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[1型糖尿病儿童和青少年躯体发育的变化方向]

[Direction of change in the somatic development in children and adolescents with type 1 diabetes].

作者信息

Kołodziejczyk Honorata, Wajda-Cuszlag Małgorzata, Świercz Anna, Szalecki Mieczysław

机构信息

Anthropology Laboratory, The Children's Memorial Health Institute, Warsaw, Poland.

Department of Endocrinology and Diabetology, The Children's Memorial Health Institute, Warsaw, Poland.

出版信息

Pediatr Endocrinol Diabetes Metab. 2017;23(2):83-95. doi: 10.18544/PEDM-23.02.0078.

Abstract

INTRODUCTION

Disorders of somatic development in children and adolescents with type 1 diabetes can lead to unstable course of the disease and the difficulties in obtaining good metabolic control.

AIM

Evaluation of somatic development in children and adolescents with type 1 diabetes in different age categories.

MATERIAL AND METHODS

Agroup of 97 girls and 90 boys with type 1 diabetes was examined. Children were divided into three age groups: girls with mean age of 9.1; 12.9; 16.2 years and boys with mean age of 7.6; 11.8; 16.2 years. In all subjects accurate anthropometric measurements and nutritional status assessment were conducted. Somatic traits and indices were expressed in terms of standard deviations of age and sex-specific Polish growth references.

RESULTS

Body measurements in girls at the age of 9.1 years and boys at the age of 7.6 years did not differ significantly from the healthy population. Girls aged 12.9 years had significantly increased widths shoulder (p=0,003)) and greater body circumferences: waist (p=0,001), arm (p=0,0008) and hips (p=0,001). The boys aged 11.8 years have significantly larger greater trunk length (p=0,04) and upper limbs length (p=0,01). The oldest girls, at the age of 16.2 years excessive body weight (p=0,00001) also significantly increased circumferences of waist and hips (p=0,000001) were observed. Boys aged 16.2 years also showed significantly increased body circumferences (p=0,0001) which was particularly evident for boys with greater body height. Body mass index BMI in girls pointed to the overweight (1.50 SDS) while in boys it was normal (-0.05 SDS). The youngest girls, the duration of the disease was 2.9 +/- 0.6 years, in the older group 5.2 +/- 0.6 years and the oldest 6.9 +/- 0.6 years. The boys, the duration of illness was 1.9 +/- 0.6 years; 2.6 +/- 0.5 years; 4.8 +/- 0.7 years. The mean HbA 1c in girls was 7.1; 7.7; and 8.4%, while boys 7.4; 7.4 and 7.6%.

CONCLUSIONS

Changes in body build in patients with diabetes type 1 are associated with chronological age, duration of disease and metabolic control. It has been observed that the increase of weight and waist circumference concern girls. Patients with overweight and obesity represent a risk of early development of complications and require special care.

摘要

引言

1型糖尿病儿童和青少年的躯体发育障碍可导致疾病进程不稳定,并难以实现良好的代谢控制。

目的

评估不同年龄组1型糖尿病儿童和青少年的躯体发育情况。

材料与方法

对97名患1型糖尿病的女孩和90名患1型糖尿病的男孩进行了检查。儿童被分为三个年龄组:女孩平均年龄为9.1岁、12.9岁、16.2岁;男孩平均年龄为7.6岁、11.8岁、16.2岁。对所有受试者进行了准确的人体测量和营养状况评估。躯体特征和指标以波兰年龄和性别特异性生长参考标准的标准差表示。

结果

9.1岁女孩和7.6岁男孩的身体测量值与健康人群无显著差异。12.9岁女孩的肩宽显著增加(p=0.003),身体周长更大:腰围(p=0.001)、臂围(p=0.0008)和臀围(p=0.001)。11.8岁男孩的躯干长度(p=0.04)和上肢长度(p=0.01)显著更长。年龄最大的16.2岁女孩出现超重(p=0.00001),腰围和臀围也显著增加(p=0.000001)。16.2岁男孩的身体周长也显著增加(p=0.0001),这在身高较高的男孩中尤为明显。女孩的体重指数(BMI)表明超重(标准差为1.50),而男孩的BMI正常(标准差为-0.05)。最年幼的女孩病程为2.9±0.6年,年龄较大组为5.2±0.6年,年龄最大组为6.9±0.6年。男孩的病程为1.9±0.6年、2.6±0.5年、4.8±0.7年。女孩的平均糖化血红蛋白(HbA1c)分别为7.1%、7.7%和8.4%,男孩分别为7.4%、7.4%和7.6%。

结论

1型糖尿病患者的体型变化与实际年龄、病程和代谢控制有关。已观察到体重和腰围增加的情况在女孩中较为常见。超重和肥胖患者存在并发症早期发生的风险,需要特别护理。

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