Department of Pediatric Endocrinology, Shanghai Children's Hospital, School of medicine, Shanghai Jiao Tong University, Shanghai, 200062, China.
BMC Pediatr. 2023 Dec 9;23(1):624. doi: 10.1186/s12887-023-04447-7.
To assess the differences in vitamin D levels in girls with rapidly progressive (RP) or slowly progressive (SP) central precocious puberty (CPP) and to compare whether the factors related to RP-CPP influenced the vitamin D status. A cross-sectional study was performed among girls with CPP classified as RP-CPP or SP-CPP.
The baseline data, gonadotropin-releasing hormone (GnRH) stimulation test results, serum 25-hydroxyvitamin D (25OHD) levels, and season of sample collection were analyzed.
The mean 25OHD level in 340 girls was 15.89 ± 6.87 ng/mL, of whom only 10 (2.9%) had normal levels (≥ 30 ng/mL). A total of 114 girls in the SP-CPP group and 226 in the RP-CPP group had similar chronological age, disease course, height SDS, bone mineral density, baseline follicle-stimulating hormone (FSH), peak FSH, and 25OHD levels. Developmental age, body mass index (BMI), BMI SDS, peak luteinizing hormone (LH)/FSH, insulin-like growth factor 1 (IGF-1), and IGF-1 SDS were independent risk factors for RP-CPP. Significant differences were observed among the different serum 25OHD levels in terms of season, disease course, IGF1 level, and BMI SDS (P < 0.05). Moreover, the sampling season was strongly correlated with serum 25OHD levels (r = 0.402, P < 0.001).
The vitamin D levels were generally deficient or insufficient in girls with CPP, but were not related to the different types of CPP. High BMI levels, IGF1 levels, or peak LH/FSH ratio, but not vitamin D levels, could promote the progression of RP-CPP. Seasonal factors mainly influenced the vitamin D levels.
评估快速进展型(RP)或缓慢进展型(SP)中枢性性早熟(CPP)女童维生素 D 水平的差异,并比较与 RP-CPP 相关的因素是否影响维生素 D 状态。对分类为 RP-CPP 或 SP-CPP 的 CPP 女童进行了横断面研究。
分析了基线数据、促性腺激素释放激素(GnRH)刺激试验结果、血清 25-羟维生素 D(25OHD)水平和样本采集季节。
340 名女童的平均 25OHD 水平为 15.89±6.87ng/mL,其中仅有 10 名(2.9%)女童的水平正常(≥30ng/mL)。SP-CPP 组共有 114 名女童,RP-CPP 组共有 226 名女童,两组的实际年龄、病程、身高标准差评分(SDS)、骨密度、基础卵泡刺激素(FSH)、峰值 FSH 和 25OHD 水平相似。发育年龄、体重指数(BMI)、BMI SDS、峰值黄体生成素(LH)/FSH、胰岛素样生长因子 1(IGF-1)和 IGF-1 SDS 是 RP-CPP 的独立危险因素。不同血清 25OHD 水平在季节、病程、IGF1 水平和 BMI SDS 方面存在显著差异(P<0.05)。此外,采样季节与血清 25OHD 水平呈强相关(r=0.402,P<0.001)。
CPP 女童的维生素 D 水平普遍不足或缺乏,但与不同类型的 CPP 无关。较高的 BMI 水平、IGF1 水平或峰值 LH/FSH 比值而不是维生素 D 水平可能促进 RP-CPP 的进展。季节因素主要影响维生素 D 水平。