{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T14:10:50Z","timestamp":1784902250047,"version":"3.55.0"},"reference-count":39,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:00:00Z","timestamp":1784160000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Lower serum 25-hydroxyvitamin D [25(OH)D] is common in pediatric overweight and obesity, but it remains unclear whether direct adiposity assessment adds information beyond an age- and sex-adjusted model containing BMI z-score and season. We tested whether DXA-derived total body fat percentage is associated with 25(OH)D and whether it adds explanatory power to that model. Methods: We analyzed cross-sectional data from 768 children\/adolescents (10\u201318 years) with overweight\/obesity. Anthropometry was available for all; DXA data for 489. The primary analysis used complete-case DXA data (n = 485). Vitamin D supplementation status was not available. Results: Participants with and without DXA were similar in age, sex, BMI z-score, and serum 25(OH)D, but blood sampling season differed (p &lt; 0.001). Adding DXA-derived body fat percentage to the age- and sex-adjusted base model increased R2 from 0.0498 to 0.0657 (\u0394R2 = 0.0159). Within the complete-case DXA subgroup (n = 485), DXA-derived total body fat percentage was inversely associated with 25(OH)D after adjustment for BMI z-score, season, age, and sex (B = \u22120.265; 95% CI, \u22120.448 to \u22120.082; p = 0.005). BMI z-score was significant in the base model but not after adjustment for DXA fat percentage. Conclusions: DXA-derived total body fat percentage added explanatory value for serum 25(OH)D beyond BMI z-score and season, but the incremental gain was small (\u0394R2 = 0.0159). The findings are consistent with BMI z-score acting as a less direct proxy for the adiposity compartment that DXA quantifies more specifically. Causal interpretation is precluded by the cross-sectional design, unknown supplementation status, and non-random DXA availability.<\/jats:p>","DOI":"10.3390\/nu18142334","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:55:59Z","timestamp":1784249759000},"page":"2334","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["DXA-Derived Total Body Fat Percentage and Serum 25(OH)D in Overweight and Obese Children: A Cross-Sectional Study"],"prefix":"10.3390","volume":"18","author":[{"given":"Jolanta","family":"\u015awiderska","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Diabetology, The Children\u2019s Memorial Health Institute (CMHI), 04-730 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Wi\u0119ckowski","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology, Feeding Disorders and Pediatrics, The Children\u2019s Memorial Health Institute (CMHI), 04-730 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0261-8133","authenticated-orcid":false,"given":"Micha\u0142","family":"Wilk","sequence":"additional","affiliation":[{"name":"Department of Oncology, European Health Center Otwock, 05-400 Otwock, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wojciech","family":"Pi\u0119tak","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Diabetology, The Children\u2019s Memorial Health Institute (CMHI), 04-730 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ma\u0142gorzata","family":"Wajda-Cuszlag","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Diabetology, The Children\u2019s Memorial Health Institute (CMHI), 04-730 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"\u015awiercz","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Diabetology, The Children\u2019s Memorial Health Institute (CMHI), 04-730 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6758-371X","authenticated-orcid":false,"given":"Maciej","family":"Jaworski","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry, The Children\u2019s Memorial Health Institute (CMHI), 04-730 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5935-4442","authenticated-orcid":false,"given":"Anna","family":"\u015awi\u0105der-Le\u015bniak","sequence":"additional","affiliation":[{"name":"Department of Anthropometry, The Children\u2019s Memorial Health Institute (CMHI), 04-730 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6997-6197","authenticated-orcid":false,"given":"Agnieszka","family":"Ochoci\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry, The Children\u2019s Memorial Health Institute (CMHI), 04-730 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4757-4859","authenticated-orcid":false,"given":"Aleksandra","family":"Borowska","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Medical University of Gda\u0144sk, 80-210 Gda\u0144sk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Baszy\u0144ska-Wilk","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Diabetology, The Children\u2019s Memorial Health Institute (CMHI), 04-730 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Socha","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology, Feeding Disorders and Pediatrics, The Children\u2019s Memorial Health Institute (CMHI), 04-730 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"El\u017cbieta","family":"Moszczy\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Diabetology, The Children\u2019s Memorial Health Institute (CMHI), 04-730 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/j.jped.2020.08.006","article-title":"Vitamin D deficiency in children and adolescents with obesity: A meta-analysis","volume":"97","author":"Fiamenghi","year":"2021","journal-title":"J. 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