Verrotti A, Chiarelli F, Morgese G
Department of Pediatrics, Ospedale Pediatrico University of Chieti, Italy.
Acta Diabetol. 1995 Jun;32(2):102-5. doi: 10.1007/BF00569566.
In order to assess whether or not the lipoprotein profile worsens throughout puberty in children with type 1 diabetes mellitus and if this change is related to dietary compliance, we studied 46 (20 female, 26 male) children. At the beginning of the study, the mean age (+/- SD) was 10.9 +/- 1.1 years; all the children studied had reached a pubertal stage of P1, G1. The mean duration of diabetes (+/- SD) was 4.9 +/- 1.8 years. The diet and the lipoprotein profile of diabetic children were analysed at the beginning of the study and after 6 years. The quality of metabolic control of subjects studied had not changed significantly at the end of the study (haemoglobin HbA1c 7.6% +/- 2.1% vs 7.9% +/- 2.0%; NS). After puberty, the diabetic patients received more energy from carbohydrate and less from lipids. Total serum cholesterol and triglycerides and levels of low-density lipoproteins were significantly higher and of high-density lipoproteins lower in the diabetic patients after puberty than before (4.47 +/- 0.7 mmol/l vs 5.99 +/- 0.6, P < 0.01; 0.90 +/- 0.02 mmol/l vs 1.45 +/- 0.03, P < 0.01; 2.2 +/- 0.3 mmol/l vs 2.8 +/- 0.5, P < 0.01; 1.5 +/- 0.2 vs 1.1 +/- 0.2, P < 0.01, respectively). These results suggest a detrimental effect of puberty on lipoproteins; probably, dietary compliance plays a role in this worsening. Dietary education should be intensified during adolescence in order to present these changes.
为了评估1型糖尿病患儿在整个青春期脂蛋白谱是否恶化以及这种变化是否与饮食依从性有关，我们研究了46名儿童（20名女性，26名男性）。研究开始时，平均年龄（±标准差）为10.9±1.1岁；所有研究对象均处于青春期P1、G1阶段。糖尿病平均病程（±标准差）为4.9±1.8年。在研究开始时和6年后分析糖尿病患儿的饮食和脂蛋白谱。研究对象的代谢控制质量在研究结束时没有显著变化（血红蛋白HbA1c为7.6%±2.1%，而7.9%±2.0%；无显著差异）。青春期后，糖尿病患者从碳水化合物中获取的能量更多，从脂质中获取的能量更少。青春期后糖尿病患者的总血清胆固醇、甘油三酯和低密度脂蛋白水平显著高于青春期前，而高密度脂蛋白水平则低于青春期前（分别为4.47±0.7 mmol/l对5.99±0.6，P<0.01；0.90±0.02 mmol/l对1.45±0.03，P<0.01；2.2±0.3 mmol/l对2.8±0.5，P<0.01；1.5±0.2对1.1±0.2，P<0.01）。这些结果表明青春期对脂蛋白有不利影响；饮食依从性可能在这种恶化中起作用。在青春期应加强饮食教育，以应对这些变化。
