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A study and the growth and the development of microvascular complications in patients with type 1 diabetes mellitus

Korean Journal of Pediatrics 2007;50(2):190-197.
Published online February 15, 2007.
A study and the growth and the development of microvascular complications in patients with type 1 diabetes mellitus
Young Ah Lee, Kyong-Ah Yun, Choong Ho Shin, Sei Won Yang
Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
1형 당뇨병 환자의 성장과 미세혈관 합병증 발생에 대한 연구
이영아, 윤경아, 신충호, 양세원
서울대학교 의과대학 소아과학교실
Correspondence: 
Choong Ho Shin, Email: chshinpd@snu.ac.kr
Abstract
Purpose
: Reduced growth and microvascular complications have been recognized as consequences of type 1 diabetes mellitus (T1DM). We assessed the effect of T1DM on growth and factors associated with the development of microvascular complications.
Methods
: We conducted a retrospective longitudinal evaluation of 154 patients above 16 years of age. We analyzed factors which affect final height standard deviation scores (SDS) and development of microvascular complications.
Results
: Final height SDS was -0.11?.15 (-0.26?.33 in females, 0.04?.91 in males). Final height SDS was significantly lower than midparental height SDS and height SDS at diagnosis. There was no difference in final height SDS according to age at onset, existence or nonexistence of complications, or average HbA1C. Height SDS at onset of puberty, midparental height SDS and pubertal growth gain affected final height SDS. The number of patients with complications was 37 (24 percent). Microvascular complications developed at a younger age and after longer duration of diabetes in patients with a prepubertal onset of T1DM compared to patients with pubertal onset. Patients with complications had a higher level of average HbA1C than patients without complications. Patients whose microalbuminuria regressed had lower levels of average HbA1C, systolic BP, second 24h urine microalbumin than patients with persistant or progressed microalbuminuria.
Conclusion
: The results suggest that degrees of glycemic control don't affect final height, but various factors associated with T1DM can impair growth potential. Additionally, the degrees of glycemic control and puberty affect the development of microvascular complications.
Key Words: Type 1 diabetes mellitus , Final height standard deviation score , Microvascular complications , HbA1C , Puberty , Microalbuminuria


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