Hamed Mohamed Saad, El-Sherbeny Alyaa Ahmed, El-Din Ahmed Mohamed Bahaa
Internal Medicine Department, Endocrinology Unit, Ain Shams University Hospitals, Cairo, Egypt.
Curr Diabetes Rev. 2019;15(5):420-428. doi: 10.2174/1573399815666190206161230.
T1DM is considered as the most common chronic metabolic autoimmune disorder in childhood and adolescence as well as in the early adulthood. It appears frequently during 12- 13 years of age with distinctive features like immune-mediated chronic damage of pancreatic β-cells, leading eventually to partial, or mostly, absolute insulin deficiency. Insulin-like growth factor 1 (IGF-1) is a polypeptide consisting of 70 amino acids with insulin-like chemical structure. In most cases, IGF-1 is a reliable growth marker and an anabolic one in adults. It plays an important role in the regulation of various physiological functions, e.g., glucose metabolism, cell survival and proliferation.
To compare the levels of IGF-1 in children having type-1 diabetes with that of healthy controls and also to determine whether there is a relationship between IGF-1 and physical features in T1DM.
The current study was conducted on 85 children of both sexes. Seventy patients were less than 12 years old with T1DMselected according to ADA 2014 criteria for diagnosis of diabetes from pediatric diabetes clinic at Ain Shams University hospital. All patients were divided into 2 groups based on the duration of diabetes to T1DM>1year duration and T1DM<1year duration and they were compared with fifteen normal children, attending the pediatric general clinics as a control group. Measurements of height, weight, and arm span, upper body segment, lower body segment, and body mass index, parents' height beside Fasting blood glucose, HbA1C, IGF-1, FSH, and LH were noted.
Height percentile significantly higher inT1DM less than 1 year median 50 (10 to 75) than T1DM more than one year (median10 (3 to 44) p-value 0.007). IGF-1 level in the group of T1DM less than 1year median 90 (70 to 110) (ng/ml) was significantly lower than other groups (p-value 0.0008). IGF1 has a significant positive relation with Aram span in group T1DM more than 1year (p-value 0.024), positive significant relationship between mother height and IGF-1 level in group T1DM less than 1 year (p-value 0.013).
IGF-1 level is reduced by the recent onset of T1DM but still it has some effect on the somatic features even in the presence of longstanding diabetes.
1型糖尿病（T1DM）被认为是儿童、青少年以及成年早期最常见的慢性代谢性自身免疫疾病。它常出现在12 - 13岁，具有独特特征，如胰腺β细胞的免疫介导慢性损伤，最终导致部分或大部分绝对胰岛素缺乏。胰岛素样生长因子1（IGF - 1）是一种由70个氨基酸组成的多肽，具有胰岛素样化学结构。在大多数情况下，IGF - 1是一种可靠的生长标志物，在成年人中是一种合成代谢因子。它在调节各种生理功能中起重要作用，例如葡萄糖代谢、细胞存活和增殖。
比较1型糖尿病儿童与健康对照者的IGF - 1水平，并确定IGF - 1与T1DM患者身体特征之间是否存在关系。
本研究对85名男女儿童进行。70例年龄小于12岁的T1DM患者根据2014年美国糖尿病协会（ADA）糖尿病诊断标准从艾因夏姆斯大学医院儿科糖尿病诊所选取。所有患者根据糖尿病病程分为两组，T1DM病程>1年组和T1DM病程<1年组，并与15名正常儿童进行比较，这些正常儿童在儿科普通门诊就诊作为对照组。记录身高、体重、臂展、上半身长度、下半身长度、体重指数、父母身高，以及空腹血糖、糖化血红蛋白A1C（HbA1C）、IGF - 1、促卵泡生成素（FSH）和促黄体生成素（LH）。
T1DM病程小于1年组的身高百分位数中位数为50（10至75），显著高于T1DM病程超过1年组（中位数10（3至44），p值0.007）。T1DM病程小于1年组的IGF - 1水平中位数为90（70至110）（ng/ml），显著低于其他组（p值0.0008）。在T1DM病程超过1年组中，IGF1与臂展呈显著正相关（p值0.024），在T1DM病程小于1年组中，母亲身高与IGF - 1水平呈显著正相关（p值0.013）。
T1DM近期发病会使IGF - 1水平降低，但即使存在长期糖尿病，它对身体特征仍有一定影响。
