Demir Korcan, Altıncık Ayça, Abacı Ayhan, Büyükgebiz Atilla, Böber Ece
Dokuz Eylül University, Department of Pediatric Endocrinology, İzmir, Turkey.
J Clin Res Pediatr Endocrinol. 2010;2(2):72-7. doi: 10.4274/jcrpe.v2i2.72. Epub 2010 May 4.
To retrospectively evaluate the effect of type 1 diabetes on growth.
Patients with Type 1 diabetes mellitus (T1DM) followed for at least one year after diagnosis, and without coexisting disorder that could affect growth, were included in this retrospective analysis. Height and body mass index (BMI) values were recorded. According to the data obtained at the end of each year of disease, the patients were divided into two groups: Group 1 (patients whose height standard deviation score (SDS) did not change or showed improvement) and Group 2 (patients whose height SDS showed a decline). The two groups were compared with respect to clinical and laboratory variables.
Among the 248 patients followed, 101 (M/F:55/46) fulfilled the inclusion criteria. Overall, the mean height SDS of the patients did not change significantly during the follow-up period. BMI SDS showed no change during the course of the disease, except for a significant rise observed at the end of the first year compared to the value at diagnosis. Height SDS of the patients in Group 1 was higher compared to those in Group 2 from the 2nd year of disease onwards (2nd year, p=0.03; 3rd year, p=0.02; 4th year, p=0.01; 5th year, p=0.03). The ratio of patients presenting with diabetic ketoacidosis at onset was significantly higher in Group 1 at the 4th year of diagnosis (p=0.03). Additionally, the mean HbA1c level showed a modest negative correlation with Δ height SDS at the 3rd year of diagnosis (r=-0.3, p=0.03).
No significant deteriorative effect of T1DM on auxological parameters was observed at short term. Some clinical and laboratory variables related with metabolic control were found to correlate with growth.
回顾性评估1型糖尿病对生长发育的影响。
本回顾性分析纳入诊断后随访至少一年且无影响生长发育的并存疾病的1型糖尿病(T1DM)患者。记录身高和体重指数(BMI)值。根据疾病各年末获得的数据,将患者分为两组:第1组(身高标准差评分(SDS)未改变或有所改善的患者)和第2组(身高SDS下降的患者)。比较两组的临床和实验室变量。
在随访的248例患者中,101例(男/女:55/46)符合纳入标准。总体而言,患者的平均身高SDS在随访期间无显著变化。BMI SDS在病程中无变化,但与诊断时的值相比,在第一年结束时显著升高。从疾病第2年起,第1组患者的身高SDS高于第2组(第2年,p = 0.03;第3年,p = 0.02;第4年,p = 0.01;第5年,p = 0.03)。在诊断第4年时,第1组发病时出现糖尿病酮症酸中毒的患者比例显著更高(p = 0.03)。此外,在诊断第3年时,平均糖化血红蛋白(HbA1c)水平与身高SDS变化量(Δ height SDS)呈适度负相关(r = -0.3,p = 0.03)。
短期内未观察到T1DM对体格学参数有显著的恶化影响。发现一些与代谢控制相关的临床和实验室变量与生长发育相关。