Vitamin and microelement status and somato­sexual development of adolescents with type 1 diabetes

Yu.V. Volkova, S. Turchina, L. Sukhova
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Abstract

Objective — to study peculiarities of the state of vitamin and microelement provision in children and adolescents with type 1 diabetes with the physiological and pathological course of puberty. Materials and methods. The study involved 143 patients (75 boys and 68 girls) with type 1 diabetes aged 10 to 17 years. The level of retinol, tocopherol, 25(OH)D3 and Zn concentration were determined in blood serum.Results and discussion. The gender characteristics of vitamin and microelement imbalance in adolescents with type type 1 diabetes were determined, the nature of which depended on the course of puberty. Among boys with type 1 diabetes under the conditions of harmonious physical development (PD), an increase in the percentage of low levels of vitamin E was recorded more often than in girls (39.1 vs. 12.2 %, рφ < 0.02). In girls with a disharmonious type of PD with increased body weight and high height, there was an increase in the frequency of high levels of vitamin E (48.1 %) under conditions of a normal level of retinol (37.0 %). In boys with high height and body weight disorders, an increased level of Zn (64.3 %) and an increase in the frequency of pronounced vitamin D deficiency (47.6 %) were recorded more often. Only 9.5 % of patients had vitamin D levels that corresponded to the optimal level of provision. In girls with disharmonious PD, the level of 25(OH)D3 was higher than in boys and was (19.06 ± 1.51) and (13.10 ± 1.53) ng/ml, respectively; (рu < 0.002). Under the conditions of disharmonious PD boys had lower values of vitamin A (52.2 vs. 29.6 %, рφ < 0.05) and vitamin E (39.1 vs. 3.7 %, рφ < 0.05) compared to girls. In boys with the physiological course of sexual development (SD), in comparison with girls, a decrease in the level of zinc, retinol and tocopherol was more often registered. Under the conditions of SD disorders, a reduced level of vitamin A was more often registered in girls (66.7 vs. 35.7 %, рφ < 0.03) with a simultaneous decrease in the frequency of its elevated values (8.3 vs. 37.5 %, рφ < 0.01) relative to patients with a physiological course of SD. At the same time, normal levels of vitamin E were recorded more often. Under conditions of sexual development delay in boys, the frequency of normal values of vitamin E was decreased compared to girls. Аt the same time, pronounced deficiency of vitamin D was more often registered in boys with a simultaneous decrease in the frequency of its suboptimal level. Conclusions. Based on the results of the study, a relationship between indicators of vitamin and microelement status and somatic and sexual development in adolescents with type I diabetes was established. The tension of reserves of vitamins A, E, D and the imbalance of zinc concentration were found in boys with disharmonious physical development. Sexual development delay in boys was accompanied by a deterioration in the nature of providing the body with vitamins D and E.
1 型糖尿病青少年的维生素和微量元素状况与躯体性发育
目的--研究患有 1 型糖尿病的儿童和青少年在青春期生理和病理过程中维生素和微量元素供应状况的特殊性。 材料和方法。研究涉及 143 名 10 至 17 岁的 1 型糖尿病患者(75 名男孩和 68 名女孩)。测定了血清中视黄醇、生育酚、25(OH)D3 和锌的含量。确定了 1 型糖尿病青少年维生素和微量元素失衡的性别特征,其性质取决于青春期的进程。在身体和谐发育(PD)条件下的 1 型糖尿病男孩中,维生素 E 含量低的比例比女孩更高(39.1% 对 12.2%,рφ < 0.02)。在体重增加和身高增高的不和谐型多发性骨髓增生症女孩中,在视黄醇水平正常(37.0%)的情况下,维生素 E 含量高的频率增加(48.1%)。在身高和体重偏高的男孩中,锌含量增高(64.3%)和维生素 D 明显缺乏(47.6%)的情况更为常见。只有 9.5%的患者的维生素 D 水平符合最佳供给水平。患有不协调性腹泻的女孩的 25(OH)D3 水平高于男孩,分别为(19.06 ± 1.51)和(13.10 ± 1.53)纳克/毫升;(рu < 0.002)。在不和谐的 PD 条件下,男孩的维生素 A 值(52.2% 对 29.6%,рφ < 0.05)和维生素 E 值(39.1% 对 3.7%,рφ < 0.05)低于女孩。与女孩相比,有性发育生理过程(SD)的男孩的锌、视黄醇和生育酚含量更容易下降。在性发育障碍的情况下,女孩体内维生素 A 含量降低的比例更高(66.7% 对 35.7%,рφ < 0.03),同时维生素 A 含量升高的比例也比生理发育障碍患者低(8.3% 对 37.5%,рφ < 0.01)。同时,维生素 E 正常水平的记录也更多。在男孩性发育迟缓的情况下,维生素 E 正常值的出现频率比女孩低。与此同时,男孩明显缺乏维生素D的情况更为常见,而维生素D低于正常水平的情况也有所减少。 结论。根据研究结果,I型糖尿病青少年的维生素和微量元素状况指标与躯体发育和性发育之间的关系已经确定。研究发现,身体发育不协调的男孩体内维生素 A、E、D 储备紧张,锌浓度失衡。男孩性发育迟缓的同时,体内维生素 D 和 E 的供应也在恶化。
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