Purpose

To analyze whether vitamin D deficiency could condition the growth response to GH therapy, as well as to analyze if GH treatment modifies both seasonal variations and vitamin D levels in these patients.

Methods

Retrospective study in 98 prepubertal children with GH deficiency (GHD), aged 4.1–8.9 years treated with GH. Growth rate and blood testing (calcium, phosphorus, IGF-I, 25(0H)D and PTH) were monitored at diagnostic and every six months until 24 months of treatment. A control group was recruited (247 healthy children, aged 3.8–9.7 years). The criteria of the US Endocrine Society were used for the definition of hypovitaminosis D.

Results

There were no significant differences in vitamin D deficiency among control (12.5%) and GHD groups (15.3%) before starting treatment. Growth rate and IGF-1 and PTH increased (p < 0.05) during GH treatment, but there were no significant differences in calcium, phosphorus and 25(OH)D. There were no significant differences in growth rate and IGF-1, calcium and phosphorus levels in relation to the seasons along GH treatment. There was no correlation between 25(OH)D and IGF-1 during GH therapy. In every programmed control, patients with vitamin D deficiency showed lower growth rate (p < 0.05) compared to patients with vitamin D insufficiency or sufficiency.

Conclusion

GH treatment, at least during the first two years, does not modify the vitamin D levels. Vitamin D deficiency could condition the response to GH therapy so vitamin D monitoring should be considered as part of the routine evaluation of children with GH treatment.

中文翻译：

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青春期前生长激素缺乏症儿童的维生素D状况和对生长激素治疗的反应。

目的

分析维生素D缺乏症是否可以调节对GH治疗的生长反应，以及分析GH治疗是否能改变这些患者的季节性变化和维生素D水平。

方法

回顾性研究了98名年龄在4.1至8.9岁之间的GH青春期前缺乏GH（GHD）的儿童。诊断时以及每6个月直至治疗24个月，监测生长速度和血液测试（钙，磷，IGF-I，25（0H）D和PTH）。招募了一个对照组（247名健康儿童，年龄3.8-9.7岁）。美国内分泌学会的标准用于维生素D缺乏症的定义。

结果

开始治疗前，对照组（12.5％）和GHD组（15.3％）之间的维生素D缺乏量无显着差异。 生长激素治疗期间生长速率，IGF-1和PTH升高（p <0.05），但钙，磷和25（OH）D差异无统计学意义。生长激素治疗期间，生长速率和IGF-1，钙和磷水平无明显差异。GH治疗期间25（OH）D和IGF-1之间无相关性。在每个程序控制中，维生素D缺乏症患者的生长速度均低于维生素D缺乏 或足够的患者（p <0.05）。

结论

至少在头两年内，GH治疗不会改变维生素D的水平。维生素D缺乏可能会影响对GH治疗的反应，因此应将维生素D监测作为对GH治疗儿童进行常规评估的一部分。