Risk factors of the physical and sexual development disorders in children and adolescents with type 1 diabetes mellitus

N. Bagatska, L. Glotka
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Abstract

Objective. To determine hereditary and environmental factors, resulting in the formation of physical and sexual development disorders in children and adolescents with type 1 diabetes mellitus (DM 1).Methods and materials. The genealogical analysis was performed in the families of 50 patients aged 8 to 18 years (22 boys and 28 girls) with DM 1, who were examined at the Institute of Child and Adolescent Health of the NAMS of Ukraine. Harmonious physical development was observed in 16 boys and 10 girls, disharmonious development — in 6 and 18, respectively. The nature of puberty, which corresponded to the normative values, was registered in 19 boys and 23 girls, and puberty disorders were observed in 3 boys and 5 girls.Results. According to the genealogical analysis data, boys with DM 1 with harmonious physical development were more likely to be born with low body weight, they were more likely to undergo surgery compared to the girls with normal sexual development. Mothers of boys with harmonious and disharmonious physical development were significantly less likely to register stress before pregnancy compared to mothers of diabetic girls with different levels of physical development. The DM 1 boys with sexual development disorders significantly more likely to be born with the increased body mass in comparison with the DM 1 girls with sexual development disorders. Hereditary burden of diabetes in the girls with harmonious and disharmonious physical development exceeded in 1.8 and 2.8 times that in boys with corresponding physical development, and in girls with normal sexual development it was in 1.7 times oftener than in the boys. Cardiovascular and gastrointestinal diseases prevailed in the relatives of diabetic boys with harmonious physical development, and in the relatives of boys with disharmonious physical development, the cardiovascular and neurological diseases dominated, and gastrointestinal pathology was rarer than the incidence of these diseases in the relatives of diabetic girls with various levels of physical development. At the same time, relatives of boys with the normal sexual development had predominantly endocrine and neurological diseases, and relatives of boys with sexual development disorders had more often cardiovascular diseases in comparison with the incidence of these pathologies in relatives of girls with various levels of sexual development.Conclusions. It can be assumed that the presence of DM 1, especially diagnosed in childhood, may adversely affect the formation and functioning of the reproductive system in adolescence. Moreover, one should consider the impact of environmental factors and diabetes hereditary burden on their health.
儿童和青少年1型糖尿病患者身体和性发育障碍的危险因素
目标。目的:探讨1型糖尿病(DM 1)儿童和青少年生理和性发育障碍形成的遗传和环境因素。对50名年龄在8至18岁的1型糖尿病患者(22名男孩和28名女孩)的家庭进行了家谱分析,这些患者在乌克兰NAMS儿童和青少年健康研究所接受了检查。身体发育和谐的男孩有16名,女孩有10名,身体发育不和谐的男孩有6名,女孩有18名。男生19例,女生23例,青春期性质符合正常值;男生3例,女生5例,出现青春期障碍。根据家谱分析数据,与性发育正常的女孩相比,患有DM 1且身体发育和谐的男孩出生时体重低的可能性更大,接受手术的可能性更大。与身体发育水平不同的糖尿病女孩的母亲相比,身体发育和谐和不和谐的男孩的母亲在怀孕前记录压力的可能性显着降低。患有性发育障碍的1型糖尿病男孩与患有性发育障碍的1型糖尿病女孩相比,出生时体重增加的可能性更大。身体发育和谐和不和谐的女孩糖尿病遗传负担分别是相应身体发育男孩的1.8倍和2.8倍,性发育正常的女孩糖尿病遗传负担是男孩的1.7倍。身体发育和谐的糖尿病男童亲属以心血管和胃肠道疾病为主,身体发育不和谐的糖尿病男童亲属以心血管和神经系统疾病为主,而不同身体发育水平的糖尿病女童亲属中胃肠道病变的发生率均低于这些疾病的发生率。与此同时,性发育正常的男童亲属以内分泌和神经系统疾病为主,性发育障碍的男童亲属心血管疾病的发病率高于不同性发育水平的女童亲属。可以假设,DM - 1的存在,特别是在儿童期诊断出来的DM - 1,可能会对青春期生殖系统的形成和功能产生不利影响。此外,还应考虑环境因素和糖尿病遗传负担对其健康的影响。
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