Vitamin D status in prepubertal children with isolated idiopathic growth hormone deficiency: effect of growth hormone therapy.
J Investig Med. 2018 Feb 24. pii: jim-2017-000618. doi: 10.1136/jim-2017-000618. Epub ahead of print
Hamza RT1, Hamed AI2, Sallam MT3.
1 Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
2 Department of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
3 Department of Clinical and Chemical Pathology, National Research Center, Cairo, Egypt.
|GH treatment||Insufficient < 30||Deficient (< 20)||Sufficient (> 30 ng)|
|After||22 %||24%||54 %|
Note: Most likely insufficient = 20-30 ng, not < 30 ng
- It appears that GH treatment ==> increases Vitamin D and Increased Vitamin D ==> increased growth
- Search VitaminDWiki for "growth hormone" 254 items as of March 2018
- Growth hormone increased height of children more if higher levels of vitamin D – Aug 2015
- Fetal Growth poor if Vitamin D-Binding Protein gene poor – Feb 2017
- Increased growth factors with vitamin D and Vitamin K2 – May 2012
- Growth Hormone treatment raised vitamin D levels – May 2014
- Vitamin D supplementation can improve velocity of growth in children with vitamin D deficiency which are in treatment with RHGH for growth hormone deficiency DOI:10.1530/boneabs.4.P9 Supplementing GH treatment with Vitamin D speeded up the growth of the child
- Vitamin D across growth hormone (GH) disorders: From GH deficiency to GH excess April 2017, free PDF online
Few studies, and with controversial results, analyzed vitamin D status in children before and after growth hormone (GH) treatment. Thus, we aimed to assess vitamin D status in prepubertal children with idiopathic growth hormone deficiency (GHD), and to evaluate the effect of GHD and GH treatment on vitamin D levels. Fifty prepubertal children with isolated GHD were compared with 50 controls. All were subjected to history, anthropometric assessment and measurement of 25 hydroxyvitamin D (25(OH)D), serum calcium, phosphorous, alkaline phosphatase and parathyroid hormone (PTH) at diagnosis and 1 year after GH therapy. Serum 25(OH)D levels <30 ng/mL and 20 ng/mL were defined as vitamin D insufficiency and deficiency, respectively. 25(OH)D was lower in cases than controls.
Forty per cent of children with GHD were 25(OH)D insufficient and 44% deficient, while 16% were sufficient at baseline. There was a positive correlation between 25(OH)D and peak GH levels. Peak GH was a significant predictor of 25(OH)D levels. After 1 year of GH therapy, 25(OH)D increased (18.42±5.41 vs 34.5±10.1 ng/mL; P<0.001). Overall, 22% of cases remained insufficient and 24% deficient, with an increase in prevalence of children with normal levels (54%; P<0.001). 25(OH) correlated negatively with PTH (r=-0.71, P=0.01).
In conclusion, hypovitaminosis D is prevalent in children with GHD and significantly improved 1 year after GH therapy. 25(OH)D should be assessed in children with GHD at diagnosis and during follow-up.
PMID: 29478008 DOI: 10.1136/jim-2017-000618