Abstract
The development of overweight has recently been recognized as a common finding especially in adolecents with IDDM. However, both normal longitudinal growth and the prevention of overweight are major goals in pediatric diabetology. We therefore investigated, how genetic factors contribute to this undesirable event. At the time of diagnosis, children with type-I liabetes are lean and slightly taller than average (SD-scores: height: +0.51 ± 0.07; weight: +0.33±0.06; BMI: + 0.08±0.05; n = 251, mean±SE). However, after > 10 years, a significant portion of the patients loose height and become overweight: (height: -0.16±0.08; weight; + 0.77±0.09, BMI: +1.10 ± 0.1; n = 87). In a subgroup of 156 patients (74 boys, 82 girls, mean age 13.5 years), height and weight of both parents was measured at our institution. Height-SDS was +0.21 ± 0.09 tor fathers and +0.22 ±0.08 for mothers. The correlation between midparental height and height-SDS in the patients (+ 0.19 ±0.08) was highly significant (r=0.41, p< 0.0001). In contrast, patients with IDDM were considerably more overweight (SD-score: +0.83±0.01) compared to their parents (+ 0.28±0.1 for fathers and +0.41 ±0.1 for mothers), and weight correlated only weakly between parents and IDDM children (r=0.20, p<0.05). This correlation was significantly stronger in boys (r = 0.31, p<0.001) compared to girls (r=0.10, n.s.). Interestingly, in IDDM girls, the SD-score for weight increased significantly with age (r = 0.28, p< 0.01), but not in boys (r=0.18, n.s.). The age of menarche in the mothers (13.3 ± 0.1 years) was not different from their daughters (13.4 ± 0.3 years).
Conclusion: In IDDM girls, obesity is primarily due to factors related to the disease, while genetic predisposition plays a minor role. In contrast, with modern therapeutic regimen, stunted growth or delayed puberty is no longer a major problem, as height in IDDM children strongly reflects their genetic potential.
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Holl, R., Seifert, M., Thon, A. et al. GENETIC INFLUENCES ON HEIGHT AND WEIGHT IN CHILDREN/ADOLESCENTS WITH TYPE-I DIABETES MELLITUS (IDDM). Pediatr Res 33 (Suppl 5), S73 (1993). https://doi.org/10.1203/00006450-199305001-00420
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DOI: https://doi.org/10.1203/00006450-199305001-00420