Two cases of insulin-dependent diabetes mellitus under insulin treatment with slow height velocity: relationship of growth hormone-binding protein, metabolic control and growth.
Inadequate blood sugar control in children with insulin-dependent diabetes mellitus (IDDM) sometimes results in low insulin-like growth factor-I (IGF-I) and sluggish height growth. High affinity growth hormone-binding protein (GHBP), which is identical to the extracellular domain of growth hormone (GH) receptor, is present in the human sera. We have determined GHBP activity in two cases of poorly controlled IDDM with low height velocity in relation to metabolic control in order to determine the mechanism of resistance to GH in this condition, as indicated by low levels of GH-dependent growth factor IGF-I in the face of high serum GH levels. GHBP activity was within the normal range in two cases of IDDM with slow height velocity, low IGF-I and high hemoglobin-A1. In both cases, improved blood sugar control normalized IGF-I to result in accelerated height velocity without a major change in GHBP levels. These results may indicate either normal peripheral GH receptor or normal free portion of serum GH, and may suggest that the major defect in slow growth in poorly controlled diabetes is due to the post GH receptor.
Murata
A
A
Department of Pediatrics, Chiba University School of Medicine, Japan.
Yasuda
T
T
Niimi
H
H
D001827:Body Height; D002352:Carrier Proteins / Q000378:metabolism*; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000378:metabolism*; D005260:Female; D006130:Growth Disorders / Q000209:etiology*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D011986:Receptors, Somatotropin / Q000378:metabolism
D002352:Carrier Proteins; D011986:Receptors, Somatotropin; D007334:Insulin-Like Growth Factor I; C051815:somatotropin-binding protein