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      Vitamin D and growth hormone in children: a review of the current scientific knowledge

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          Abstract

          Background

          Human growth is a complex mechanism that depends on genetic, environmental, nutritional and hormonal factors. The main hormone involved in growth at each stage of development is growth hormone (GH) and its mediator, insulin-like growth factor 1 (IGF-1). In contrast, vitamin D is involved in the processes of bone growth and mineralization through the regulation of calcium and phosphorus metabolism. Nevertheless, no scientific study has yet elucidated how they interact with one another, especially as a dysfunction in which one influences the other, even if numerous biochemical and clinical studies confirm the presence of a close relationship.

          Main body

          We reviewed and analyzed the clinical studies that have considered the relationship between vitamin D and the GH/IGF-1 axis in pediatric populations. We found two main areas of interest: the vitamin D deficiency status in patients affected by GH deficit (GHD) and the relationship between serum vitamin D metabolites and IGF-1. Although limited by some bias, from the analysis of the studies presented in the scientific literature, it is possible to hypothesize a greater frequency of hypovitaminosis D in the subjects affected by GHD, a reduced possibility of its correction with only substitution treatment with recombinant growth hormone (rGH) and an improvement of IGF-1 levels after supplementation treatment with vitamin D.

          Conclusions

          These results could be followed by preventive interventions aimed at reducing the vitamin D deficit in pediatric age. In addition, further research is needed to fully understand how vitamin D and growth are intertwined.

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          Most cited references91

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          Insulin-like growth factors and their binding proteins: biological actions.

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            Resurrection of vitamin D deficiency and rickets.

            The epidemic scourge of rickets in the 19th century was caused by vitamin D deficiency due to inadequate sun exposure and resulted in growth retardation, muscle weakness, skeletal deformities, hypocalcemia, tetany, and seizures. The encouragement of sensible sun exposure and the fortification of milk with vitamin D resulted in almost complete eradication of the disease. Vitamin D (where D represents D2 or D3) is biologically inert and metabolized in the liver to 25-hydroxyvitamin D [25(OH)D], the major circulating form of vitamin D that is used to determine vitamin D status. 25(OH)D is activated in the kidneys to 1,25-dihydroxyvitamin D [1,25(OH)2D], which regulates calcium, phosphorus, and bone metabolism. Vitamin D deficiency has again become an epidemic in children, and rickets has become a global health issue. In addition to vitamin D deficiency, calcium deficiency and acquired and inherited disorders of vitamin D, calcium, and phosphorus metabolism cause rickets. This review summarizes the role of vitamin D in the prevention of rickets and its importance in the overall health and welfare of infants and children.
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              Vitamin D deficiency in children and its management: review of current knowledge and recommendations.

              Given the recent spate of reports of vitamin D deficiency, there is a need to reexamine our understanding of natural and other sources of vitamin D, as well as mechanisms whereby vitamin D synthesis and intake can be optimized. This state-of-the-art report from the Drug and Therapeutics Committee of the Lawson Wilkins Pediatric Endocrine Society was aimed to perform this task and also reviews recommendations for sun exposure and vitamin D intake and possible caveats associated with these recommendations.
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                Author and article information

                Contributors
                +39 075 5784417 , susanna.esposito@unimi.it
                alberto.leonardi88@gmail.com
                lucia.lanciotti@gmail.com
                marta.cofini@gmail.com
                giulia25muzi@gmail.com
                laura.penta@ospedale.perugia.it
                Journal
                J Transl Med
                J Transl Med
                Journal of Translational Medicine
                BioMed Central (London )
                1479-5876
                18 March 2019
                18 March 2019
                2019
                : 17
                : 87
                Affiliations
                ISNI 0000 0004 1757 3630, GRID grid.9027.c, Pediatric Clinic, Department of Surgical and Biomedical Sciences, , Università degli Studi di Perugia, ; Piazza Menghini 1, 06129 Perugia, Italy
                Author information
                http://orcid.org/0000-0003-4103-2837
                Article
                1840
                10.1186/s12967-019-1840-4
                6421660
                30885216
                c9d57c8f-506b-46c3-b185-605213345019
                © The Author(s) 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 22 December 2018
                : 9 March 2019
                Categories
                Review
                Custom metadata
                © The Author(s) 2019

                Medicine
                igf-1,growth hormone,growth hormone deficit,recombinant growth hormone,vitamin d
                Medicine
                igf-1, growth hormone, growth hormone deficit, recombinant growth hormone, vitamin d

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