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CASE REPORT
Year : 2014  |  Volume : 11  |  Issue : 2  |  Page : 81-82

Study of growth promoting effect of vitamin D supplementation in vitamin D deficient hypothyroid children


Endocrinologist, 301, Udaiman Apartment, Opp. A. N. College, Boring Road, Boring Road, Patna, Bihar, India

Date of Web Publication31-Mar-2014

Correspondence Address:
Santosh Kumar Singh
Endocrinologist, 301, Udaiman Apartment, Opp. A. N. College, Boring Road, Patna - 800 001, Bihar
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-0354.129737

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  Abstract 

Insulin-like growth factor 1 (IGF-1) regulates growth. 1,250HD 3((1,25 dihydroxy vitamin D3) promotes IGF-1 action, hence vitamin D deficiency may impair growth. This retrospective study showed that vitamin D supplementation in vitamin D deficient children promoted growth.

Keywords: Insulin-like growth factor 1, vitamin D IGFBP-3 (Insulin Like Growth Factor Binding Protein-3)


How to cite this article:
Singh SK. Study of growth promoting effect of vitamin D supplementation in vitamin D deficient hypothyroid children. Thyroid Res Pract 2014;11:81-2

How to cite this URL:
Singh SK. Study of growth promoting effect of vitamin D supplementation in vitamin D deficient hypothyroid children. Thyroid Res Pract [serial online] 2014 [cited 2017 May 22];11:81-2. Available from: http://www.thetrp.net/text.asp?2014/11/2/81/129737


  Introduction Top


1,250 Dihydroxy VitaminD3 1,250HD 3 has been shown to promote the action of insulin-like growth factor 1 (IGF-1) by increasing IGF-1 receptors. IGF-1 elevates 1,250HD 3 by stimulating 1α-hydroxylase and inhibits the catabolism of 1250HD 3 by decreasing 24-hydroxylase gene expression. Moreover, insulin-like growth factor-binding protein-3 (IGFBP-3) increases in response to 1250HD 3 . IGF-1 appears to have predominant role in regulation of growth. [1],[2],[3] This retrospective study was done to evaluate the growth promoting effect of vitamin D supplementation in vitamin D deficient hypothyroid children.


  Case Report Top


A retrospective study was done in five hypothyroid boys in the age range of 10-16 years. They were euthyroid when vitamin D supplementation was commenced. Supplementation was done with cholecalciferol 60,000 IU weekly for 8 weeks and then monthly. One patient received injectable vitamin D. Vitamin D deficiency was defined as 250HD 3 <20 ng/ml.

Case A

A 15.75-year-old boy showed a height gain of 4.3 cm in 1 year before commencement of vitamin D supplementation. He gained 3.5 cm in 6 months (7 cm/year) after vitamin D supplementation. His pre- and post-treatment 250HD 3 levels were 13.24 ng/mL and 21.57 ng/mL, respectively.



Case B

A 13.25-year-old boy showed a height gain of 5 cm in 9 months (6.67 cm/year) after vitamin D supplementation. His pre-treatment 250HD 3 level was 9.27 ng/mL.



Case C

A 15.5-year-old boy showed a height gain of 5 cm in 9 months (6.67 cm/year). His pre-treatment-SMR (Sexual Maturation Rate) was G 4 P 3 . His pre- and post-treatment 250HD 3 levels were 7.81 ng/mL and 44.47 ng/mL, respectively. He received injectable (IM-Intramuscular) vitamin D (3 lakh units every 3 month).



Case D

A 10-year-old boy showed a height gain of 1 cm in 2 months (6 cm/year) before vitamin D supplementation. He gained 4 cm in 6 months (8 cm/year) after vitamin supplementation. His pre- and post-treatment 250HD 3 levels were 4.5 ng/mL and 24.4 ng/mL, respectively.



Case E

A 12-year-old boy gained 0.5 cm in 2 months (3 cm/year) before vitamin D supplementation. With supplementation he gained 3 cm in 4 months (9 cm/year). His pre-treatment 250HD 3 level was 10.23 ng/mL.




  Discussion Top


There was a distinct gain in height with vitamin D supplementation in a boy (case A) who showed lesser height gain despite onset of puberty, prior to vitamin D supplementation. Similarly, there was greater height gain after vitamin D supplementation as compared to pre-supplementation (cases D and E).

Vitamin D supplementation showed a definite growth promoting effect which could be due to promotion of IGF-1 action and increment of IGFBP-3 by active vitamin D. Both IGF-1 and IGF-1/IGFBP-3 treatment has been shown to improve linear growth but, equimolar dose of IGF-1 is superior to IGF-1/IGFBP-3 treatment. [3]

The study highlights the importance of vitamin D supplementation in vitamin D deficient hypothyroid children for proper growth as impairment of growth could be due to hypothyroidism and concomitant vitamin D deficiency.

 
  References Top

1.Gómez JM. The role of insulin-like growth factor I components in the regulation of vitamin D. Curr Pharm Biotechnol 2006;7:125-32.  Back to cited text no. 1
    
2.Le Roith D. Seminars in medicine of the Beth Israel Deaconess Medical Center. Insulin-like growth factors. N Engl J Med 1997;336:633-40.  Back to cited text no. 2
    
3.Ekström K, Carlsson-Skwirut C, Ritzén EM, Bang P. Insulin-like growth factor-I and insulin-like growth factor binding protein-3 cotreatment versus insulin-like growth factor-I alone in two brothers with growth hormone insensitivity syndrome: Effects on insulin sensitivity, body composition and linear growth. Horm Res Paediatr 2011;76:355-66.  Back to cited text no. 3
    




 

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