Ege Journal of Medicine
Research Article
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Evaluation of the relationship between ınsulin-like growth factor-1 and calcium, phosphorus and Vitamin D levels in children presenting with growth retardation

Year 2023, Volume: 62 Issue: 3, 467 - 472, 18.09.2023

Eren ER Didem GÜLCÜ TAŞKIN

Abstract

Aim: The main hormone that plays a role in growth at all stages of development is growth hormone
(GH) and its mediator, insulin-like growth factor 1 (IGF-1). No scientific studies have yet clarified the
relationship between IGF-1 and calcium, phosphorus and vitamin D. The aim of this study is to
investigate the effect of serum calcium, phosphorus and vitamin D levels on IGF-1 in children who are
admitted with growth retardation.
Materials and Methods: 155 children (80 male, 75 female) admitted to Adana City Training and
Research Hospital Pediatric Gastroenterology Outpatient Clinic 1 between 01.10.2017-31.08.2022
due to growth retardation were included in this retrospective study. Anthropometric and biochemical
data files were obtained. The relationship between serum calcium, phosphorus and vitamin D and
IGF-1 was analyzed.
Results: The mean age of the children participating in the study was 8.13 ± 4.98 years. The mean
IGF-1 level of the participants was 115.06 ± 83.33 ng/ml. Mean serum calcium, phosphorus and
25(OH)D levels were 9.79 ± 0.43 mg/dl, 4.76 ± 0.59 mg/dl and 31.49 ± 12.9 ng/ml, respectively.
Univariate analysis results showed that serum phosphorus was significantly correlated with IGF-1
level. In addition, a linear relationship was observed between serum phosphorus and IGF-1 level, after
adjusting for possible confounding factors. According to the results of the adjusted linear regression,
no significant correlation could be demonstrated with serum calcium and 25(OH)D level and IGF-1
level (β: 0.045, 95% CI: -11.583; 28.863, p =0.400 and β: -0.018, 95% CI: -0.845;0.617, p = 0.758;
respectively). However, serum phosphorus has been shown to be positively associated with IGF-1 (β:
0.122, 95% CI: 1.31; 33.16; p = 0.034).
Conclusion: This study showed that serum phosphorus levels may be significantly related to IGF-1
levels in children who presented with growth retardation. Additional research is needed to fully
elucidate the relationship between serum calcium, phosphorus, and vitamin D and IGF-1.

Keywords

Calcium, phosphorus, vitamin D, IGF-1, growth retardation

References

  • Bereket A, Turan S, Omar A, Berber M, Ozen A, Akbenlioglu C, vd. Serum IGF-I and IGFBP-3 levels of Turkish children during childhood and adolescence: establishment of reference ranges with emphasis on puberty. Horm Res. 2006;65(2):96-105.
  • Brabant G, von zur Mühlen A, Wüster C, Ranke MB, Kratzsch J, Kiess W, vd. Serum insulin-like growth factor I reference values for an automated chemiluminescence immunoassay system: results from a multicenter study. Horm Res. 2003;60(2):53-60.
  • Clemmons DR. Clinical utility of measurements of insulin-like growth factor 1. Nat Clin Pract Endocrinol Metab. Ağustos 2006;2(8):436-46.
  • Ameri P, Giusti A, Boschetti M, Murialdo G, Minuto F, Ferone D. Interactions between vitamin D and IGF-I: from physiology to clinical practice. Clin Endocrinol (Oxf). Ekim 2013;79(4):457-63.
  • Gómez JM, Maravall FJ, Gómez N, Navarro MA, Casamitjana R, Soler J. Relationship between 25-(OH) D3, the IGF-I system, leptin, anthropometric and body composition variables in a healthy, randomly selected population. Horm Metab Res Horm Stoffwechselforschung Horm Metab. Ocak 2004;36(1):48-53.
  • Bogazzi F, Rossi G, Lombardi M, Tomisti L, Sardella C, Manetti L, vd. Vitamin D status may contribute to serum insulin-like growth factor I concentrations in healthy subjects. J Endocrinol Invest. Eylül 2011;34(8):e200-203.
  • Wei S, Tanaka H, Seino Y. Local action of exogenous growth hormone and insulin-like growth factor-I on dihydroxyvitamin D production in LLC-PK1 cells. Eur J Endocrinol. Ekim 1998;139(4):454-60.
  • Nesbitt T, Drezner MK. Insulin-like growth factor-I regulation of renal 25-hydroxyvitamin D-1-hydroxylase activity. Endocrinology. Ocak 1993;132(1):133-8.
  • Ameri P, Giusti A, Boschetti M, Bovio M, Teti C, Leoncini G, vd. Vitamin D increases circulating IGF1 in adults: potential implication for the treatment of GH deficiency. Eur J Endocrinol. Aralık 2013;169(6):767-72.
  • Soliman AT, Al Khalaf F, AlHemaidi N, Al Ali M, Al Zyoud M, Yakoot K. Linear growth in relation to the circulating concentrations of insulin-like growth factor I, parathyroid hormone, and 25-hydroxy vitamin D in children with nutritional rickets before and after treatment: endocrine adaptation to vitamin D deficiency. Metabolism. Ocak 2008;57(1):95-102.
  • Locatelli V, Bianchi VE. Effect of GH/IGF-1 on Bone Metabolism and Osteoporsosis. Int J Endocrinol. 2014;2014:1-25.
  • Seikaly MG, Brown R, Baum M. The Effect of Recombinant Human Growth Hormone in Children With XLinked Hypophosphatemia. Pediatrics. 01 Kasım 1997;100(5):879-84.
  • Baroncelli GI, Bertelloni S, Ceccarelli C, Saggese G. Effect of growth hormone treatment on final height, phosphate metabolism, and bone mineral density in children with X-linked hypophosphatemic rickets. J Pediatr. Şubat 2001;138(2):236-43.
  • Živičnjak M, Schnabel D, Staude H, Even G, Marx M, Beetz R, vd. Three-Year Growth Hormone Treatment in Short Children with X-Linked Hypophosphatemic Rickets: Effects on Linear Growth and Body Disproportion. J Clin Endocrinol Metab. Aralık 2011;96(12):E2097-105.
  • Alexander LS, Mahajan A, Odle J, Flann KL, Rhoads RP, Stahl CH. Dietary Phosphate Restriction Decreases Stem Cell Proliferation and Subsequent Growth Potential in Neonatal Pigs. J Nutr. 01 Mart 2010;140(3):477-82.
  • Colak A, Yildiz O, Toprak B, Turkon H, Halicioglu O, Coker I. Correlation between calcium and phosphorus in cord blood and birth size in term infants. Minerva Pediatr. Haziran 2016;68(3):182-8.
  • Laviola L, Natalicchio A, Giorgino F. The IGF-I Signaling Pathway. Curr Pharm Des. 01 Mart 2007;13(7):663- 9.
  • Nakamura A, Miyado K, Yamatoya K, Kawano N, Umezawa A. Breast milk stimulates growth hormone secretion in infant mice, and phosphorus insufficiency disables this ability and causes dwarfism-like symptoms. Regen Ther. Aralık 2015;2:49-56.
  • Van Hemelrijck M, Shanmugalingam T, Bosco C, Wulaningsih W, Rohrmann S. The association between circulating IGF1, IGFBP3, and calcium: results from NHANES III. Endocr Connect. Eylül 2015;4(3):187-95.
  • Marwaha RK, Garg MK, Gupta S, Ganie MA, Gupta N, Narang A, vd. Association of insulin-like growth factor-1 and IGF binding protein-3 with 25-hydroxy vitamin D in pre-pubertal and adolescent Indian girls. J Pediatr Endocrinol Metab. 28 Mart 2018;31(3):289-95.
  • Gannagé-Yared MH, Chahine E, Farah V, Ibrahim T, Asmar N, Halaby G. Serum Insulin-Like Growth Factor 1 In Lebanese Schoolchildren And Its Relation To Vitamin D And Ferritin Levels. Endocr Pract. Nisan 2017;23(4):391-8.

Gelişme geriliği nedeni ile başvuran çocuklarda insulin benzeri büyüme faktörü-1 ile kalsiyum, fosfor ve Vitamin D düzeyleri arasındaki ilişkinin değerlendirilmesi

Year 2023, Volume: 62 Issue: 3, 467 - 472, 18.09.2023

Eren ER Didem GÜLCÜ TAŞKIN

Abstract

Amaç: Gelişimin tüm aşamalarında, büyümede rol oynayan ana faktörler, büyüme hormonu (BH) ve
onun aracısı olan insülin benzeri büyüme faktörü 1 (IGF-1)’dir. IGF-1 ile kalsiyum, fosfor ve D vitamini
arasındaki ilişkiyi henüz hiçbir bilimsel çalışma netleştirememiştir. Bu çalışmanın amacı, gelişme
geriliği nedeni ile başvuran çocuklarda, serum kalsiyum, fosfor ve D vitamini düzeylerinin IGF-1
üzerindeki etkisini araştırmaktır.
Gereç ve Yöntem: Bu retrospektif çalışmaya, Adana Şehir Eğitim ve Araştırma Hastanesi Çocuk
Gastroenteroloji Poliklinik 1’de 01.10.2017-31.08.2022 tarihleri arasında gelişme geriliği nedeni ile
başvuran 155 (80 kız, 75 erkek) çocuk dahil edildi. Antropometrik ve laboratuvar verileri hasta
dosyalarından elde edildi. Serum kalsiyum, fosfor ve D vitamini ile IGF-1 arasındaki ilişki analiz edildi.
Bulgular: Çalışmaya katılan çocukların ortalama yaşı 8,13 ± 4,98 yıl idi. Katılımcıların ortalama IGF-1
düzeyi 115,06 ± 83,33 ng/ml idi. Ortalama serum kalsiyum, fosfor ve 25(OH)D seviyeleri sırasıyla 9,79
± 0,43 mg/dl, 4,76 ± 0,59 mg/dl ve 31,49 ± 12,9 ng/ml idi. Tek değişkenli analiz sonuçları, serum
fosforunun, IGF-1 düzeyi ile anlamlı derecede ilişkili olduğunu gösterdi. Ek olarak, olası karıştırıcı
faktörler için düzeltildikten sonra, serum fosforu ile IGF-1 düzeyi arasında doğrusal bir ilişki
gözlemlendi. Düzeltilmiş lineer regresyonun sonuçlarına göre, serum kalsiyumu ve 25(OH)D düzeyi ile
IGF-1 düzeyi ile anlamlı bir ilişkili gösterilemedi (sırasıyla, β: 0,045, %95 CI:-11,583;28,863, p =0,400
ve β: -0,018, %95 CI: -0,845;0,617, p = 0,758 ). Ancak serum fosforun IGF-1 ile pozitif olarak ilişkili
olduğunu gösterilmiştir (β: 0,122, %95 CI: 1,31;33,16; p = 0.034).
Sonuç: Bu çalışma, gelişme geriliği nedeni ile başvuran çocuklarda serum fosfor düzeylerini IGF-1
düzeyleri ile anlamlı ilişkili olabileceğini göstermiştir. Serum kalsiyum, fosfor ve D vitamini ile IGF-1
arasındaki ilişkiyi tam olarak aydınlatmak için ek araştırmalara ihtiyaç vardır.

Keywords

Kalsiyum, fosfor, vitamin D, IGF-1, gelişme geriliği

References

  • Bereket A, Turan S, Omar A, Berber M, Ozen A, Akbenlioglu C, vd. Serum IGF-I and IGFBP-3 levels of Turkish children during childhood and adolescence: establishment of reference ranges with emphasis on puberty. Horm Res. 2006;65(2):96-105.
  • Brabant G, von zur Mühlen A, Wüster C, Ranke MB, Kratzsch J, Kiess W, vd. Serum insulin-like growth factor I reference values for an automated chemiluminescence immunoassay system: results from a multicenter study. Horm Res. 2003;60(2):53-60.
  • Clemmons DR. Clinical utility of measurements of insulin-like growth factor 1. Nat Clin Pract Endocrinol Metab. Ağustos 2006;2(8):436-46.
  • Ameri P, Giusti A, Boschetti M, Murialdo G, Minuto F, Ferone D. Interactions between vitamin D and IGF-I: from physiology to clinical practice. Clin Endocrinol (Oxf). Ekim 2013;79(4):457-63.
  • Gómez JM, Maravall FJ, Gómez N, Navarro MA, Casamitjana R, Soler J. Relationship between 25-(OH) D3, the IGF-I system, leptin, anthropometric and body composition variables in a healthy, randomly selected population. Horm Metab Res Horm Stoffwechselforschung Horm Metab. Ocak 2004;36(1):48-53.
  • Bogazzi F, Rossi G, Lombardi M, Tomisti L, Sardella C, Manetti L, vd. Vitamin D status may contribute to serum insulin-like growth factor I concentrations in healthy subjects. J Endocrinol Invest. Eylül 2011;34(8):e200-203.
  • Wei S, Tanaka H, Seino Y. Local action of exogenous growth hormone and insulin-like growth factor-I on dihydroxyvitamin D production in LLC-PK1 cells. Eur J Endocrinol. Ekim 1998;139(4):454-60.
  • Nesbitt T, Drezner MK. Insulin-like growth factor-I regulation of renal 25-hydroxyvitamin D-1-hydroxylase activity. Endocrinology. Ocak 1993;132(1):133-8.
  • Ameri P, Giusti A, Boschetti M, Bovio M, Teti C, Leoncini G, vd. Vitamin D increases circulating IGF1 in adults: potential implication for the treatment of GH deficiency. Eur J Endocrinol. Aralık 2013;169(6):767-72.
  • Soliman AT, Al Khalaf F, AlHemaidi N, Al Ali M, Al Zyoud M, Yakoot K. Linear growth in relation to the circulating concentrations of insulin-like growth factor I, parathyroid hormone, and 25-hydroxy vitamin D in children with nutritional rickets before and after treatment: endocrine adaptation to vitamin D deficiency. Metabolism. Ocak 2008;57(1):95-102.
  • Locatelli V, Bianchi VE. Effect of GH/IGF-1 on Bone Metabolism and Osteoporsosis. Int J Endocrinol. 2014;2014:1-25.
  • Seikaly MG, Brown R, Baum M. The Effect of Recombinant Human Growth Hormone in Children With XLinked Hypophosphatemia. Pediatrics. 01 Kasım 1997;100(5):879-84.
  • Baroncelli GI, Bertelloni S, Ceccarelli C, Saggese G. Effect of growth hormone treatment on final height, phosphate metabolism, and bone mineral density in children with X-linked hypophosphatemic rickets. J Pediatr. Şubat 2001;138(2):236-43.
  • Živičnjak M, Schnabel D, Staude H, Even G, Marx M, Beetz R, vd. Three-Year Growth Hormone Treatment in Short Children with X-Linked Hypophosphatemic Rickets: Effects on Linear Growth and Body Disproportion. J Clin Endocrinol Metab. Aralık 2011;96(12):E2097-105.
  • Alexander LS, Mahajan A, Odle J, Flann KL, Rhoads RP, Stahl CH. Dietary Phosphate Restriction Decreases Stem Cell Proliferation and Subsequent Growth Potential in Neonatal Pigs. J Nutr. 01 Mart 2010;140(3):477-82.
  • Colak A, Yildiz O, Toprak B, Turkon H, Halicioglu O, Coker I. Correlation between calcium and phosphorus in cord blood and birth size in term infants. Minerva Pediatr. Haziran 2016;68(3):182-8.
  • Laviola L, Natalicchio A, Giorgino F. The IGF-I Signaling Pathway. Curr Pharm Des. 01 Mart 2007;13(7):663- 9.
  • Nakamura A, Miyado K, Yamatoya K, Kawano N, Umezawa A. Breast milk stimulates growth hormone secretion in infant mice, and phosphorus insufficiency disables this ability and causes dwarfism-like symptoms. Regen Ther. Aralık 2015;2:49-56.
  • Van Hemelrijck M, Shanmugalingam T, Bosco C, Wulaningsih W, Rohrmann S. The association between circulating IGF1, IGFBP3, and calcium: results from NHANES III. Endocr Connect. Eylül 2015;4(3):187-95.
  • Marwaha RK, Garg MK, Gupta S, Ganie MA, Gupta N, Narang A, vd. Association of insulin-like growth factor-1 and IGF binding protein-3 with 25-hydroxy vitamin D in pre-pubertal and adolescent Indian girls. J Pediatr Endocrinol Metab. 28 Mart 2018;31(3):289-95.
  • Gannagé-Yared MH, Chahine E, Farah V, Ibrahim T, Asmar N, Halaby G. Serum Insulin-Like Growth Factor 1 In Lebanese Schoolchildren And Its Relation To Vitamin D And Ferritin Levels. Endocr Pract. Nisan 2017;23(4):391-8.

Details

Primary Language Turkish
Subjects Pediatric Endocrinology, Pediatric Gastroenterology
Journal Section Research Articles
Authors

Eren ER
Sağlık Bilimleri Üniversitesi, Tepecik Eğitim ve Araştırma Hastanesi, Çocuk Endokrinolojisi Kliniği, İzmir, Türkiye
Türkiye

Didem GÜLCÜ TAŞKIN
Sağlık Bilimleri Üniversitesi, Adana Şehir Eğitim ve Araştırma Hastanesi, Çocuk Gastroenteroloji Kliniği, Adana, Türkiye
Türkiye

Publication Date September 18, 2023
Submission Date November 3, 2022
Published in Issue Year 2023Volume: 62 Issue: 3

Cite

Vancouver
ER E, GÜLCÜ TAŞKIN D. Gelişme geriliği nedeni ile başvuran çocuklarda insulin benzeri büyüme faktörü-1 ile kalsiyum, fosfor ve Vitamin D düzeyleri arasındaki ilişkinin değerlendirilmesi. EJM. 2023;62(3):467-72.
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