title: Sexual dimorphism in growth and insulin-like growth factor-I in children with type 1 diabetes mellitus.
abstract: OBJECTIVE
  Impaired linear growth and reduced IGF-I levels in children with type 1 diabetes (T1DM) have been related to poor metabolic control. The aim of this study was to identify additional factors which may negatively affect growth and IGF system in patients with T1DM.
  
  
  METHODS
  Ninety-one T1DM children (54 males, age=: 11.73±3years, disease duration=5.6±2.1years) were studied. All children were on intensive insulin therapy: 62 children were on multiple injection therapy (MI) and 29 children on continuous subcutaneous insulin infusion (CSII).
  
  
  RESULTS
  Height velocity (HV) SDS and IGF-I levels were higher in females and in pubertal children [HV SDS: females=0.6±2.4 vs males=-0.45±2.3 (p=0.04); IGF-I SDS: females=-1.09±0.58 vs males=-1.4±0.6 (p=0.02); IGF-I/IGFBP-3 molar ratio: females=0.25±0.1 vs males=0.21±0.08 (p=0.04); IGF-I SDS: pre-pubertal=-1.58±0.46 vs pubertal=-1.15±0.65 (p<0.001); IGF-I/IGFBP-3 molar ratio: pre-pubertal=0.16±0.08 vs pubertal=0.26±0.09 (p<0.001)]. No differences between children on CSII or MI therapy were found. IGF-I SDS was positively related to C peptide level (p<0.001), puberty (p<0.001) and female gender (p=0.02) and negatively related to HbA1c (p=0.04). IGF-I/IGFBP-3 molar ratio was positively affected by C peptide level (p<0.001), puberty (p<0.001) and daily insulin dose (p<0.001).
  
  
  CONCLUSIONS
  Our results indicate that despite intensive insulin therapy, T1DM still negatively affects IGF-I secretion and linear growth. Growth impairment is more severe in males and primarily related to poor glycemic control and loss of the residual beta cell mass.
authors.affiliation: Unit of Endocrinology and Diabetes, Bambino Gesù Children's Hospital, Rome, Italy. Electronic address: carla.bizzarri@opbg.net.
authors.forename: Carla
authors.initials: C
authors.lastname: Bizzarri
authors.affiliation: Unit of Endocrinology and Diabetes, Bambino Gesù Children's Hospital, Rome, Italy.
authors.forename: Danila
authors.initials: D
authors.lastname: Benevento
authors.affiliation: Department of Chemistry, Bambino Gesù Children's Hospital, Rome, Italy.
authors.forename: Germana
authors.initials: G
authors.lastname: Giannone
authors.affiliation: Unit of Endocrinology and Diabetes, Bambino Gesù Children's Hospital, Rome, Italy.
authors.forename: Marzia
authors.initials: M
authors.lastname: Bongiovanni
authors.affiliation: Unit of Endocrinology and Diabetes, Bambino Gesù Children's Hospital, Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Anziano
authors.affiliation: Unit of Endocrinology and Diabetes, Bambino Gesù Children's Hospital, Rome, Italy.
authors.forename: Ippolita Patrizia
authors.initials: IP
authors.lastname: Patera
authors.affiliation: Unit of Endocrinology and Diabetes, Bambino Gesù Children's Hospital, Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Cappa
authors.affiliation: Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden; D.P.U.O. Bambino Gesù Children's Hospital-Tor Vergata University, Rome, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Cianfarani
mesh_terms: D000293:Adolescent; D001827:Body Height; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007328:Insulin / Q000008:administration & dosage; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood*; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008297:Male; D011446:Prospective Studies; D012727:Sex Characteristics
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin; D018972:Insulin-Like Growth Factor Binding Protein 3; D007334:Insulin-Like Growth Factor I
keywords: Child; Growth; IGF-I; Type 1 diabetes