Serum 25(OH)D Levels And Correlation Analysis In Short Children With Recombinant Human Growth Hormone Therapy

OBJECTIVE:To observe the changes of 25-hydroxyl D(25(OH)D)levels before and after treatment with recombinant human growth hormone(rhGH)in children with short stature,and to understand the 25(OH)D level of children with short stature in specific air environment in Hebei,and to discuss.The effect of short-term rhGH treatment on 25(OH)D levels and its correlation with other growth indicators were discussed.METHODS:Thirty patients with short stature who received rhGH were included in the study,including 18 cases of growth hormone deficiency(GHD)and 12 cases of idiopathic short stature(ISS).RhGH was administered subcutaneously before bedtime at a therapeutic dose of 0.10-0.20 IU /(kg.d).The height(Ht),height growth rate(GV),body weight(Wt),body mass index(BMI),and height standard deviation(HtSDS)before and after treatment were recorded.Serum 25(OH)D,insulin-like growth factor-1(IGF-1),insulin-like growth factor binding protein-3(IGFBP-3),fasting blood glucose(FBG),fasting insulin(FINS),serum triiodothyronine Indicators such as tyrosine(TT3),thyroid hormone(TT 4),and thyroid stimulating hormone(TSH)levels were measured before and after 3 months of rhGH treatment.Results: 1.Comparison of general characteristics of children before rhGH treatmentThirty patients with short stature were enrolled,including 18 patients with GHD and 12 patients with ISS.The age ranged from 6.8 years to 13.8 years,height ranged from 108.9 cm to 137.8 cm,and body weight ranged from 14.5 kg to 32.14 kg.The results showed that there were no significant differences in the indicators of Age,Ht,Wt,BMI and HtSDS between the GHD and ISS groups before treatment.2.Comparison of growth parameters before and after rhGH treatmentAfter 3 months of rhGH treatment Ht,Wt,HtSDS and GV of the 30 patients,were significantly higher than before treatment,but BMIwas not changed significantly before treatment.According to the etiology group comparison,the growth parameters,Ht,Wt,HtSDS and GV of GHD and ISS groups were higher than before treatment,but BMI was not significantly changed before treatment;GHD and ISS group were treated for 3 months.There was no statistical difference in the growth parameters between the two groups,and better therapeutic effects were achieved.3.Changes in serum markers after 3 months of rhGH treatmentSerum IGF-1 and IGFBP-3 levels in children with rhGH after 3 months of treatment were significantly higher than those before treatment,and the difference was statistically significant.Serum IGF-1 and IGFBP-3 levels were increased before and after treatment in the GHD group and ISS group,and the difference was statistically significant,while there were no significant difference of the levels of IGF-1 and IGFBP-3in the GHD and ISS groups after rhGH treatment.The fasting insulin level of children after rhGH treatment was higher than that before treatment.The difference was statistically significant.There were no significant differences in serological indexes such as TT3,TT4,TSH and FBG.After treatment,there were no significant differences in fasting insulin,FBG,TT3,TT4,and TSH.between GHD and ISS groups.4.Changes of serum 25(OH)D levels in children before and after rhGH treatmentThe serum 25(OH)D level of children after rhGH treatment was higher than that before treatment,and the difference was statistically significant.There was a statistically significant difference in serum 25(OH)D levels between the GHD and ISS groups before treatment,but there was no statistical difference between the two groups after treatment,indicating that levels of 25(OH)D wereincreased in both groups after rhGH treatment.The serum 25(OH)D level of children after rhGH treatment was higher than that before treatment,and the difference was statistically significant.There was a statistically significant difference in serum 25(OH)D levels between the GHD and ISS groups before treatment,but there was no statistical difference between the two groups after treatment,indicating that both levels of 25(OH)D were elevated after rhGH treatment.According to the analysis of vitamin D deficiency in Chengdu,60% of the children with sufficient 25(OH)D,children with 25(OH)D deficiency accounted for 26.66%,and children with 25(OH)D deficiency accounted for 13.33%.Children with adequate serum 25(OH)D accounted for 86.67%,children with 25(OH)D deficiency accounted for 10.00%,and children with 25(OH)D deficiency accounted for 3.33%.It indicates that the children with short stature had vitamin D deficiency or deficiency before treatment in before treatment,and was improved after treatment.5.Correlation analysis of serum 25(OH)D with growth parameters and serological markers before and after rhGH treatment There was no correlation between serum 25(OH)D levels and Ht,HtSDS,GV,IGF-1,IGFBP-3,TT3,TT4,TSH,FBG,FINS and other indicators before rhGH treatment;There was correlation between 25(OH)D levels and BMI after 3 months of rhGH treatment,but no other indicators(including Ht,HtSDS,GV,IGF-1,IGFBP-3,TT3,TT4,TSH,FBG,FINS).The levels of 25(OH)D in both GHD and ISS groups were significantly negatively correlated with BMI.Conclusion:1.There is a higher prevalence of 25(OH)D deficiency in Short stature children and their insuffcient or deficiency is significantly improved after treatment with growth hormone.2.After 3 months of treatment with rhGH,the level of 25(OH)D in GHD and ISS patients was significantly improved,suggesting that growth hormone may affect the metabolism of 25(OH)D in the body.3.During the treatment of rhGH,the level of 25(OH)D should be monitored while avoiding excessive weight gain.