Clarson C, Daneman D, Ehrlich R M
Diabetes Res. 1985 Sep;2(5):237-41.
Growth and pubertal development were studied in 122 children aged 13.4 +/- 2.9 yr (mean +/- SD) with IDDM of 6.1 +/- 3.8 yr duration. Height and weight, pubertal status, insulin dose (u/kg), frequency of insulin administration and HbA1 were measured every 3 months for a minimum period of 1 yr for each child. The mean and distribution of height and height velocity percentiles were normal for boys and girls. The mean weight percentile for boys was increased (62 +/- 27, p less than 0.01), but was normal for girls. The mean and distribution of weight velocity percentiles were normal for both sexes. The mean and distribution of age of onset of Tanner 2 in both boys (11.9 +/- 1.4 yr) and girls (11.2 +/- 1.3) was normal, as was the age of menarche (13.2 +/- 1.2 yr). The mean HbA1 level was 11.1 +/- 2.0% (normal less than 7.5%). There was no correlation of mean HbA1 levels (calculated from 4 or more measurements for each child) with height velocity or with weight velocity percentiles or with mean height or weight percentiles. These results indicate that diabetic control, as reflected by HbA1 levels, was not a major determinant of growth in this group of children with IDDM, who displayed normal growth patterns and pubertal development despite a wide range of HbA1 levels. Normal growth may not reflect optimal metabolic control but "average" control.
对122名年龄为13.4±2.9岁（平均±标准差）、患IDDM（胰岛素依赖型糖尿病）6.1±3.8年的儿童进行了生长和青春期发育研究。每3个月测量每个儿童的身高、体重、青春期状态、胰岛素剂量（单位/千克）、胰岛素给药频率和糖化血红蛋白（HbA1），每个儿童至少测量1年。男孩和女孩的身高及身高速度百分位数的均值和分布均正常。男孩的平均体重百分位数升高（62±27，p<0.01），但女孩正常。男女体重速度百分位数的均值和分布均正常。男孩（11.9±1.4岁）和女孩（11.2±1.3岁）坦纳2期开始的平均年龄及分布正常，初潮年龄（13.2±1.2岁）也正常。平均HbA1水平为11.1±2.0%（正常<7.5%）。每个儿童4次或更多次测量计算得出的平均HbA1水平与身高速度、体重速度百分位数、平均身高或体重百分位数均无相关性。这些结果表明，HbA1水平所反映的糖尿病控制情况并非该组IDDM儿童生长的主要决定因素，尽管HbA1水平范围很广，但这些儿童仍表现出正常的生长模式和青春期发育。正常生长可能并不反映最佳代谢控制，而是“平均”控制。
