steatotic liver disease (MASLD)-related hydroxylase dysfunction, while VDD in turn aggravates adipogenesis, leptin resistance and chronic low-grade inflammation, locking children into a self-perpetuating cycle. Meta-analysis of 12 randomised trials (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20091,538) revealed that vitamin D supplementation improves insulin sensitivity and lowers systolic blood pressure only when baseline 25-hydroxyvitamin D (25(OH)D) is &amp;lt;20\u2005ng\/mL and systemic inflammation is modest; no consistent reduction in BMI or fat mass was observed. Obese youths require 2\u20133 times the standard dose to reach 30\u2005ng\/mL, yet incremental metabolic benefit plateaus near 4,000\u2005IU\/day and is lost when systemic inflammation is present. Precision-dosing algorithms incorporating VDR\/CYP2R1\/DBP genotypes and MASLD status are urgently needed. Multi-omic longitudinal trials should clarify the adipose-tissue threshold at which hepatic cytochrome P450 family 27 subfamily B member 1 (CYP27B1) becomes substrate-limited and evaluate the vascular safety of intermittent high-dose boluses before personalised supplementation is translated into routine paediatric practice.\n                  <\/jats:p>","DOI":"10.3389\/fped.2025.1700949","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T06:32:30Z","timestamp":1768285950000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["The interplay between childhood obesity and vitamin D deficiency: mechanisms and implications"],"prefix":"10.3389","volume":"13","author":[{"given":"Xiao","family":"Zhou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhe","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianxin","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaobing","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanmei","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lidan","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1146\/annurev-clinpsy-100219-060201","article-title":"Prevention 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