Muñoz M T, Barrios V, Pozo J, Argente J
Autonomous University, Department of Pediatrics, Hospital of Niño Jesús, Madrid, Spain.
Pediatr Res. 1996 Jun;39(6):992-8. doi: 10.1203/00006450-199606000-00011.
Values of IGF-I after extraction, its binding proteins, and the high affinity GH-binding protein (BP) are not well established in pediatric patients with insulin-dependent diabetes mellitus (IDDM). We report data for IGF-I, IGFBP-1, and -3, and GHBP in 92 Spanish children with IDDM, separated according to pubertal stage: prepubertal (n = 49); pubertal onset (n = 17); mid-puberty (n = 17), and complete puberty (n = 9), as well as to metabolic control (HbA1 < 9% or > or = 9%). IGF-I levels in IDDM patients increased throughout development (p < 0.001), but were diminished at every developmental stage when compared with marched control subjects. IGF-I concentrations showed a negative correlation with the degree of metabolic control, in particular during the prepubertal stage of development. A negative correlation (r = -0.22; p < 0.005) between IGF-I concentrations and HbA1 was found. Serum IGFBP-I levels diminish during maturation in diabetic patients (p < 0.001). However, IDDM patients have significantly higher levels of IGFBP-1 than control subjects at every stage of development, and IDDM patients with inadequate metabolic control exhibit even greater differences when compared with matched control subjects. A positive correlation (r = 0.22; p < 0.005) between IGFBP-1 concentrations and HbA1 was found. IGFBP-3 serum levels were similar to those observed in normal subjects, and no correlation was observed in relation to the metabolic control. In IDDM patients, GHBP levels change significantly during maturation, as they do in normal control subjects; however, significantly lower GHBP levels were found in prepubertal and pubertal IDDM patients. GHBP levels were independent of metabolic control, although a tendency toward lower levels of GHBP was seen when HbA1 levels increased. We suggest that a partial GH resistance syndrome exists in IDDM patients, and this may be related to the metabolic control. Hence, the biochemical markers measured here may be of value in evaluating the smaller pubertal growth spurt in diabetic patients.
胰岛素依赖型糖尿病（IDDM）患儿提取后的胰岛素样生长因子-I（IGF-I）及其结合蛋白以及高亲和力生长激素结合蛋白（BP）的值尚未完全明确。我们报告了92名西班牙IDDM患儿的IGF-I、IGFBP-1和-3以及生长激素结合蛋白（GHBP）的数据，这些患儿根据青春期阶段进行了分组：青春期前（n = 49）；青春期开始（n = 17）；青春期中期（n = 17）和青春期后期（n = 9），同时也根据代谢控制情况（糖化血红蛋白A1<9%或≥9%）进行了分组。IDDM患者的IGF-I水平在整个发育过程中升高（p<0.001），但与年龄匹配的对照受试者相比，在每个发育阶段均降低。IGF-I浓度与代谢控制程度呈负相关，尤其是在青春期前发育阶段。发现IGF-I浓度与糖化血红蛋白A1之间存在负相关（r = -0.22；p<0.005）。糖尿病患者血清IGFBP-1水平在成熟过程中降低（p<0.001）。然而，IDDM患者在每个发育阶段的IGFBP-1水平均显著高于对照受试者，与匹配的对照受试者相比，代谢控制不佳的IDDM患者差异更大。发现IGFBP-1浓度与糖化血红蛋白A1之间存在正相关（r = 0.22；p<0.005）。IGFBP-3血清水平与正常受试者相似，与代谢控制无相关性。在IDDM患者中，GHBP水平在成熟过程中显著变化，与正常对照受试者一样；然而，青春期前和青春期IDDM患者的GHBP水平显著降低。GHBP水平与代谢控制无关，尽管当糖化血红蛋白A1水平升高时，GHBP水平有降低的趋势。我们认为IDDM患者存在部分生长激素抵抗综合征，这可能与代谢控制有关。因此，此处测量的生化标志物可能有助于评估糖尿病患者青春期较小的生长突增。
