Vitamin D status and response to growth hormone treatment in prepubertal children with growth hormone deficiency
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Published on: January 7, 2016
T Durá-Travé1,2,3, F Gallinas-Victoriano4, P Moreno-González4
1Department of Pediatrics, School of Medicine, University of Navarra, Pamplona, Spain. tduratra@cfnavarra.es.
Insights
Vitamin D deficiency may impact growth response in children receiving growth hormone (GH) therapy. Monitoring vitamin D levels is recommended for children undergoing GH treatment to optimize growth outcomes.
Area of Science:
- Pediatric Endocrinology
- Nutritional Science
- Growth Hormone Therapy
Background:
- Growth hormone (GH) therapy is a standard treatment for children with GH deficiency (GHD).
- The role of vitamin D status in modulating the efficacy of GH therapy is not fully understood.
- Vitamin D deficiency is prevalent and can affect bone metabolism and overall growth.
Purpose of the Study:
- To investigate if vitamin D deficiency influences the growth response to GH therapy in prepubertal children with GHD.
- To determine if GH treatment affects seasonal variations in vitamin D levels or alters vitamin D status in these patients.
Main Methods:
- A retrospective study involving 98 prepubertal children with GHD treated with GH.
- Growth rates and biochemical markers (IGF-I, 25(OH)D, PTH, calcium, phosphorus) were monitored over 24 months.
- A control group of 247 healthy children was included for comparison.
Main Results:
- No significant difference in vitamin D deficiency prevalence between GHD and control groups initially.
- GH therapy increased growth rate, IGF-1, and PTH, but did not alter vitamin D levels or seasonal variations.
- Children with vitamin D deficiency exhibited a lower growth rate compared to those with sufficient or insufficient vitamin D levels during GH therapy.
Conclusions:
- GH treatment does not appear to modify vitamin D levels in the first two years.
- Vitamin D deficiency may condition the growth response to GH therapy.
- Routine monitoring of vitamin D status is advisable for children receiving GH treatment.
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.
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