Association Between Vitamin D and Carboxy-Terminal Cross-Linked Telopeptide of Type I Collagen in Children During Growth Hormone Replacement Therapy.

Abstract

Growth hormone and insulin-like growth factor-1 (IGF-1) play a crucial role in the regulation of bone turnover. Adequate vitamin D status supports proper bone remodeling, leading to normal longitudinal bone growth and normal peak bone mass. The aim of this study was to evaluate the association between serum 25-hydroxyvitamin D [25(OH)D] and carboxy-terminal cross-linked telopeptide of type I collagen (ICTP) in children and adolescents with growth hormone deficiency at baseline and during recombinant human growth hormone (rhGH) replacement therapy. The study was prospective and included 30 children and adolescents aged 5 to 17years. Concentrations of 25(OH)D, ICTP, and IGF-1 were measured at baseline and during the first year of rhGH therapy. Baseline serum 25(OH)D concentration correlated with ICTP concentrations during the first trimester of rhGH therapy (r=0.38, p<0.050); the correlation was stronger in the second trimester of therapy (r=0.6, p=0.002). We conclude that proper vitamin D status is important in reaching the adequate dynamics of bone remodeling during growth, which is essential to achieve a catch-up growth during rhGH therapy.