Ponderal gain, waist-to-hip ratio, and pubertal development in girls with type-1 diabetes mellitus.
OBJECTIVE
We assessed pubertal development, height, weight, and waist-to-hip ratio (WHR), an index of central adiposity during puberty, in girls with type-1 diabetes mellitus (T1DM), compared to a contemporary control group.


METHODS
Pubertal development, weight, height and WHR were studied in 100 pubertal girls with T1DM, and were compared to a control group of 576 normal girls (C), recruited from schools with a similar socioeconomic level and ethnicity. The age of onset of various pubertal stages was estimated by using probit analysis.


RESULTS
Breast Tanner stage 2 (BT2) began at 8.89 +/- 0.11 and 9.10 +/- 0.28 yr in C and T1DM, respectively. A delay of 6 months was observed in T1DM for BT3 and BT4 (p < 0.05). Menarche occurred 6 months later in girls with T1DM (p = 0.03). WHR decreased during puberty in C (p < 0.001), but not in T1DM. In girls with T1DM, the body mass index standard deviation score (BMI-SDS) increased throughout puberty (p < 0.001), but it was stable in C. In T1DM girls, BMI-SDS, but not hemoglobin A1c levels (HbA1c), was a significant determinant of pubertal development. Final height was similar in T1DM and C.


CONCLUSIONS
Pubertal development in girls with T1DM occurred earlier than described in historical cohorts, but a later onset of menarche and final stages of breast development were observed. The increase in BMI-SDS and the stability of WHR in girls with T1DM during puberty suggest that this period may be critical for determining later weight gain and body composition in adult women with this condition.
Codner
Ethel
E
Institute of Maternal and Child Research, School of Medicine, University of Chile, Santiago, Chile. ecodner@med.uchile.cl
Barrera
Alvaro
A
Mook-Kanamori
Dennis
D
Bazaes
Rodrigo A
RA
Unanue
Nancy
N
Gaete
Ximena
X
Avila
Alejandra
A
Ugarte
Francisca
F
Torrealba
Isabel
I
Pérez
Virginia
V
Panteón
Eugenia
E
Cassorla
Fernando
F
D000293:Adolescent; D000886:Anthropometry; D049628:Body Size; D002648:Child; D002677:Chile; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008572:Menarche / Q000502:physiology; D011627:Puberty; D012016:Reference Values; D015430:Weight Gain
D006442:Glycated Hemoglobin