目的 研究不同生长激素分泌状态的矮身材儿童25-(OH)D的水平,为临床评估提供理论依据。方法 收集2017年6月-2018年12月就诊于台州市立医院儿科的矮身材儿童101例,依据生长激素药物激发试验峰值分为生长激素完全缺乏(CGHD)组、生长激素部分缺乏(PGHD)组、特发性矮小(ISS)组,并随机选取20例身高正常的健康儿童为对照组,用化学发光法检测各组血清25-(OH)D值。结果 101例儿童中CGHD组26例、PGHD组37例、ISS组38例,三组25-(OH)D水平均低于正常组(P<0.01),CGHD组25-(OH)D低于PGHD、ISS组,差异有统计学意义(P<0.05);CGHD、PGHD、ISS组维生素D缺乏和不足的发病率高于正常组(P<0.01),CGHD、PGHD、ISS三组间差异无统计学意义(P>0.05)。结论 25-(OH)D在不同生长激素分泌状态矮身材儿童中的水平存在不同程度的下降,以CGHD组最为明显。
Abstract
Objective To study the levels of 25-hydroxy vitamin D[25-(OH)D] in short stature children with different growth hormone secretion status, So as to provide theoretical basis for clinicl evaluation. Method Totally 101 children with short stature treated in the department of pediatrics of Taizhou Municiple Hospital from June 2017 to December 2018 were enrolled in this study.and were divided into completely growth hormone deficiency(CGHD)group,part growth hormone deficiency(PGHD)group and idiopathic short stature(ISS)group according to the peak value of growth hormone drug stimulation test.Meanwhile,20 children of normal height were randomly selected as control group.Serum25-(OH)D levels of each group were determined by chemiluminescence. Result Among the 101 children,there were 26 cases in the CGHD group,37 cases in the PGHD group and 38 cases in the ISS group.Levels of 25-(OH)D in the three groups were all significantly lower than those in normal group(P<0.01),and the levels of 25-(OH)D in the CGHD group were significantly lower than those in the PGHD and ISS groups(P<0.05).The incidence rates of vitamin D deficiency and insufficiency in the CGHD,PGHD and ISS groups were higher thanthose in the normal group (P<0.01),and there was no significant difference among the CGHD,PGHD and ISS three groups (P>0.05). Conclusions The level of 25-(OH)D in short stature children with different growth hormone secretion status decreases in different degrees,especially in CGHD group.
关键词
矮小症 /
生长激素 /
生长激素缺乏症 /
25羟维生素D
Key words
short stature /
growth hormone /
growth hormone deficiency /
25-hydroxy vitamin D
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Cutfield WS,Albert BB.Growth Hormone Treatment for Idiopathic Short Stature[J].Pediatr Endocrinol Rev,2018,16(Suppl 1):113-122.
[2] Esposito S,Leonardi A,Lanciotti L,et al.Vitamin D and growth hormone in children:a review of the current scientific knowledge[J].J Transl Med,2019,17(1):1-18.
[3] Goltzman D.Functions of vitamin D in bone[J].Histochem Cell Biol,2018,149(4):305-312.
[4] Bełz A,Stolecki M,Kudła M,et al.Vitamin D-a geriatric point of view[J].Wiad Lek,2018,71(8):1628-1631.
[5] Gong QH,Li SX,Li H,et al.25-Hydroxyvitamin D status and its association with sleep duration in Chinese school children[J].Nutrients,2018,10(8):1-9.
[6] Baron J,Sävendahl L,De Luca F,et al.Short and tall stature:a new paradigm emerges[J].Nat Rev Endocrinol,2015,11(12):735-746.
[7] Witkowska-Sędek E,Kucharska A,Rumińska M,et al.Relationship Between 25-(OH)D and IGF-I in children and adolescents with growth hormone Deficiency[J].Adv Exp Med Biol,2016,912:43-49.
[8] 王慧燕,陶洪群,王玲莉,等.矮小症儿童GH激发试验及25- (OH)D水平的调查分析[J].医学研究杂志,2016,45(1):132-134.
[9] Savanelli MC,Scarano E,Muscogiuri G,et al.Cardiovascular risk in adult hypopituitaric patients with growth hormone deficiency:is there a role for vitamin D? [J].Endocrine,2016,52(1):111-119.
[10] Hamza RT,Hamed AI,Sallam MT.Vitamin D status in prepubertal children with isolated idiopathic growth hormone deficiency:effect of growth hormone therapy[J].J Investig Med,2018,66(5):1-8.
[11] Ciresi A,Cicciò F,Giordano C.High prevalence of hypovitaminosis D in Sicilian children affected by growth hormone deficiency and its improvement after 12 months of replacement treatment[J].J Endocrinol Invest,2014,37(7) :631-638.
[12] 羊小华,何炜,郑彬.重组人生长激素对生长激素缺乏症儿童维生素D、骨代谢、肾上腺皮质功能的影响[J].浙江中西医结合杂志,2019,29(1):68-70.
[13] Ciresi A,Giordano C.Vitamin D across growth hormone (GH) disorders:From GH deficiency to GH excess[J].Growth Horm IGF Res,2017,33:35-42.
[14] Rothermel J,Reinehr T.Metabolic alterations in paediatric GH deficiency[J].Best Pract Res Clin Endocrinol Metab,2016,30(6):757-770.
[15] Munns CF,Shaw N,Kiely M,et al.Global Consensus recommendations on prevention and management of nutritional rickets[J].J Clin Endocrinol Metab,2016,101(2):394-415.
[16] Wójcik D,Szalewski L,Pietryka-Michałowska E,et al.Vitamin D3 and dental caries in children with growth hormone deficiency[J].Int J Endocrinol,2019,21:1-8.
[17] Kužma M,Binkley N,Bednárová A,et al.Trabecular bone score change differs with regard to 25(OH)D levels in patients treated for adultonset growth hormone deficiency[J].Endocr Pract,2016,22(8):951-958.
[18] Witkowska-Sędek E,Stelmaszczyk-Emmel A,Majcher A,et al.The relationship between alkaline phosphatase and bone alkaline phosphatase activity and the growth hormone/insulin-like growth factor-1 axis and vitamin D status in children with growth hormone deficiency[J].Acta Biochim Pol,2018,65(2):269-275.
[19] Mortensen C,Mølgaard C,Hauger H,et al.Winter vitamin D3 supplementation does not increase muscle strength,but modulates the IGF-axis in young children[J].Eur J Nutr,2019,58(3):1183-1192.
[20] Marwaha RK,Garg MK,Gupta S,et al.Association of insulin-like growth factor-1 and IGF binding protein-3 with 25-hydroxy vitamin D in pre-pubertal and adolescent Indian girls[J].J Pediatr Endocrinol Metab,2018,31(3):289-295.
PDF(420 KB)
