Growth Hormone/Insulin Growth Factor-1 and Growth in IDDM Children and Adolescents

抄録

Diabetes mellitus is a syndrome of disturbed energy homeostasis caused by a deficiency of insulin or of its action and resulting in abnormal metabolism of carbohydrate, protein, and fat. The aim of this study was to study, by use of different anthropometrical parameters, the effect of diabetes mellitus either controlled or non-controlled on the growth pattern of the Egyptian children. At the same time, changes in the growth hormone/insulin-like growth factor-1 (GH/IGF-1) axis in the studied groups were investigated. The study was carried out on 50 healthy normal children and 127 diabetic children with insulin-dependent diabetes mellitus (IDDM) aged 2-18 years. They were classified according to their fasting blood glucose level into controlled <150mg/dl and non-controlled 150-300mg/dl. Then they were subdivided according to their age into three subgroups, 2-9, 10-14, 15-18 years. At the start of the study the 2-9-year-old children had been diabetic since 1.8±0.32 years and the 10-18-year-old children, since 3.96±0.12 years. Clinical and some anthropometrical measurements were made including height and weight; and from them the body mass index (BMI) and Z-score for height and weight were calculated. In addition, mid-arm, wrist, head, and chest circumferences were measured. Radio-immunoassay (RIA) techniques for estimation of serum GH and IGF-1 were performed. The results obtained in this study indicated that the longitudinal growth was the parameter, which was more affected in the IDDM children, especially in those with non-controlled disease. The mean±SEM of the Z-score for their height was -1.16±0.27, -1.047±0.18, and -1.68±0.019 for the age groups 2-9, 10-14, and 15-18 years, respectively. The GH/IGF-1 axis was distributed, and GH concentrations were found to be numerically higher in the different age groups of the non-controlled diabetic children than in those of the normal children. Serum IGF-1 levels were significantly reduced among the diabetic patients when compared with those recorded among their counterpart normal children. The reduction in the IGF-1 levels was pronounced in the non-controlled patients. A significant positive correlation was observed between all the anthropometric measurements and IGF-1 concentrations of the adolescents non-controlled diabetic children aged 10-14 years, defining its role in their growth. Thus the disturbed GH/IGF-1 axis in IDDM children and adolescents might contribute to their growth failure, mainly in the non-controlled patients.