Abstract: Objective To compare the levels of 25-hydroxyvitamin D[25-(OH)D] in children with growth hormone deficiency (GHD) and idiopathic short stature (ISS), and to study its relationship with the growth hormone/insulin-like growth factor-1 (GH/IGF-1) axis. Methods A total of 138 children with GHD and 199 children with ISS were selected. The levels of 25-(OH)D and the proportion of vitamin D deficiency were compared between the two groups. The correlation factors of 25-(OH)D in children with short stature were analyzed, and a multivariate linear regression model with IGF-1 as the dependent variable was established. Result sThe level of 25-(OH)D in GHD group was higher than that in ISS group, and the difference was statistically significant (P<0.05). The proportion of 25-hydroxyvitamin D deficiency and insufficiency in ISS group was higher than that in GHD group, the difference was statistically significant (χ² = 5.966, P=0.015). 25-(OH)D was negatively correlated with age, body mass index (BMI), IGF-1, insulin-like growth factor binding protein-3 (IGFBP-3) and growth hormone peak (GHpeak) (P<0.05), and positively correlated with bone age index (BAI)(P<0.05). There was no correlation with gender (P>0.05). Multivariate linear regression model showed that age, BMI and BAI were the influencing factors of IGF-1 (P<0.05), while 25-(OH)D did not constitute the influencing factors of IGF-1 (P>0.05). Conclusion Insufficient or deficient vitamin D is common in ISS and GHD children, especially in ISS children. 25-(OH)D does not constitute a factor in the GH/IGF-1 axis in children with short stature, and routine vitamin D supplementation is recommended for GHD and ISS children, but not as an alternative to recombinant human growth hormone therapy.

Key words: 25-hydroxyvitamin D, dwarfism, growth hormone/insulin-like growth factor-1 axis, growth hormone deficiency, idiopathic short stature

摘要： 目的 比较生长激素缺乏症（GHD）、特发性矮身材（ISS）儿童的25羟维生素D[25-(OH)D]水平,研究其与生长激素/胰岛素样生长因子-1（GH/IGF-1）轴的关系。方法 选取GHD患儿138例、ISS患儿199例,对比2组25-(OH)D水平、维生素D缺乏的比例。分析矮小症儿童25-(OH)D的相关因素,建立IGF-1为因变量的多因素线性回归模型。结果 GHD组儿童25-(OH)D水平高于ISS组,差异有统计学意义（P<0.05）。ISS组25羟维生素D缺乏和不足的比例高于GHD组,差异有统计学意义（χ²=5.966,P=0.015）。25-(OH)D与年龄、体质量指数（BMI）、IGF-1、胰岛素样生长因子结合蛋白-3（IGFBP-3）、生长激素峰值（GHpeak）呈负相关（P<0.05）,与骨龄指数呈正相关（P<0.05）,与性别无相关性（P>0.05）。多因素线性回归模型显示,年龄、BMI、骨龄指数是IGF-1的影响因素（P<0.05）,25-(OH)D不构成IGF-1的影响因素（P>0.05）。结论 ISS和GHD儿童常见维生素D不足或缺乏,ISS儿童更明显。矮小症儿童25-(OH)D不构成GH/IGF-1轴的影响因素,GHD和ISS儿童建议常规补充生理需要量的维生素D,但不能作为重组人生长激素（rhGH）治疗的替代选择。

关键词: 25羟维生素D, 矮小症, 生长激素/胰岛素样生长因子-1轴, 生长激素缺乏症, 特发性矮身材