Pubertal Growth in ID DM Is Determined by HbA1c Levels, Sex, and Bone Age

Author:

Ahmed Marion L1,Connors Matthew H1,Drayer Nick M1,Jones Jennifer S1,Dunger David B1

Affiliation:

1. Department of Paediatrics, University of Oxford Oxford, U.K

Abstract

OBJECTIVE In cross-sectional studies of subjects with IDDM, the relationship between suboptimal pubertal growth, glycemic control, and abnormal insulin-like growth factor 1 (IGFI) levels has proved difficult to define. The objective of this study was to examine these relationships in a longitudinal prospective study. RESEARCH DESIGN AND METHODS A total of 46 children (23 boys) were measured every 3 months, and their bone age was assessed annually. Blood samples were obtained for HbA1c, 1GF-I, and C-peptide. Growth data were compared with national standards, and 1GFI data were compared with a parallel longitudinal study of normal schoolchildren. Data were analyzed as SD scores (mean ± SD). RESULTS The onset of puberty was not delayed, although in the girls, bone age was advanced (bone age, 11.48 ± 1.01 years vs. chronological age, 10.93 ± 0.86 years “mean ± SD”; P = 0.04). The timing of peak height velocity (PHV) was normal in both sexes, but the magnitude was reduced in girls (PHV SDS = −0.56 ± 0.90, P < 0.02), and reductions in height SDS between diagnosis and final height were observed (P = 0.014). At PHV, 1GF-1 levels were reduced in both sexes, and there were no sex differences in HbA1c levels and insulin doses. 1GF- 1 SDS correlated with insulin dose (r = 0.47, P = 0.004) but not with PHV SDS, whereas HbA1c correlated negatively with PHV SDS in both sexes (r = −0.35, P = 0.03). In a stepwise multiple regression analysis, the major determinants of PHV SDS were HbA1c (P = 0.04), sex (P = 0.0007), and bone age (P = 0.01). CONCLUSIONS We conclude that the magnitude of the pubertal growth spurt is related to HbAlc levels in both sexes, but it is reduced only in girls. This sexual dimorphism cannot be explained by differences in 1GF-I levels and may relate to the bone age advance at the onset of puberty in the girls.

Publisher

American Diabetes Association

Subject

Advanced and Specialized Nursing,Endocrinology, Diabetes and Metabolism,Internal Medicine

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3