Longitudinal Data on Growth and Final Height in Diabetic Children

Caju, M. V. L. Du; Rooman, Raoul; Beeck, L. Op De

doi:10.1203/00006450-199510000-00022

Cited by 64 publications

(60 citation statements)

References 28 publications

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“…Holl et al reported a normal final height in a group of 76 patients with T1DM (58). Similar data were reported by Du Caju et al who showed normal final height in boys with diabetes while only a slightly reduced final height was reported in girls (60). Furthermore, the final height of 80 children studied in Oxford was 2 0.06 SDS, which did not differ significantly from their mid parental height SDS (61).…”

Section: Final Heightsupporting

confidence: 71%

“…Gunczler et al showed that childen with poor control have a significantly lower growth velocity compared with well controlled subjects (64). Although there is a greater agreement on height loss after diagnosis of diabetes, Du Caju et al showed a normal pre-pubertal growth, as a similar height SDS at the age of 7 and 10 has been reported (60).…”

Section: Growth and Developmentmentioning

confidence: 87%

“…While some studies observe that children with diabetes are taller than controls at diagnosis (2, 53 -58) others report normal or lower height in children with newly diagnosed diabetes (3,59,60). The most important factor influencing this evaluation is the reference data that may be severely influenced by age trend variations.…”

Section: Growth and Developmentmentioning

confidence: 99%

“…Although the chronological age at onset of puberty and the duration of the pubertal growth spurt is not significantly different between subjects with T1DM and healthy adolescents, several studies have shown a blunted pubertal growth spurt which seems to be associated with a reduced peak of height velocity SDS (2,60,61,86,88,89).…”

Section: Growth At Pubertymentioning

confidence: 99%

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Growth, growth factors and diabetes

Chiarelli

Giannini²,

Mohn³

2004

European Journal of Endocrinology

107

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Type 1 diabetes mellitus (T1DM) and other chronic diseases in children are well known to adversely affect linear growth and pubertal development. In the years immediately following the introduction of insulin therapy, short stature was consistently reported in children with T1DM. However, over the past 50 years significant improvement in the prognosis for growth and final height in children with diabetes has been achieved. Although pre-pubertal and post-pubertal growth are important phases in growth, puberty and its related hormonal changes represent a critical phase for growth gain and final height particularly in patients with T1DM. Growth impairment reported in diabetic patients is dependent on abnormalities in physiological bone growth and corresponds to abnormalities of the growth hormone -insulin-like growth-I (GH -IGF-I) axis. These alterations seem to be related to appropriate insulin levels and thereby to glycaemic control as judged by haemoglobin levels. Modern diabetes care, particularly intensified insulin regimens, might improve metabolic control in patients with T1DM, therefore preventing abnormalities of the GH -IGF-I axis and leading to normal growth and final height similar to that of their unaffected peers. European Journal of Endocrinology 151 U109-U117

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Section: Final Heightsupporting

confidence: 71%

Section: Growth and Developmentmentioning

confidence: 87%

Section: Growth and Developmentmentioning

confidence: 99%

Section: Growth At Pubertymentioning

confidence: 99%

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Growth, growth factors and diabetes

Chiarelli

Giannini²,

Mohn³

2004

European Journal of Endocrinology

107

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“…Penfold e col. (14) mostraram que houve interferência da doença na estatura final em 181 pacientes diabéticos com média de escore z igual a -0,22±0,09 em relação à curva do NCHS (p <0,01) (31). Outros autores sugeriram interferência da doença sobre o crescimento, principalmente nas meninas, que têm redução do estirão puberal, mas não identificaram interferência na estatura final (16)(17)(18)22,(37)(38)(39). Em muitos desses estudos, no entanto, o número de pacientes avaliados foi pequeno e a falta de uniformidade entre os critérios utilizados pode ser parcialmente responsável pelas divergências.…”

Section: Discussionunclassified

Estatura final de pacientes com diabetes mellitus do tipo 1

Rodrigues

Silva

2001

Arq Bras Endocrinol Metab

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RESUMOCom o objetivo de conhecer a estatura final de indivíduos com diabetes mellitus do tipo 1 (DM1) e possíveis fatores intervenientes sobre o crescimento foram avaliados 72 pacientes, diagnosticados na infância ou iní-cio da adolescência. O grupo foi acompanhado no Serviço de Endocrinologia do HC/UFMG. A idade média (±DP) era 21,2±3,2 anos e o tempo de doença 11,9±5,7 anos. A estatura final foi 159,5±8,1cm (escore z= -1,23±1,05), sendo 156,7±6,0cm para o sexo feminino (n= 53) e 167,5±8,2cm para o sexo masculino (n= 19). O escore z foi -1,16±0,99 para o sexo feminino e -1,42±1,25 para o masculino. A estatura final dos pacientes comparada à curva de referência do NCHS mostrou que 88,9% deles se apresentavam, anormalmente, com estatura abaixo da média. Houve, também, redução de 0,5 escore z na estatura final (-1,08±1,23) em relação à estatura do ano de diagnóstico (-0,53±0,77), num subgrupo de 23 pacientes (p= 0,01). Em outro subgrupo (n= 22), 15 apresentavam mau controle metabólico com hemoglobina glicosilada de 13,1±1,0% e sete, controle satisfatório, com hemoglobina glicosilada de 10±0,8%. Houve comprometimento da estatura final desse primeiro grupo (mau controle) em relação ao segundo (escore z= -1,83±0,78 vs. -0,83±1,07; p= 0,02). Concluímos que nossos resultados são compatíveis com prejuízo na estatura final dos pacientes diabéticos avaliados em relação à população geral e parecem estar, também, relacionados ao controle metabólico ruim. ABSTRACTThe final height of 72 patients with DM1 followed in the Endocrine Service at Hospital das Clínicas of Universidade Federal de Minas Gerais was evaluated. DM1 began before puberty was completed. Mean age was 21.2±3.2 years and they had 11.9±5.7 years of disease. Mean final height of the group was 159.5±8.1cm (z score= -1.23±1.05), 156.7± 6.0cm for female (n= 53) and 167.5±8.2cm for male (n= 19). The z scores were -1.16±0.99 for female and -1.42±1.25 for male. The comparison of patients final height curve with that from the NCHS shows that the stature of 88.9% of diabetics was abnormally below the mean reference. A reduction of 0.5 SD was observed in final height (-1.08±1.23) in relation to height at the year of diagnosis (-0.53±0.77) in a subset of 23 patients (p= 0.01). A group with poor metabolic control (n= 15; glycosylated hemoglobin of 13.1±1.0%) showed impaired final height results (z score= -1.83±0.78 vs. -0.83±1.07; p= 0.02) when compared to the better-controlled group (n= 7; glycosylated hemoglobin = 10±0.83%). We conclude that our results support the notion that DM1 has a detrimental effect on the final stature of these patients, which is also related to the status of metabolic control.

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