Vitamin D status in children with idiopathic stunting
DOI:
https://doi.org/10.15574/SP.2024.5(141).4954Keywords:
idiopathic short stature, vitamin D, childrenAbstract
Short stature is considered idiopathic in the absence of systemic, endocrine, nutritional, or genetic abnormalities and is defined as growth below two standard deviations of the mean for age, sex, and population.
Aim - analysis of laboratory and auxological indicators and levels of vitamin D in children with idiopathic short stature (ISS) depending on gender to improve the diagnosis of this pathology.
Materials and methods. Thirty-five children with ISS were examined. The following were taken into account: the patient's gender and age, anthropometric data, the blood level of vitamin D, bone age, the level of growth hormone (GH) after stimulation tests (clonidine, insulin), levels of insulin-like growth factor 1 (IGF-1), serum level of total and ionized calcium.
Results. In boys with ISS with an existing vitamin D deficiency basal level of GH was low and 1.7 times lower than in girls with the corresponding deficiency. In the insulin-test, an increase in GH levels was observed in both sexes to normal levels, but in girls, the GH level was 1.6 times higher compared to boys. Showed that regardless of the vitamin D, this indicator was within the normal range. In children with vitamin D deficiency its levels were slightly higher in boys than in girls, but not significantly. In conditions of vitamin D deficiency, a lower level of vitamin D was lower in girls than in boys.
Conclusions. Boys were found to have a low level of vitamin D in blood serum (85.7%), while its deficiency occurred in 46.4% and insufficiency in 39.3%. Girls have a low level of vitamin D occurred in 100% of them, mostly vitamin D deficiency was observed (57.1%), vitamin D deficiency was present in 42.9% of girls with ISS. In children with ISS and hypovitaminosis D, no abnormalities were found in a number of biochemical indicators - creatinine, urea, cholesterol, calcium (total and ionized) and phosphorus in the blood.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. It was found that most of the studied patients had a low level of vit. D, which may be a prerequisite for a standard recommendation to determine this vitamin in children with ISS.
No conflict of interests was declared by the author.
References
Absound M, Cummins C, Lim MJ, Wassmer E, Shaw N. (2011). Prevelance and predictors of vitamin D insufficiency in children: a Great Britain population Based study. PLoS One. 6(7): e22179. https://doi.org/10.1371/journal.pone.0022179
Bopape PG, Wagenaar C, Poka M, Bronkhorst E. (2023, Oct 17). Vitamin D supplementation in a post-pandemic era: A narrative review. S Afr Fam Pract. (2004). 65(1): e1-e6. https://doi.org/10.4102/safp.v65i1.5752
Bouillon R, Norman AW, Lips P. (2007, Nov 8). Vitamin D deficiency. N Engl J Med. 357(19): 1980-1981; author reply 1981-1982. PMID: 17989396. https://doi.org/10.1056/NEJMc072359
Caccamo D, Ricca S, Currò M, Ientile R. (2018, Mar 17). Health Risks of Hypovitaminosis D: A Review of New Molecular Insights. Int J Mol Sci. 19(3): 892. https://doi.org/10.3390/ijms19030892
Calvo MS, Uribarri J. (2013). Public health impact of dietary phosphorus excess on bone and cardiovascular health in the general population. Am J Clin Nutr. 98(1): 6-15. https://doi.org/10.3945/ajcn.112.053934
Christakos S, Dhawan P, Verstuyf A, Verlinden L, Carmeliet G. (2016, Jan). Vitamin D: Metabolism, Molecular Mechanism of Action, and Pleiotropic Effects. Physiol Rev. 96(1): 365-408. PMID: 26681795; PMCID: PMC4839493. https://doi.org/10.1152/physrev.00014.2015
Cohen LE. (2014, May 7). Idiopathic short stature: a clinical review. JAMA. 311(17): 1787-1796. https://doi.org/10.1001/jama.2014.3970
Fleet JC. (2017, Sep 15). The role of vitamin D in the endocrinology controlling calcium homeostasis. Mol Cell Endocrinol. 453: 36-45. https://doi.org/10.1016/j.mce.2017.04.008
Esposito S, Leonardi A, Lanciotti L, Cofini M, Muzi G, Penta L. (2019, Mar 18). Vitamin D and growth hormone in children: a review of the current scientific knowledge. J Transl Med. 17(1): 87. https://doi.org/10.1186/s12967-019-1840-4
Gaksch M, Jorde R, Grimnes G, Joakimsen R, Schirmer H, Wilsgaard T et al. (2017, Feb 16). Vitamin D and mortality: Individual participant data meta-analysis of standardized 25-hydroxyvitamin D in 26916 individuals from a European consortium. PLoS One. 12(2): e0170791. https://doi.org/10.1371/journal.pone.0170791
Ganmaa D, Stuart JJ, Sumberzu lN, Ninjin B, Giovannucci E, Kleinman K et al. (2017). Vitamin D supplementation and growth in urban Mongol school children: Results from two randomized clinical trials. PLoSONE. 12(5): e0175237. https://doi.org/10.1371/journal.pone.0175237
Gilbert-Diamond D, Baylin A, Mora-Plazas M, Marin C, Arsenault JE, Hughes MD et al. (2010). Vitamin D deficiency and anthropometric indicators of adiposity in school-age children: a prospective study. AJCN. 92(6): 1446-1451. https://doi.org/10.3945/ajcn.2010.29746
Hamza RT, Hamed AI, Sallam MT. (2018, Jun). Vitamin D status in prepubertal children with isolated idiopathic growth hormone deficiency: effect of growth hormone therapy. J Investig Med. 66(5): 1-8. Epub 2018 Feb 24. PMID: 29478008. https://doi.org/10.1136/jim-2017-000618
Hatun S, Islam O, Cizmecioglu F, Kara B, Babaoglu K et al. (2005, Feb). Subclinical vitamin D deficiency is increased in adolescent girls who wear concealing clothing. J Nutr. 135(2): 218-222. https://doi.org/10.1093/jn/135.2.218
Henry HL. (2011, Aug). Regulation of vitamin D metabolism. Best Pract Res Clin Endocrinol Metab. 25(4): 531-541. https://doi.org/10.1016/j.beem.2011.05.003
Herrmann M, Farrell CL, Pusceddu I, Fabregat-Cabello N, Cavalier E. (2017, Jan 1). Assessment of vitamin D status - a changing landscape. ClinChem Lab Med. 55(1): 3-26. https://doi.org/10.1515/cclm-2016-0264
Hoel DG, Berwick M, de Gruijl FR et al. (2016). The risks and benefits of sun exposure 2016. Dermatoendocrinol. 8: e1248325. https://doi.org/10.1080/19381980.2016.1248325
Karczmarewicz E, Czekuc-Kryskiewicz E, Płudowski P. (2013). Effect of vitamin D status on pharmacological treatment efficiency: Impact on cost-effective management in medicine. Dermatoendocrinol. 5: 299-304. https://doi.org/10.4161/derm.25279
Kołłątaj W, Kołłątaj B, Klatka M, Wrzołek K, Krzewska A. (2015). Witamina D - rekomendacje czy też konieczność indywidualizacji dawek? Endokrynol Pediatr. 14.1.50: 11-21. https://doi.org/10.18544/EP-01.14.01.1506
Kowalówka M, Główka AK, Karaźniewicz-Łada M, Kosewski G. (2020, Sep 11). Clinical Significance of Analysis of Vitamin D Status in Various Diseases. Nutrients. 12(9): 2788. https://doi.org/10.3390/nu12092788
Kremer R, Campbell PP, Reinhardt T, Gilsanz V. (2009). Vitamin D status and its relationship to body fat, final height, and peak bone mass in young women. J Clin Endocrinol Metab. 94: 67-73. https://doi.org/10.1210/jc.2008-1575
Lappe JM, Travers-Gustafson D, Davies KM, Recker RR, Heaney RP. (2007). Vitamin D and calcium supplementation reduces cancer risk: Results of randomized trial. Am J Clin Nutr. 85: 1586-1591. https://doi.org/10.1093/ajcn/85.6.1586
Lazar L, Eshel A, Moadi L, Yackobovitch-Gavan M, Bar-Maisels M, Shtaif B et al. (2024, Feb 23). Children with idiopathic short stature have significantly different gut microbiota than their normal height siblings: a case-control study. Front Endocrinol (Lausanne). 15: 1343337. https://doi.org/10.3389/fendo.2024.1343337
Li H, Huang T, Xiao P, Zhao X, Liu J, Cheng H et al. (2020, Mar). Widespread vitamin D deficiency and its sex-specific association with adiposity in Chinese children and adolescents. Nutrition. 71: 110646. https://doi.org/10.1016/j.nut.2019.110646
Lips P, Cashman KD, Lamberg-Allardt C, Bischoff-Ferrari HA, Obermayer-Pietsch B, Bianchi ML et al. (2019, Apr). Current vitamin D status in European and Middle East countries and strategies to prevent vitamin D deficiency: a position statement of the European Calcified Tissue Society. Eur J Endocrinol. 180(4): P23-P54. https://doi.org/10.1530/EJE-18-0736
Marcus R, Butterfield G, Holloway L, Gilliland L, Baylink DJ et al. (1990, Feb). Effects of short term administration of recombinant human growth hormone to elderly people. J Clin Endocrinol Metab. 70(2): 519-527. https://doi.org/10.1210/jcem-70-2-519
Minghui S, Wenhua Y, Qianqian Z, Baolan J, Bo B, Mei Z. (2020). Association between serum calcium and phosphorus levels and insulin-like growth factor-1 in chinese children and adolescents with short stature. Int J Gen Med. 13: 1168-1173. https://doi.org/10.2147/IJGM.S276261
Nair R, Maseeh A. (2012, Apr). Vitamin D: The "sunshine" vitamin. J Pharmacol Pharmacother. 3(2): 118-126. doi: 10.4103/0976-500X.95506.
Ryan LM, Brandoli C, Freishtat RJ, Wright JL, Tosi L, Chamberlain JM. (2010). Prevalence of vitamin D insufficiency in African American children with forearm fractures: a preliminary study. J Pediatr Orthop. 30(2): 106-109. https://doi.org/10.1016/j.bone.2007.04.106
Sun M, Yan W, Zhao Q, Ji B, Ban B, Zhang M. (2020). Association between serum calcium and phosphorus levels and insulin-like growth factor-1 in chinese children and adolescents with short stature. Int J Gen Med. 13: 1168-1173. https://doi.org/10.2147/IJGM.S276261
Żak T, Basiak A, Zubkiewicz-Kucharska A, Noczyńska A. (2010). The effect of one year therapy with recombinant human growth hormone (rhGH) on growth velocity, calcium-phosphorus metabolism, bonemineral density and changes in body composition in children with growth hormone deficiency (GHD). Pediatr Endocrinol Diabetes Metab. 16(1): 39-43.
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