Residual β-Cell Mass Influences Growth of Prepubertal Children With Type 1 DiabetesBizzarri C. · Benevento D. · Patera I.P. · Bongiovanni M. · Boiani A. · Fusco C. · Cianfarani S. · Cappa M.
aUnit of Endocrinology and Diabetes and bMolecular Endocrinology Unit, Bambino Gesù Children's Hospital, Rome, Italy; cDepartment of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
Background: The growth deceleration observed in children with type 1 diabetes (T1D) has been related to poor glycemic control. It is unclear whether growth impairment persists despite the optimization of therapy. We analyzed the effects of intensive insulin treatment on prepubertal growth. Methods: One hundred and four T1D children were evaluated from T1D diagnosis up to puberty onset. Height, weight, insulin requirement and glycated hemoglobin (HbA1c) were recorded at 3- to 6-month intervals. Residual β-cell mass was estimated by fasting C-peptide at T1D onset. Results: Age at T1D onset was 5.91 ± 1.9 years. Follow-up duration was 4.84 ± 1.58 years. Height velocity standard deviation score (SDS) was -0.14 ± 1.84. Height SDS changed from 0.52 ± 1.04 at T1D onset, to 0.36 ± 1.10 at the end of follow-up (p = 0.04). BMI SDS increased from -0.04 ± 1.48 to 0.32 ± 1.03 (p = 0.01). Multivariate analysis showed that height velocity was directly affected by C-peptide (p = 0.03) and insulin requirement (p = 0.004) and inversely related to HbA1c (p = 0.006). BMI gain was negatively influenced by HbA1c (p = 0.01) and positively related to T1D duration (p = 0.01). Conclusion: Despite insulin intensive therapy, T1D still negatively affects growth. Residual β-cell mass has a direct positive impact on growth, independently from the quality of glycemic control.
‘Bambino Gesù' Children's Hospital
Piazza S. Onofrio 4
IT-00165 Rome (Italy)
Stefano Cianfarani and Marco Cappa equally contributed as senior authors.
Received: May 28, 2013
Accepted: August 19, 2013
Published online: September 18, 2013
Number of Print Pages : 6
Number of Figures : 0, Number of Tables : 3, Number of References : 35
Hormone Research in Paediatrics (From Developmental Endocrinology to Clinical Research)
Vol. 80, No. 4, Year 2013 (Cover Date: October 2013)
Journal Editor: Czernichow P. (Paris)
ISSN: 1663-2818 (Print), eISSN: 1663-2826 (Online)
For additional information: http://www.karger.com/HRP