Growth data in large series of 587 children and adolescents with type 1 diabetes mellitus.
OBJECTIVE
Discordant data were found in recent growth studies in children with type-1 diabetes mellitus. This study focuses on growth data and final height in the largest cohort of diabetic children studied so far.


METHODS
7598 growth data collected in a longitudinal/cross sectional way between 1971 and 1996 in 587 diabetic subjects (317 males, 270 females) were available for analysis of height and BMI, together with 3889 HbA1c measurements. Final height data were correlated with target height in 123 subjects. The individual growth and BMI linear regression curve of each patient was compared to growth standards and correlated with HbA1c.


RESULTS
Children of both sexes were taller at the first observation (males, SDS 0.15 +/- 1.10, mean +/- SD, P=0.02, females, SDS 0.74 +/- 1.46, P<0.001) and tended to lose height afterwards (males, P<0.001, females, n.s.). Males reached a final height of 176.5 cm (n=62, target height 176.8, n.s.) and females 167.0 cm (n=61, target height 165.6, n.s.). Children of both sexes had a higher than normal BMI at first observation (males, SDS 0.32 +/- 1.31, P<0.001, females, SDS 0.10 +/- 0.52, P=0.02). Females but not males gained weight over-proportionally afterwards. HbA1c did not predict any of the variables.


CONCLUSIONS
Diabetic children are taller close to the diabetes onset, which may be due to the synchronization of onset of diabetic symptoms with the mid-childhood growth spurt or the pubertal growth spurt accompanied by elevated growth hormone and/or androgen levels and increased insulin resistance. The subsequent growth deceleration may represent a physiological lag-down growth. This concept is supported by normal adult heights following growth deceleration.
Lebl
Jan
J
Department of Pediatrics, 3rd Faculty of Medicine, Charles University, Prague, Czech Republic. lebl@fnkv.cz
Schober
Edith
E
Zidek
Thomas
T
Baldis
Susana
S
Rami
Birgit
B
Pruhova
Stepanka
S
Kolouskova
Stanislava
S
Snajderova
Marta
M
Frisch
Herwig
H
D000293:Adolescent; D001827:Body Height / Q000502:physiology; D015992:Body Mass Index; D002648:Child; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006128:Growth / Q000502:physiology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male
D006442:Glycated Hemoglobin