背景:本研究旨在评估1型糖尿病(T1DM)儿童和青少年的人体测量和青春期发育,并检测影响这些测量的危险因素及其与血糖控制的联系。
方法:使用人体测量法对200名儿童和青少年进行了评估。身材矮小者使用胰岛素样生长因子1(IGF-1)进一步评估,骨龄,和甲状腺轮廓,而青春期延迟的患者则使用性激素和垂体促性腺激素测定进行评估。
结果:我们发现我们的患者中有12.5%身材矮小(身高SDS<-2),其中72%的IGF-1小于-2SD。身材矮小的患者糖尿病发病年龄较早,糖尿病持续时间较长,HbA1C和尿白蛋白/肌酐比值高于正常身材(p<0.05)。此外,与青春期正常患者相比,青春期延迟患者的HbA1c和血脂异常较高(p<0.05).回归分析显示,与身材矮小相关的因素是;诊断时的年龄,HbA1C>8.2,白蛋白/肌酐比值>8(p<0.05)。
结论:患有未控制的T1DM的儿童有身材矮小和青春期延迟的风险。糖尿病持续时间和控制似乎是身材矮小的独立危险因素。
BACKGROUND: This study aimed to assess the anthropometric measures and pubertal growth of children and adolescents with Type 1 diabetes mellitus (T1DM) and to detect risk determinants affecting these measures and their link to glycemic control.
METHODS: Two hundred children and adolescents were assessed using anthropometric measurements. Those with short stature were further evaluated using insulin-like growth factor 1 (IGF-1), bone age, and thyroid profile, while those with delayed puberty were evaluated using sex hormones and pituitary gonadotropins assay.
RESULTS: We found that 12.5% of our patients were short (height SDS < -2) and IGF-1 was less than -2 SD in 72% of them. Patients with short stature had earlier age of onset of diabetes, longer duration of diabetes, higher HbA1C and urinary albumin/creatinine ratio compared to those with normal stature (p < 0.05). Additionally, patients with delayed puberty had higher HbA1c and dyslipidemia compared to those with normal puberty (p < 0.05). The regression analysis revealed that factors associated with short stature were; age at diagnosis, HbA1C > 8.2, and albumin/creatinine ratio > 8 (p < 0.05).
CONCLUSIONS: Children with uncontrolled T1DM are at risk of short stature and delayed puberty. Diabetes duration and control seem to be independent risk factors for short stature.