title: Significant association among growing pains, vitamin D supplementation, and bone mineral status: results from a pilot cohort study.
abstract: The aim of our study was to analyze the possible relationship between growing pains, vitamin D levels, and bone mineral status. We enrolled 33 children affected by growing pains. Their pain intensity was evaluated through a questionnaire using the Wong-Baker Faces Pain Rating Scale for pain assessment. Serum 25-hydroxyvitamin D (25-OH-D), parathyroid hormone (PTH), and alkaline phosphatase levels were measured as well. A quantitative ultrasound assessment (QUS) was also done, measuring both the amplitude-dependent speed of sound (AD-SOS) and the bone transmission time (BTT), correlating, respectively, with bone density and with cortical thickness. After 3 and 24 months of vitamin D supplementation, we re-evaluated pain intensity and laboratory results. After 24 months we re-assessed QUS parameters. At the beginning of the study the children reported a mean growing pain intensity of 7.5 ± 1.6 SD. The mean values of 25-OH-D and PTH levels were 15.7 ± 6.9 ng/ml and 57.3 ± 27.3 pg/ml, respectively. The AD-SOS Z score was -0.53 ± 1.19 SD, and the mean value of the BTT Z score was -0.72 ± 0.96 SD. After the first 3 months of vitamin D supplementation we observed an increase in 25-OH-D levels (34.1 ± 17.8, p < 0.001) and a reduction in both PTH levels (47.3 ± 30.6, p = 0.135) and pain intensity (2.7 ± 2.2, p < 0.001). After 24 months we observed a further significant reduction in the pain intensity (3.9 ± 3.4, p < 0.001) and in PTH levels (43.7 ± 28.5, p = 0.004) and an improvement in the QUS parameters, in particular in BTT Z scores (p = 0.014). Our study suggests an interesting relationship between growing pains, vitamin D levels and bone mineral status.
authors.affiliation: Department of Life and Reproduction Sciences, Pediatric Clinic, Giambattista Rossi Hospital, University of Verona, Piazzale Ludovico Antonio Scuro, 10, 37134, Verona, Italy, grazia.morandi@gmail.com.
authors.forename: Grazia
authors.initials: G
authors.lastname: Morandi
authors.forename: E
authors.initials: E
authors.lastname: Maines
authors.forename: C
authors.initials: C
authors.lastname: Piona
authors.forename: E
authors.initials: E
authors.lastname: Monti
authors.forename: M
authors.initials: M
authors.lastname: Sandri
authors.forename: R
authors.initials: R
authors.lastname: Gaudino
authors.forename: A
authors.initials: A
authors.lastname: Boner
authors.forename: F
authors.initials: F
authors.lastname: Antoniazzi
mesh_terms: D000469:Alkaline Phosphatase / Q000378:metabolism; D015519:Bone Density / Q000502:physiology*; D001842:Bone and Bones / Q000378:metabolism / Q000502:physiology*; D002648:Child; D015331:Cohort Studies; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain / Q000378:metabolism / Q000503:physiopathology*; D010281:Parathyroid Hormone / Q000378:metabolism; D010865:Pilot Projects; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000378:metabolism
chemical_list: D010281:Parathyroid Hormone; D014807:Vitamin D; C104450:25-hydroxyvitamin D; D000469:Alkaline Phosphatase