Age at onset and long-term metabolic control affect height in type-1 diabetes mellitus.
Reduced height as a consequence of type-I-diabetes mellitus in childhood has been reported in many studies.
However, it is still debated whether good metabolic control can normalize the growth rate.
A total of 436 children (204 boys, 232 girls, mean age at diagnosis of diabetes 8.2 ± 0.2 years) were followed at our outpatient diabetes centre.
Z-scores for height were evaluated in relation to duration of diabetes, age at onset and long-term metabolic control.
At diagnosis, height in children with diabetes was significantly above the reference population (+0.43 ± 0.09).
Standardized height decreased during the subsequent course of diabetes.
This likely represents a delay of growth, as the final height (chronological age>18 years, n=144) was+0.27 ± 0.09.
Growth reduction was more pronounced in patients diagnosed before the onset of puberty and final height in patients with a prepubertal onset of diabetes was significantly lower (+0.10 ± 0.13) compared to patients with a pubertal postpubertal onset (+0.52 ± 0.14).
Among patients with a prepubertal onset, the subgroup with « poor'metabolic control (long-term median HbA1c>7%) lost significantly more height compared to patients with » good'metabolic control.
Conclusion Despite modern treatment regimens, reduced longitudinal growth can still be demonstrated in type-I diabetes.
This parameter therefore provides a valuable endpoint for quality control in paediatric diabetology.
Mots-clés Pascal : Diabète insulinodépendant, Retard, Taille corporelle, Complication, Association, Age apparition, Equilibre, Glycémie, Long terme, Etude statistique, Epidémiologie, Allemagne, Europe, Hémoglobine A1, Sexe, Enfant, Homme, Adolescent, Endocrinopathie, Immunopathologie, Maladie autoimmune, Biologie clinique
Mots-clés Pascal anglais : Insulin dependent diabetes, Delay, Body size, Complication, Association, Age of onset, Equilibrium, Glycemia, Long term, Statistical study, Epidemiology, Germany, Europe, Hemoglobin A1, Sex, Child, Human, Adolescent, Endocrinopathy, Immunopathology, Autoimmune disease, Clinical biology
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0049605
Code Inist : 002B21E01B. Création : 31/05/1999.