Department of Pediatrics, Technical University Munich, Munich, Germany.
J Pediatr. 2012 Jun;160(6):900-3.e2. doi: 10.1016/j.jpeds.2011.12.007. Epub 2012 Jan 11.
To investigate the effect of type 1 diabetes on growth and adult height.
Data from 22 651 children (10 494 females) with type 1 diabetes documented at onset of the disease from specialized centers in Germany and Austria were analyzed. Patients of non-German and non-Austrian origin and patients with celiac disease were excluded from the analysis. Near-adult height data were available in 1685 patients.
At the time of diagnosis of type 1 diabetes, the mean age of the 22 651 children was 8.8 ± 4.2 years, with a mean height SDS of 0.22 ± 1.0. The 1685 patients with diabetes onset before age 11 years reached a mean adult height of -0.16 ± 1.0 SDS. Mean adult height was was 167.1 ± 6.2 cm (-0.16 ± 0.97 SDS) in females (n = 846) and 179.6 ± 7.1 cm (-0.17 ± 1.0 SDS) in males (n = 839). Mean duration of diabetes was 9.1 ± 2.6 years, and mean Hemoglobin A1c concentration was 7.9% ± 1.2% (63 ± 10 mmol/mol). In a multivariate regression model, adult height was positively correlated with height at onset of diabetes (P < .0001) and negatively with mean Hemoglobin A1c (P < .0001) and duration of diabetes (P = .0015).
Height at the time of diagnosis of type 1 diabetes is above average. Even with intensive insulin therapy, growth and adult height remain indicators of metabolic diabetes control in the 21st century.
探讨 1 型糖尿病对生长和成年身高的影响。
分析了来自德国和奥地利专门中心记录的 22651 名（10494 名女性）1 型糖尿病患儿发病时的数据。排除了非德国和非奥地利原籍的患者和乳糜泻患者。在 1685 名患者中可获得接近成年的身高数据。
在 1 型糖尿病诊断时，22651 名儿童的平均年龄为 8.8 ± 4.2 岁，平均身高 SDS 为 0.22 ± 1.0。11 岁前发病的 1685 名患者成年身高平均为-0.16 ± 1.0 SDS。女性（n = 846）和男性（n = 839）的平均成年身高分别为 167.1 ± 6.2 cm（-0.16 ± 0.97 SDS）和 179.6 ± 7.1 cm（-0.17 ± 1.0 SDS）。糖尿病平均病程为 9.1 ± 2.6 年，平均 HbA1c 浓度为 7.9% ± 1.2%（63 ± 10 mmol/mol）。在多元回归模型中，成年身高与糖尿病发病时的身高呈正相关（P <.0001），与平均 HbA1c（P <.0001）和糖尿病病程（P =.0015）呈负相关。
1 型糖尿病诊断时的身高高于平均水平。即使采用强化胰岛素治疗，生长和成年身高仍然是 21 世纪代谢性糖尿病控制的指标。
