强化胰岛素治疗后1型糖尿病儿童生长发育情况调查

Development and linear growth in diabetic children who receiving insulin pigment

目的:调查接受胰岛素治疗、血糖控制良好的1型糖尿病患儿的生长发育与一般人群是否存在差异。方法:选取自1993年1月～2003年1月于本院首次确诊的1型糖尿病患儿57例(男26例,女31例,起病年龄6～10岁)。记录并进行回顾分析其自起病至成年的身高、体重以及青春启动年龄和女性患儿的初潮年龄。结果:患儿起病时身高稍高于同年龄同性别儿童,终身高略低于一般人群,但均无统计学差异。男孩青春启动的中位年龄12.02(95%CI 11.54～12.50)岁较一般人群延迟,女孩青春启动的中位年龄11.13(95%CI 10.80～11.46)岁和初潮的中位年龄14.15(95%CI 13.64～14.65)岁均较一般人群推迟。患儿起病初,体重均较同龄儿低[男孩BMI:(14.45±1.35)kg/m2;女孩BMI:(13.50±1.87)kg/m2],达到终身高时,体重明显增加,在女孩中尤其明显[男孩BMI(21.43±1.62)kg/m2;女孩BMI(23.95±2.37)kg/m2]。结论:1型糖尿病患儿即使在予胰岛素治疗后血糖控制达标的情况下,对患儿的青春发育仍有负面影响,但是对身高的影响不显著,患儿普遍有体重增加的现象,在女性中尤其明显。

Objective：To ascertain if there is difference between the development and linear growth of children diagnosed with diabetes who have been receiving insulin pigment and unaffected children.Methods：Retrospective analysis of 57 children with diabetes who were diagnosed from the ages of 6 to 10 years old（26 boys and 31 girls）,record their height and weight until they reached their 18th birthday.Results：At the onset of diabetes,diabetic children were slightly taller than unaffected children.When they reached their finial height,they were slightly shorter than unaffectd people,however,there was no significant difference between the two groups both in these two periods.The onset of puberty was delayed significantly both in boys and girls.The median age of onset of puberty was 12.62（95%CI 11.54～12.50） years in diabetic boys versus 10.55（10.27～10.79） years in general-population boys and 11.13（95%CI 10.8～11.46） years versus 9.2（9.06～9.32） years in girls,with the menarche of diabetic girls starting at 14.15（13.64 ～14.65） years versus 12.27（12.16 ～12.39） years.All the children with diabetes were thinner than the general-population children when they were diagnosed [male BMI：（14.45 ± 1.35） kg / m 2 versus（16.08 ± 0.59） kg / m 2,t =-0.63,P 〈 0.05;female BMI：（13.50 ± 1.87） kg / m 2 versus（15.46 ± 0.45） kg / m 2,t =-6.67,P 〈 0.05],however,as they reached their finial height,they became fatter,especially the females [male BMI（21.43±1.62）kg / m 2 versus（20.80 ± 0.00） kg / m 2,t = 1.97,P 〉 0.05;female BMI（23.95 ± 2.37） kg / m 2 versus（20.30 ± 0.00） kg / m 2,t = 8.60,P 〈 0.05].Conclusion：The development of patients with diabetes who have been receiving insulin pigment were still adversely affected but the finial height haven’t been affected significantly.All the children,especially girls,became fatter when they reached their finial height.