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糖尿病患儿身高和体重的发育:两项前瞻性多中心研究报告,一项横断面研究,一项纵向研究。

Development of height and weight in children with diabetes mellitus: report on two prospective multicentre studies, one cross-sectional, one longitudinal.

作者信息

Thon A, Heinze E, Feilen K D, Holl R W, Schmidt H, Koletzko S, Wendel U, Nothjunge J

机构信息

Department of Paediatrics, University of Ulm, Donau, Federal Republic of Germany.

出版信息

Eur J Pediatr. 1992 Apr;151(4):258-62. doi: 10.1007/BF02072224.

Abstract

Optimal regimen for insulin therapy should lead to normal longitudinal growth and weight gain in children with diabetes mellitus. However, reports published so far indicate that this goal of paediatric diabetology is currently not achieved in a considerable number of patients. In a cross-sectional sample of 89 children with insulin dependent diabetes mellitus (IDDM) for more than 3 years, we found the relation of height to weight to be significantly different compared to 102 healthy school children of similar age. Using bivariate analysis, body shape in these children with diabetes was shifted towards small and obese (P less than 0.05) compared to control children. We subsequently initiated a longitudinal study and followed children from the onset of diabetes for the following 3 years, recording height, weight and bone age as well as glycosylated haemoglobin and daily insulin requirement. At diagnosis, height SDS was identical in children with IDDM (+0.04 +/- 0.10) compared to control children (-0.07 +/- 0.10; M +/- SE), while weight SDS was -0.26 +/- 0.10 in children with diabetes (controls: + 0.01 +/- 0.01). Bone age was identically retarded in newly diagnosed IDDM children (-0.73 +/- 0.12 SDS) and in our control group of children from the same regional background (-0.50 +/- 0.12; n.s.). In this group of children with diabetes mellitus followed prospectively, height to weight relationship differed from controls after 2 and after 3 years of the disease (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

胰岛素治疗的最佳方案应能使糖尿病患儿实现正常的纵向生长和体重增加。然而,迄今为止发表的报告表明,相当多的患者目前尚未实现儿科糖尿病学的这一目标。在一个由89名患有胰岛素依赖型糖尿病(IDDM)超过3年的儿童组成的横断面样本中,我们发现与102名年龄相仿的健康学童相比,他们的身高与体重的关系存在显著差异。通过双变量分析,与对照儿童相比,这些糖尿病患儿的体型倾向于矮小和肥胖(P小于0.05)。随后,我们开展了一项纵向研究,对糖尿病发病后的儿童进行了为期3年的跟踪,记录身高、体重、骨龄以及糖化血红蛋白和每日胰岛素需求量。诊断时,IDDM患儿的身高标准差分值(SDS)与对照儿童相同(+0.04±0.10)(对照儿童为-0.07±0.10;均值±标准误),而糖尿病患儿的体重SDS为-0.26±0.10(对照儿童为+0.01±0.01)。新诊断的IDDM患儿的骨龄同样延迟(-0.73±0.12 SDS),我们来自相同地区背景的儿童对照组也是如此(-0.50±0.12;无显著差异)。在这组前瞻性跟踪的糖尿病患儿中,患病2年和3年后,身高与体重的关系与对照儿童不同(P小于0.05)。(摘要截选至250字)

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