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垂体柄中断综合征所致生长激素缺乏症患儿的维生素D

Vitamin D in children with growth hormone deficiency due to pituitary stalk interruption syndrome.

作者信息

Delecroix Cécile, Brauner Raja, Souberbielle Jean-Claude

机构信息

Fondation Ophtalmologique Adolphe de Rothschild and Université Paris Descartes, Paris, France.

Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Service d'Explorations Fonctionnelles, Paris, France.

出版信息

BMC Pediatr. 2018 Jan 24;18(1):11. doi: 10.1186/s12887-018-0992-3.

Abstract

BACKGROUND

Recent studies have shown a relationship between vitamin D status and growth hormone (GH) and insulin-like growth factor 1 (IGF1). The objective of this study was to assess vitamin D status in children with GH deficiency due to pituitary stalk interruption syndrome (PSIS) and to investigate the relationship between 25-hydroxyvitamin D (25OHD) and 1,25-dihydroxyvitamin D (1,25 (OH) D) serum levels and patient characteristics.

METHODS

A retrospective single-center study of 25OHD and 1,25(OH)D serum concentrations in 50 children with PSIS at the initial evaluation before treatment.

RESULTS

Mean concentrations of 33.2 ± 18.0 ng/mL for 25OHD and 74.5 ± 40.7 ng/L for 1,25(OH)D were measured. Additionally, 25OHD concentrations were significantly higher in boys than in girls (p = 0.04) and lower in the cold season than in the sunny season (p = 0.03). Significant positive correlations were observed between the GH peak and serum 1,25 (OH) D concentrations (Rho = 0.35; p = 0.015) and the 1,25(OH)D/25OHD ratio (Rho = 0.29; p < 0.05). No correlation was found for other characteristics, including IGF1.

CONCLUSIONS

Vitamin D status in children with hypothalamic-pituitary deficiency due to PSIS was similar to that reported in national and European studies in healthy children. The positive significant correlations between the GH peak and the 1,25 (OH)D concentration as well as with the 1,25 (OH)D/25OHD ratio suggest that even in these patients who had severely impaired GH secretion and low IGF1 levels, an interplay between the GH/IGF1 axis and the vitamin D system still exists.

摘要

背景

近期研究表明维生素D状态与生长激素(GH)及胰岛素样生长因子1(IGF1)之间存在关联。本研究的目的是评估因垂体柄中断综合征(PSIS)导致生长激素缺乏的儿童的维生素D状态,并探讨血清25-羟基维生素D(25OHD)和1,25-二羟基维生素D(1,25(OH)D)水平与患者特征之间的关系。

方法

一项对50例PSIS患儿治疗前初始评估时的25OHD和1,25(OH)D血清浓度进行的回顾性单中心研究。

结果

测得25OHD的平均浓度为33.2±18.0 ng/mL,1,25(OH)D的平均浓度为74.5±40.7 ng/L。此外,25OHD浓度在男孩中显著高于女孩(p = 0.04),在寒冷季节低于阳光充足季节(p = 0.03)。观察到生长激素峰值与血清1,25(OH)D浓度(Rho = 0.35;p = 0.015)以及1,25(OH)D/25OHD比值(Rho = 0.29;p < 0.05)之间存在显著正相关。未发现与包括IGF1在内的其他特征存在相关性。

结论

因PSIS导致下丘脑 - 垂体功能减退的儿童的维生素D状态与国内及欧洲关于健康儿童的研究报告相似。生长激素峰值与1,25(OH)D浓度以及与1,25(OH)D/25OHD比值之间的显著正相关表明,即使在这些生长激素分泌严重受损且IGF1水平较低的患者中,生长激素/IGF1轴与维生素D系统之间仍存在相互作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/878e/5784716/9a1000581b42/12887_2018_992_Fig1_HTML.jpg

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