Keywords
vitamin D receptor gene polymorphism
growth hormone
insulin-like growth factor-1
ghrelin
children and adolescents
short stature
hypothalamic dysfunction
obesity
type 1 diabetes mellitus
How to Cite
Abstract
Abstract. Hypovitaminosis D was found in 90.44% of children with growth retardation, in 86.00% – with obesity associated with hypothalamic dysfunction, in 87.5% – with type 1 diabetes mellitus (T1DM). There is a close relationship between the growth hormone (GH)/insulin-like growth factor-1 (IGF-1) axis and the content of vit. D and vitamin D-binding protein (VD-BP), which is confirmed by strong/medium correlations between these indicators. An inverse correlation was found between the content of ghrelin and VD-BP and a direct correlation with the basal level of GH, IGF-1. The risk of development is significantly increased: for growth hormone deficiency (GHD) in the presence of VDR gene polymorphisms BsmI G/A; TagI T/C; ApaI C/A; for idiopathic short stature – in the presence of allele A of the rs1544410 BsmI locus, allele C of the rs731236 TaqI
locus; for biologically inactive GH syndrome – in the presence of BsmI A/A and TaqI C/C polymorphisms; for Intrauterine growth retardation – in the presence of the pathological variant A/A of the BsmI polymorphism. The most significant changes in lipid fractions, leptin levels, VD-BP, and parathyroid hormone were observed in patients with stage III obesity against the background of the lowest content of 25(OH)D in the blood (p <0.05). Vit. D3 supplementation is accompanied by a tendency to improve glycemic control in 71.4% of children with T1DM.
Conclusions. The presence in most patients with short stature, T1DM, obesity on the background of hypothalamic dysfunction as a consequence of hypovitaminosis D, significant correlations between the GH/IGF-1 axis and vit. D and VD-BP determine the need to take into account the content of vit. D in the diagnosis, treatment, and monitoring of patients with certain endocrinopathies. The study of polymorphic variants TaqI T/C
(rs731236), BsmI G/A (rs1544410) and ApaIA/C (rs7975232) of the VDR gene allows us to assess the risk of short stature. Combination therapy (rGH + vitamin D) leads to increased efficacy of growthstimulating therapy.
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