Longitudinal Height Growth in Children and Adolescents with Type-1 Diabetes Mellitus Compared to Controls in Pune, India

IF 3.9 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Pediatric Diabetes Pub Date : 2023-07-01 DOI:10.1155/2023/8813031

Sandra Aravind Areekal, A. Khadilkar, P. Goel, T. Cole

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Abstract

Background. Height growth is affected by longterm childhood morbidity. Objectives. To compare the growth curves of Indian children diagnosed with Type-1 diabetes mellitus (T1DM) and a control group of children without diabetes, and to see how parental height and disease severity affect the growth pattern. Subjects and Methods. The data came from: (i) the Sweetlings T1DM (STDM) study with 460 subjects aged 4–19 years, previously diagnosed with T1DM and followed for 2–6 (median 3) years, with repeat measurements of height and glycated hemoglobin (HbA1c), and (ii) the Pune School-Children Growth (PSCG) study with 1,470 subjects aged 4–19 years, and height measured annually for median 6 years. Height growth was modeled using SuperImposition by Translation and Rotation (SITAR), a mixed effects model which fits a cubic spline mean curve and summarizes individual growth in terms of differences in mean size, and pubertal timing and intensity. Results. SITAR explained 99% of the variance in height, the mean curves by sex showing that compared to controls, the children with diabetes were shorter (by 4/5 cm for boys/girls), with a later (by 1/6 months) and less intense (−5%/−10%) pubertal growth spurt. Adjusted for mean height, timing and intensity, the diabetic and control mean curves were very similar in shape. SITAR modeling showed that mean HbA1c peaked at 10.5% at age 15 years, 1.0% higher than earlier in childhood. Individual growth patterns were highly significantly related to parental height, age at diabetes diagnosis, diabetes duration, and mean HbA1c. Mean height was 3.4 cm more per + 1 SD midparental height, and in girls, 2 cm less per + 1 SD HbA1c. Conclusion. The results show that the physiological response to T1DM is to grow more slowly, and to delay and extend the pubertal growth spurt. The effects are dose-related, with more severe disease associated with greater growth faltering.

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印度浦那1型糖尿病儿童和青少年与对照组的纵向身高增长

背景。身高增长受儿童长期发病率的影响。目标。比较诊断为1型糖尿病(T1DM)的印度儿童和对照组无糖尿病儿童的生长曲线，并了解父母身高和疾病严重程度如何影响生长模式。研究对象和方法。数据来自:(i) Sweetlings T1DM (STDM)研究，460名年龄在4-19岁的受试者，先前诊断为T1DM，随访2-6年(中位数为3年)，重复测量身高和糖化血红蛋白(HbA1c); (ii)普纳学龄儿童生长(PSCG)研究，1470名年龄在4-19岁的受试者，每年测量身高，中位数为6年。身高生长采用平移旋转叠加模型(superstacking by Translation and Rotation, SITAR)，这是一种混合效应模型，拟合三次样条平均曲线，总结了个体生长在平均尺寸、青春期时间和强度方面的差异。结果。SITAR解释了99%的身高差异，按性别划分的平均曲线显示，与对照组相比，糖尿病儿童更矮(男孩/女孩低4/5厘米)，青春期生长突增时间更晚(1/6个月)，强度更低(- 5%/ - 10%)。调整平均身高、时间和强度后，糖尿病患者和对照组的平均曲线在形状上非常相似。SITAR模型显示，平均HbA1c在15岁时达到10.5%的峰值，比儿童早期高1.0%。个体生长模式与父母身高、糖尿病诊断年龄、糖尿病病程和平均HbA1c高度显著相关。平均身高每增加1 SD增加3.4 cm，女孩每增加1 SD HbA1c减少2 cm。结论。结果表明，T1DM的生理反应是生长缓慢，青春期生长突增期延迟和延长。其影响与剂量有关，疾病越严重，生长速度越慢。

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来源期刊

Pediatric Diabetes 医学-内分泌学与代谢

CiteScore

6.60

自引率

14.70%

发文量

141

审稿时长

4-8 weeks

期刊介绍： Pediatric Diabetes is a bi-monthly journal devoted to disseminating new knowledge relating to the epidemiology, etiology, pathogenesis, management, complications and prevention of diabetes in childhood and adolescence. The aim of the journal is to become the leading vehicle for international dissemination of research and practice relating to diabetes in youth. Papers are considered for publication based on the rigor of scientific approach, novelty, and importance for understanding mechanisms involved in the epidemiology and etiology of this disease, especially its molecular, biochemical and physiological aspects. Work relating to the clinical presentation, course, management and outcome of diabetes, including its physical and emotional sequelae, is considered. In vitro studies using animal or human tissues, whole animal and clinical studies in humans are also considered. The journal reviews full-length papers, preliminary communications with important new information, clinical reports, and reviews of major topics. Invited editorials, commentaries, and perspectives are a regular feature. The editors, based in the USA, Europe, and Australasia, maintain regular communications to assure rapid turnaround time of submitted manuscripts.