Assessment and Correlation of the Vitamin D Level With Growth Status as Measured by the Cervical Vertebral Maturation Index and Insulin-Like Growth Factor 1 Level in 10-14-Year-Old Patients.

内容摘要

Introduction Growth assessment is a fundamental process in orthodontics as accurate determination of skeletal maturity guides the timing of treatment intervention. Biochemical and radiographic indicators can be used to evaluate growth status during adolescence. Insulin-like growth factor-1 (IGF-1) serves as a reliable biochemical marker of active growth, while the cervical vertebral maturation index (CVMI) provides a radiographic assessment of skeletal maturity. Vitamin D plays a vital role in bone metabolism and skeletal development. It may also influence growth mediators such as IGF-1. This study aims to assess and correlate levels of vitamin D with both IGF-1 and CVMI in 10-14-year-old patients. Method Patients who visited the Department of Orthodontics and Dentofacial Orthopaedics at Ranjeet Deshmukh Dental College and Research Centre of 10 to 14 years age were included in the study, provided they were not suffering from any systemic or endocrine disorders and had not consumed any vitamin D supplements. According to the established inclusion and exclusion criteria, a total of 50 subjects were selected for the study. Cervical vertebral maturation stages were assessed on a lateral cephalogram, which is routinely taken for orthodontic treatment. Two milliliters of blood samples were collected under all aseptic conditions with parental consent for assessment of IGF-1 by ELISA (DRG Diagnostics IGF-1 kit in Lisa Plus Elisa microplate reader) and vitamin D level by using ichroma vitamin D neo fluorescence Immunoassay. Results  There was a statistically significant difference in vitamin D levels across CVMI stages (χ² = 14.813, p = 0.005). Mean vitamin D levels increased from Stage 2 (11.97 ± 0.96 ng/ml) to Stage 4 (24.54 ± 4.76 ng/ml), followed by a slight decline in Stage 5 (23.05 ± 4.88 ng/ml) and Stage 6 (19.10 ng/ml). Mean IGF-1 levels showed a consistent increasing trend: Stage 2 (19.57 ± 0.90 µg/dl), Stage 3 (24.77 ± 2.56 µg/dl), Stage 4 (28.78 ± 2.49 µg/dl), Stage 5 (29.25 ± 2.84 µg/dl), and Stage 6 (33.80 µg/dl). This demonstrates a progressive rise in IGF-1 levels with skeletal maturation. Considering the overall sample, there was a weak to moderately positive correlation between vitamin D and IGF-1 levels (ρ = 0.428). Conclusion Levels of vitamin D had significant variations among CVMI stages. IGF-1 showed a consistent increase with advancing stages of CVMI, reflecting its positive association with pubertal growth and skeletal maturation. Correlation analysis revealed a weak to moderately positive correlation between vitamin D and IGF-1 levels. Therefore, IGF-1 is a more reliable indicator of skeletal maturation as compared to vitamin D, while vitamin D may still play a supportive role in growth-related biologic processes and skeletal development.