Linear Growth in Children and Adolescents with Type 1 Diabetes Mellitus
Abstract
:1. Introduction
2. The GH/IGF1 Axis in Children with Type 1 Diabetes Mellitus (T1DM)
3. Height at Diagnosis of Type 1 Diabetes Mellitus (T1DM) and Growth Before Puberty
4. Growth during Puberty and Final Adult Height in Patients with Type 1 Diabetes Mellitus (T1DM)
Study | Study Population Number Age (Range) years | H at T1DM onset (Mean SDS ± SD) | Final H (Mean SDS ± SD) | Other | Conclusions | |
---|---|---|---|---|---|---|
Cianfarani 2000 [29] | 60 (35 M, 25 F) (2.5–10) yrs | cases 0.64 ± 1.4 vs. controls 0.64 ± 0.9*; P ns | Nd | H at T1DM onset was not significantly different from H of healthy peers. | Increased IGFBP-3 proteolytic activity and reduced IGF-1 levels in T1DM children. | |
Bizzarri 2014 [31] | 91 (54 M, 37 F) (4.1–15.3) yrs | Nd | Nd | HV during puberty (mean SDS ± SD): M: −0.45 ± 2.3 vs. F: 0.6 ± 2.4; p = 0.04 | HV SDS was higher in F than in M during pubertal age. | IGF-I SDS and IGF-I/IGFBP-3 molar ratio were significantly lower in M than in F. No differences in CSII or MDI therapy. |
Chiarelli 2004 [32] | 30 (30 M) Prepubertal: 10.3 ± 2.0 yrs Pubertal: 13.8 ± 1.1 yrs Post-pubertal: 18.5 ± 1.3 yrs | Nd | Nd | H (SDS ± SD): Prepubertal: 0.68 ± 0.9 vs. 0.46 ± 0.9*, P ns Pubertal: 0.15 ± 1.6 vs. 0.17 ± 1.33*, P ns Post-pubertal: 0.19 ± 0.8 vs. 0.18 ± 0.7* P ns | H SDS was not different from that of healthy peers. | No statistically significant differences in IGF-1 and IGFBP3 serum concentrations between T1DM groups and control subjects. |
Mao 2011 [53] | 57 (26 M, 31 F) (6–10) yrs | M: 0.34 ± 0.93 F: 0.38 ± 0.50 | M: –0.42 ± 0.95 F: –0.60 ± 0.98 | H at the start of puberty: M: –0.66 ± 1.07 F: –0.93 ± 1.13 | H at diagnosis was higher than healthy peers in both sexes. Final H was reduced compared to the healthy group. | |
Bizzarri 2013 [54] | 104 (51 M, 53 F) (1.02–11.08) yrs | 0.52 ± 1.04 | H at puberty onset: 0.36 ± 1.10 | HV: –0.14±1.84^ ΔH: –0.15±0.83^ | Increased H at onset in prepubertal children in comparison with reference standards. | HV was directly affected by C-peptide (p = 0.03) and insulin requirement (p = 0.004) and inversely related to HbA1c (p = 0.006). |
Lebl 2003 [56] | 587 (317 M, 270 F) (0.3–20.3) yrs | F: 0.74 ± 1.46 M: 0.15 ± 1.1 | Mean final H (cm) (approximately 123 patients): F 167 (GTH 165.6) M 176.5 (GTH 176.8) | H at diagnosis was significantly greater than standards population both in M and in F. Significant lose of H after diagnosis in M (p < 0.001). | HbA1c did not correlate with growth pattern. | |
Elamin 2006 [58] | 72 (37 M, 35 F) (7–13) yrs | M: 0.04 ± 0.96 F: 0.15 ± 0.40 | M: −1.63 ± 0.44 F: -1.72 ± 0.79 | Pubertal H gain ΔH cm (range) M: 20.6 (13.0 – 28.0) F: 17.9 (12.0 – 23.0) | H at diagnosis was greater than GTH. Significant reduction in pubertal growth spurt. Mean final H attained was lower than GTH. | |
Bizzarri 2018 [59] | 104 (51 M, 53 F) (5.91 ± 1.9) yrs | Mean H SDS (±SD) 0.52 ± 1.04 vs GTH SDS 0.01 ± 1.02 p < 0.05 | M 0.04 ± 1.1 F –0.27 ± 1.0 P ns | Pubertal H gain ΔH cm (range) M 24.4 ± 4.9 cm F 19.0 ± 3.8 cm | H at the onset was significantly higher than GTH. H at puberty onset and final H were not different from GTH. | No statistically significant differences in growth between patients treated with CSII and MDI. Final H was positively related to the daily dose of basal insulin during puberty. |
Bonfig 2012 [65] | 1685 (839 M, 846 F) <11 yrs | All: 0.22 ± 1 | M: −0.17 ± 1 F: −0.16 ± 0.97 | H at onset is above mean standard values. Final H was normal in patients with a mean HbA1c <7.0%, but significantly decreased in those with mean HbA1c 7.0%-8.0% and mean HbA1c >8.0%. | Final H was positively correlated with H at onset (p < 0.0001) and negatively correlated with mean HbA1c (p < 0.0001) and duration of diabetes (p = 0.0015). | |
Wong 2000 [79] | 58 (22 M, 36 F) (1.75–14.79) yrs | M: + 0.76 vs. F: −0.07 p = 0.015 | M + 0.14 F - 0.57 | H at diagnosis in M was significantly greater than F and than standards population (p = 0.015); Mean final H in F was shorter than their GTH ( p = 0.04) while was normal in M. | ||
Marcovecchio 2014 [81] | 206 (107 M, 99 F) (11–18) yrs | Nd | MA+ vs. MA-: Differences in final H (cm) 4.29 cm, p = 0.001 | ΔH SDS during puberty: All:−0.148, p < 0.001 MA+ −0.286 vs. MA- 0.083; p = 0.023 | In the group as a whole, mean H SDS significantly declined during puberty, p < 0.001. In MA+ group the H SDS declined during puberty greater than MA- group (p = 0.023). | |
Plamper 2017 [82] | 1294 (664 M, 630 F) (7–16) yrs | H SDS at study start (Mean SDS): All 0.17 M 0.17 F 0.17 | H SDS at study end (Mean SDS): All 0.01 M −0.02 F 0.04 | Mean HV at the peak of the growth spurt was significantly reduced in M (p < 0.001) but not in F. In F: HV declined more rapidly after reaching pubertal peak HV compared to the reference population. | For both M and F, H SDS during the study period differed significantly from the reference population (p < 0.0001). The growth impairment was more pronounced in patients with poor metabolic control. | |
Luna 2005 [83] | 83 (46 M, 37 F) (8 yrs—adult bone age) | M: 0.08 ± 0.16 F: 0.40 ± 0.16 | M: −1.02 ± 0.27 F: 0.13 ± 0.24 | Final H SDS was significantly decreased compared to H at diagnosis in M (p < 0.01). In F final H SDS was lower compared to H at diagnosis but not significantly (p < 0.05). | Apparently minor role of metabolic control . | |
Kanumakala 2002 [84] | 92 (43 M, 49 F) (8–18) yrs | M: −0.17 ± 0.99 F: −0.29 ± 1.19 | M: −0.39 ± 0.99 F: −0.13 ± 1.07 | Normal mean Final H compared to the general population. | No correlation between metabolic control and linear growth. | |
Huang 2001 [85] | 44 (317 M, 270 F) (0.3–20.3) yrs | M: −0.03 ± 0.67 F: 0.44 ± 0.91 | M: −0.13 ± 0.66 F: −0.05 ± 0.86 | Mean final H had a lower SDS than H at diagnosis (p = 0.009). Both M and F attained a normal mean final H compared to their GTH (p < 0.005). | The final H as well as the reduction in H SDS was not correlated with the age at diagnosis or with metabolic control. | |
Parthasarathy 2016 [90] | 160 (75 M, 85 F) (4–16) yrs | H SDS at study start (Mean SDS ± SD): 0.9 ± 1.3 | Nd | HV at study end: (Mean SDS ± SD): −0.3 ± 1.5 | T1DM children had lower HV than healthy children | Children on basal-bolus therapy had higher HV those on a split mix regimen (p < 0.05). Children diagnosed before 5 yr had lowest HV. |
Choudhury 2000 [91] | 61 (39 M, 22 F) (3.7–16.8) yrs | All:−0.095 ± 0.96 M: −0.091 ± 0.95 F: −0.10 ± 0.93 | Data on 12 children: −0.24 (±1.24) | H SDS in M with onset <5 yr: 0.39 (±0.75), p < 0.05 | M with onset before 5 yrs were significantly taller than standard population. Normal prepubertal linear growth. | |
Demir 2010 [93] | 101 (55 M, 46 F) (2–15.5) yrs | M: 0.3 ± 1.1 F: 0.1 ± 0.9 | H SDS at study end: M: 0.1 ± 1 F: −0.3 ± 0.9 | H at diagnosis, for both M and F, was significantly higher compared to GTH. Mean H SDS did not change significantly during the follow-up period. | Mean HbA1c showed a negative correlation with ΔH SDS at the 3rd year of diagnosis (p = 0.03). |
5. The Effects of Insulin Therapy on Linear Growth in Patients with Type 1 Diabetes Mellitus (T1DM)
6. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Santi, E.; Tascini, G.; Toni, G.; Berioli, M.G.; Esposito, S. Linear Growth in Children and Adolescents with Type 1 Diabetes Mellitus. Int. J. Environ. Res. Public Health 2019, 16, 3677. https://doi.org/10.3390/ijerph16193677
Santi E, Tascini G, Toni G, Berioli MG, Esposito S. Linear Growth in Children and Adolescents with Type 1 Diabetes Mellitus. International Journal of Environmental Research and Public Health. 2019; 16(19):3677. https://doi.org/10.3390/ijerph16193677
Chicago/Turabian StyleSanti, Elisa, Giorgia Tascini, Giada Toni, Maria Giulia Berioli, and Susanna Esposito. 2019. "Linear Growth in Children and Adolescents with Type 1 Diabetes Mellitus" International Journal of Environmental Research and Public Health 16, no. 19: 3677. https://doi.org/10.3390/ijerph16193677