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Seasonal variations in vitamin D in relation to growth in short prepubertal children before and during first year growth hormone treatment

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Abstract

Purpose

This study investigated the relationship between seasonal variations in 25-hydroxyvitamin D (25(OH)D) levels and growth in prepubertal children during both the pretreatment year and the first year of GH treatment.

Methods

The study included 249 short prepubertal children with a broad range of GH secretion, GHmax during a 24 h profile median 23; range 1–127 mU/L, 191 boys (mean age ± SD, 8.6 ± 2.6 years), 58 girls (7.5 ± 1.9 years) receiving GH treatment (mean 43 µg/kg/day; range 17–99 µg/kg/day). Serum 25(OH)D was measured using an automated IDS-iSYS immunoassay.

Results

25(OH)D levels showed seasonal variation, and decreased significantly during GH treatment. 25(OH)D levels at start and first year reduction in 25(OH)D, correlated (−) with the first year growth response during treatment. The degree of GH secretion capacity within our study population of mainly non-GH deficient children and 25(OH)D sufficient (67 ± 29 nmol/L) had no influence on 25(OH)D levels. Growth during GH treatment were independent of seasonal variations in 25(OH)D. Multiple regression analysis showed that 25(OH)D levels at treatment start, together with auxological data and IGF-binding protein-3SDS, explained 61 % of the variation in first year gain in heightSDS.

Conclusion

25(OH)D levels were associated with first year growth response to GH and may be a useful contribution to future growth prediction models.

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Acknowledgments

The authors are thankful for skilled laboratory work by Lisbeth Larsson, fruitful discussions with Dagmar Kasper (IDS) and language editing by Harriet Crofts. We thank IDS for providing free reagents for 25(OH)D measurements. The authors also thank the investigators and their teams of all the clinical trials for taking care of the children and families. These investigator-initiated and sponsored studies (TRN 88-080; TRN 88-177; TRN 89-071; TRN 98-0198-003) were supported by unrestricted research grants from Pharmacia/Pfizer, the Swedish Research Council grant no 7509, the Wilhelm & Martina Lundgrens Foundation, Wera Ekströms Foundation for Pediatric Research, the Foundation Växthuset for Children, Sahlgrenska University Hospital (ALF), West Sweden Region (VGR) grants, and the County Council of Östergötland. The only funding institution was Göteborg Pediatric Growth Research Center, Department of Pediatrics, Institute of Clinical Sciences, as well as Department of Physiology/Endocrinology, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Sweden.

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Authors and Affiliations

  1. Department of Physiology/Endocrinology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, SE-405 30, Göteborg, Sweden

    B. Andersson & K. Albertsson-Wikland

  2. Göteborg Pediatric Growth Research Center, Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden

    D. Swolin-Eide & L. Gelander

  3. Institution of Clinical Sciences/Pediatrics, Umeå University, Umeå, Sweden

    B. Kriström

  4. Angered Hospital, Göteborg, Sweden

    L. Gelander

  5. Department of Clinical Chemistry and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden

    P. Magnusson

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  1. B. Andersson
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  2. D. Swolin-Eide
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  3. B. Kriström
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  4. L. Gelander
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  6. K. Albertsson-Wikland
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Corresponding author

Correspondence to B. Andersson.

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Conflict of interest

BA, DSE, LG and PM have no conflicting interests to declare. BK has received lecture and consultation honoraria from Novo Nordisk, Pfizer and Sandoz. KAW, the sponsor of all the trials, received an unrestricted research grant from Pharmacia/Pfizer until 2005.

Ethical approval

The protocols of the clinical trials (TRN 88-080; TRN 88-177; TRN 89-071; TRN 98-0198-003) were approved by the ethical boards of the Universities of Gothenburg (for children from Gothenburg and Halmstad) and the Medical Product Agency of Sweden. TRN 98-0198-003 was also approved by the ethical boards of Universities of Umeå, Uppsala and Malmö, and TRN 88-080 and TRN 88-177 were also approved by the ethical board of the Karolinska Institutet. These approvals included ‘serum markers of bone metabolism’.

Informed consent

Written informed consent was obtained from all parents and from children if old enough. The trials were performed in accordance with the Declaration of Helsinki and Good Clinical Practice guidelines.

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Andersson, B., Swolin-Eide, D., Kriström, B. et al. Seasonal variations in vitamin D in relation to growth in short prepubertal children before and during first year growth hormone treatment. J Endocrinol Invest 38, 1309–1317 (2015). https://doi.org/10.1007/s40618-015-0360-1

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