Interaction between vitamin D and the growth hormone/insulin-like growth factor 1 axis in children: a systematic review and meta-analysis.
Vitamin D supplementation may increase IGF-1 levels in children, particularly when combined with rhGH therapy, but the clinical implications of these findings require careful consideration.
Where it sits
this study against the rest of the hgh (somatropin) corpusSummary and findings
This systematic review and meta-analysis evaluated the relationship between vitamin D and the growth hormone/insulin-like growth factor 1 axis in children. The study found that vitamin D supplementation increased IGF-1 levels and that vitamin D combined with recombinant human growth hormone (rhGH) therapy resulted in higher IGF-1 levels compared to rhGH alone. The meta-analysis included 24 studies with various findings on vitamin D levels in children with growth hormone deficiency and idiopathic short stature.
Abstract
Background This article presents a systematic review and meta-analysis of relevant studies to clarify the relationship between vitamin D and the growth hormone/insulin-like growth factor 1(GH/IGF-1) axis. Methods PubMed/MEDLINE, Web of Science, SCOPUS, Embase, and CNKI databases were searched. Relevant articles on the effect of vitamin D on IGF-1 levels were reviewed. The effect of recombinant human growth hormone supplementation on 25-hydroxyvitamin D[25(OH)D] levels was meta-analyzed, and subgroup analyses were conducted. Results IGF-1 levels increased after vitamin D supplementation. Vitamin D combined with rhGH therapy resulted in higher IGF-1 levels than rhGH alone. The meta-analysis included 24 studies. Vitamin D levels increased after rhGH treatment (WMD: 5.83 ng/mL, 95% CI: 3.72 to 7.94, I² = 99%, p < 0.00001), both in children with GHD (WMD: 7.78 ng/mL, 95% CI: 2.02 to 13.55, I² = 99%, p = 0.008) and ISS(WMD: 2.74 ng/mL, 95% CI: 1.25 to 4.23, I² = 98%, p = 0.0003). Results showed that vitamin D levels in children with growth hormone deficiency (GHD) were significantly lower than those in healthy children (WMD: -8.69 ng/mL, 95% CI: -15.91 to -1.46, I² = 96%, p = 0.02). There was no significant difference in vitamin D levels between children with idiopathic short stature (ISS) and healthy children (WMD: -3.86 ng/mL, 95% CI: -7.70 to -0.01, I² = 98%, p = 0.05). However, vitamin D levels in short children remained lower than those in healthy children after rhGH treatment (WMD: -1.68 ng/mL, 95% CI: -2.53 to -0.82, I² = 84%, p = 0.0001). Conclusion The increase in IGF-1 levels following vitamin D supplementation should be accounted for in clinical practice when evaluating IGF-1 values to optimize the diagnosis of short stature causes. Children with GHD have lower vitamin D levels, and rhGH supplementation can increase vitamin D levels. Combined vitamin D and rhGH therapy can better promote growth and development in children with short stature.
Background
Not reported in abstract.
Methods
Not reported in abstract.
Results
Not reported in abstract.
Interpretation
Not reported in abstract.
Limitations
Not reported in abstract.