title: Ponderal gain, waist-to-hip ratio, and pubertal development in girls with type-1 diabetes mellitus.
abstract: 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.
authors.affiliation: Institute of Maternal and Child Research, School of Medicine, University of Chile, Santiago, Chile. ecodner@med.uchile.cl
authors.forename: Ethel
authors.initials: E
authors.lastname: Codner
authors.forename: Alvaro
authors.initials: A
authors.lastname: Barrera
authors.forename: Dennis
authors.initials: D
authors.lastname: Mook-Kanamori
authors.forename: Rodrigo A
authors.initials: RA
authors.lastname: Bazaes
authors.forename: Nancy
authors.initials: N
authors.lastname: Unanue
authors.forename: Ximena
authors.initials: X
authors.lastname: Gaete
authors.forename: Alejandra
authors.initials: A
authors.lastname: Avila
authors.forename: Francisca
authors.initials: F
authors.lastname: Ugarte
authors.forename: Isabel
authors.initials: I
authors.lastname: Torrealba
authors.forename: Virginia
authors.initials: V
authors.lastname: Pérez
authors.forename: Eugenia
authors.initials: E
authors.lastname: Panteón
authors.forename: Fernando
authors.initials: F
authors.lastname: Cassorla
mesh_terms: 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
chemical_list: D006442:Glycated Hemoglobin