Department of Pediatrics, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
Department of Pediatric Orthopaedics, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
PLoS One. 2021 Mar 8;16(3):e0247886. doi: 10.1371/journal.pone.0247886. eCollection 2021.
To investigate the growth velocity-improving effects of vitamin D replacement therapy in pediatric patients diagnosed with vitamin D deficiency and insufficiency.
A retrospective cohort study was conducted in 34 pediatric patients diagnosed with vitamin D deficiency/insufficiency. Based on the clinical findings, the subjects were divided into two groups: a bowed leg (BL) group and a non-bowed leg (non-BL) group. After the initiation of alfacalcidol, the standard deviation score (SDS) of their heights, weights and growth velocities in each group were monitored.
The median age at the first visit was significantly lesser in the BL group (1.58 years old [interquartile range (IQR): 1.33, 2.17]) than that in the non-BL group (3.00 years old [IQR: 2.33, 3.67]). On the contrary, the SDS for height was significantly lower in the non-BL group (-2.27 [IQR: -2.63, -1.94]) than that in the BL group (-1.37 [IQR: -1.91, -1.07]). One-year treatment with alfacalcidol showed significant improvements in both height SDSs and growth velocity SDSs not only in the BL group but also in the non-BL group.
The current study revealed that vitamin D replacement therapy improved the growth rate in children with vitamin D deficiency/insufficiency, regardless of the presence of BL. This study emphasizes the importance of assessing the vitamin D status in children with poor growth rates and suggests that alfacalcidol could be a valid option for the treatment of short stature.
探讨维生素 D 替代治疗对维生素 D 缺乏和不足的儿科患者生长速度的改善作用。
对 34 例维生素 D 缺乏/不足的儿科患者进行回顾性队列研究。根据临床发现,将患者分为弯腿(BL)组和非弯腿(非 BL)组。在开始使用阿尔法骨化醇后,监测每组患者的身高、体重和生长速度的标准差评分(SDS)。
BL 组的首次就诊年龄中位数(1.58 岁 [四分位距(IQR):1.33,2.17])明显小于非 BL 组(3.00 岁 [IQR:2.33,3.67])。相反,非 BL 组的身高 SDS 明显较低(-2.27 [IQR:-2.63,-1.94]),而 BL 组则较高(-1.37 [IQR:-1.91,-1.07])。使用阿尔法骨化醇治疗 1 年后,BL 组和非 BL 组的身高 SDS 和生长速度 SDS 均显著改善。
本研究表明,维生素 D 替代治疗可改善维生素 D 缺乏/不足儿童的生长速度,无论是否存在 BL。本研究强调了评估生长速度较慢儿童维生素 D 状态的重要性,并提示阿尔法骨化醇可能是治疗身材矮小的有效选择。