Estatura de indivíduos com diabetes Mellitus Tipo 1: dados de estudo multicêntrico no Brasil

Abstract

Growth assessment is a good indicator of health in pediatrics, and should be highlighted in the follow-up of patients with type 1 diabetes Mellitus (DM1). The data described in the literature regarding the effect of DM1 on growth are controversial, this may be due to the small number of participants in the research already performed. The objective of this study is to evaluate the stature of children and adolescents with DM1 in relation to the standard deviation for the same age group and the possible interference of the disease in the growth. This is a cross-sectional study, which included 3,591 individuals with DM1 participating in the Brazilian DiabetesType 1 Study Group (BrazDiab1). For the analysis, two groups were created, following chronological age (CI) criteria: (1) CI ≥ 19 years and (2) CI <19 years. Glycemic control was based on the American Diabetes Association (ADA) criteria. The height-for-age (A / I) ratios were assessed using the Z score A / I. The reference growth curves were those of the World Health Organization (WHO) in 2006 and 2007. Of the total of 3,285, the mean age was 21 years, and the duration of the disease was 9.35 years. From these data, n = 1644 (Group 1), and n = 1441 (Group 2) were extracted. The mean Z score for definitive A / I in DM1, in Group 1, was -0.56 ± 1.1. The mean Z adult A / I score was -0.77 ± 1.1, when we subdivided group 1 in HF ≥19 years and age at diagnosis (ID) <10 years, with -0.68 ± 1.2 in the females and -0.89 ± 1.23 in males (p <0.05). The glycemic control evaluation was performed in Group 2, with the general mean of glycated hemoglobin (HbA1c) being 9.4 ± 2.5. In subjects with disease time> 5 years, the mean HbA1c was 9.8 ± 2.5 Vs. 9.2% ± 2.5 with disease time <5 years (p <0.05). Multiple linear regression analysis showed a negative correlation of disease time and HbA1c with the Z score A / I (p <0.05). A lower mean Z score A / I was observed in relation to the reference curve population, which was even lower with ID <10 years. Regarding glycemic control, a negative association between disease time and HbA1c levels was verified with the A / I score. These data stand out in relation to the previously known data given the sample representativity of the analyzed sample.