Durá-Travé Teodoro, Gallinas-Victoriano Fidel
Department of Pediatrics, School of Medicine, University of Navarra, Avenue Irunlarrea 1, 31008 Pamplona, Spain.
Department of Pediatrics, Navarra Hospital Complex, 31008 Pamplona, Spain.
Children (Basel). 2022 May 15;9(5):725. doi: 10.3390/children9050725.
Background. There is some controversy concerning a potential interaction between vitamin D and PTH and the GH/IGF-1 axis. The goal of this study is to assess vitamin D and PTH status in children with GH deficiency at diagnostic and during treatment with rhGH. Methods. Longitudinal and descriptive study in 110 patients, aged 3.3−9.1 years, with GH deficiency (GHD group) treated with rhGH. At diagnosis and after 12, 24, 36, and 48 months of treatment, a clinical (height, weight, and bone age) and laboratory (phosphorus, calcium, calcidiol, PTH, IGF-1) evaluation was performed. Concurrently, 377 healthy children, aged 3.8−9.7 years, were enrolled and constituted a control group. Vitamin D status was stated in accordance to the U.S. Endocrine Society criteria. Results. No significant differences were found in the prevalence of vitamin D deficiency among control (11.43%) and GHD (13.6%) groups at the moment of diagnosis, remaining without significant changes at 12 (12.9%), 24 (14.6%), 36 (13.1%), and 48 months (13.3%) of treatment. There were not any significant differences in serum levels of calcium, phosphorus, and calcidiol, but a steady increase (p < 0.001) in PTH was detected. Conclusions. Prepubertal patients with GH deficient do not appear to have a higher risk of vitamin D deficiency than healthy subjects, and with treatment with rhGH, no changes in the organic content of vitamin D were observed although a significant increase in PTH levels was detected.
背景。维生素D与甲状旁腺激素(PTH)以及生长激素/胰岛素样生长因子-1(GH/IGF-1)轴之间的潜在相互作用存在一些争议。本研究的目的是评估生长激素缺乏症患儿在诊断时以及重组人生长激素(rhGH)治疗期间的维生素D和PTH状况。方法。对110例年龄在3.3 - 9.1岁、接受rhGH治疗的生长激素缺乏症患者(GHD组)进行纵向描述性研究。在诊断时以及治疗12、24、36和48个月后,进行临床(身高、体重和骨龄)和实验室(磷、钙、骨化二醇、PTH、IGF-1)评估。同时,招募了377名年龄在3.8 - 9.7岁的健康儿童作为对照组。根据美国内分泌学会标准确定维生素D状况。结果。诊断时,对照组(11.43%)和GHD组(13.6%)维生素D缺乏的患病率无显著差异,在治疗12个月(12.9%)、24个月(14.6%)、36个月(13.1%)和48个月(13.3%)时也无显著变化。血清钙、磷和骨化二醇水平无显著差异,但检测到PTH稳步升高(p < 0.001)。结论。青春期前生长激素缺乏的患者维生素D缺乏风险似乎并不高于健康受试者,并且在rhGH治疗期间,尽管检测到PTH水平显著升高,但维生素D的含量未观察到变化。