Determinants of Growth in Diabetic Pubertal Subjects
| Autor: | G Dahlqvist, I Zachrisson, Kerstin Brismar, Kerstin Hall, M Wallensteen |
|---|---|
| Rok vydání: | 1997 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.drug_class Endocrinology Diabetes and Metabolism Radioimmunoassay Growth Body Mass Index chemistry.chemical_compound Dehydroepiandrosterone sulfate Internal medicine Immunopathology Diabetes mellitus Diabetes Mellitus Internal Medicine Humans Hypoglycemic Agents Insulin Medicine Insulin-Like Growth Factor I Child Glycated Hemoglobin Sweden Advanced and Specialized Nursing Autoimmune disease Sex Characteristics Dehydroepiandrosterone Sulfate business.industry Puberty medicine.disease Androgen Body Height Pathophysiology Insulin-Like Growth Factor Binding Protein 1 Endocrinology chemistry Metabolic control analysis Insulin dependent diabetes Female business Biomarkers |
| Zdroj: | Karolinska Institutet |
| ISSN: | 1935-5548 0149-5992 |
| DOI: | 10.2337/diacare.20.8.1261 |
| Popis: | OBJECTIVE To analyze the relationship among metabolic control, IGF-I, and growth in pubertal diabetic subjects. RESEARCH DESIGN AND METHODS In 72 diabetic children, we have studied the pattern of change of IGF-I, IGF-I SD score, IGF binding protein (BP)-1, and growth rate in different pubertal stages and have analyzed their relation to age sex, weight/length index, HbA1c, insulin concentration, insulin dose, and dehydroepiandrosteronesulfate (DHEAS). RESULTS The serum IGF-I values increased up to Tanner stage 4 and thereafter decreased, whereas IGFBP-1 showed the inverse pattern. When transforming the IGF-I values into SD scores, correcting for age, sex, and pubertal stage, it was shown that the deviation from normal values increased with increasing pubertal stage in boys, but was equal in stages 3–5 in girls. Using multiple regression analysis, HbA1c, insulin dose, and DHEAS were significantly correlated to IGF-I SD score (R2 = 0.253, P = 0.001). IGFBP-I levels in the afternoon were within normal range. LogIGFBP-1 showed an inverse correlation, to insulin concentration in single correlation (r = −0.26, P = 0.02). In single correlation, growth rate correlated significantly to insulin dose (r = 0.25, P = 0.03). In a multiple regression analysis, only DHEAS and IGF-I SD score were found to be significantly correlated to growth rate (R2 = 0.370, P < 0.001). The 18 adolescents who had reached their final height did not deviate from their target final height, according to their recorded growth since birth. CONCLUSIONS In a group of fairly well-controlled diabetic children, the normal increase in IGF-I during puberty is blunted. Despite decreased IGF-I levels, target final height was attained, probably because of adequate insulin compensation leading to normal IGFBP-l, thus adequate bioavailability of IGF-I. Our results point out the importance of sufficient exogenous insulin in the period of rapid linear growth. |
| Databáze: | OpenAIRE |
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