- Changes of Insulin-like Growth Factor- I, Insulin-like Growth Factor Binding Protein-3 and 24-hour Urinary Growth Hormone in PrepubertalChildren with Insulin Dependent Diabetes Mellitus.
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Choong Ho Shin, Sei Won Yang
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Korean Diabetes J. 1999;23(1):25-35. Published online January 1, 2001
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Abstract
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- BACKGROUND
The growth hormone - insulin-like growth factor-I(GH/IGF-I) axis and the insulin nutrition axis constitute two major anabolic hormone systems that interact at varous levels. It is well established that patients with type 1 diabetes mellitus have elevated GH levels and inappropriate low IGF-I for high GH levels. Such a deranged GH/IGF-I axis may complicate the somatic growth of children with diabetes. The purpose of this study assess the nature of deranged GH/IGF-I axis and the effect on somatic growth. METHODS: In the present study, serum levels of IGF-I and IGFBP-3 were measured in 31 prepubertal children with type 1 DM (age, 8.93.1yr) and were compared with those levels in children with normal short stature (control) (age, 8.4+/-2.5 yr). RESULTS: In diabetic patients, age-adjusted serum levels of IGF-I and IGFBP-3 were significantly lower than those in controls (p<0.05). The difference of serum levels of IGF-I and IGFBP-3 between diabetic patients and control increased with chronologic age. There was no difference in 24-h urinary GH (24-h uGH) excretion between diabetic patients and normal controls. Simple regression analysis reveled no correlation between height SDS (standard deviation score)and HbA, (average 7.4%), IGF-I, IGFBP-3, urinary growth hormone, and chronological age. But height SDS had a tendency to decrease with the duration of diabetes, but without statistical significance. In diabetic patients, the 24-h uGH expressed as ng/24 h was correlated with chronologic age, IGF-I, and IGFBP-3, but such correlation was not obsc:rved when the 24-h uGH was expressed as ng/g creatinine In the control group, the 24-h u(GH was expressed as ng/24 h, correlated with only IGFRP-3. CONCLUSION: The growth impairment during puberty (which may be dependent on the degree of blood glucose control), rather than during prepuberty is probably responsible for the reduced final adult height in diabetic patients. This might be partly due to a relatively good blood glucose ontrol during prepubertal period. More importantly, it is suggested that this reduced final adult height comes from a gradual decrease in IGF-I and IGFBP-3 levels for long period during diabetes, regardless of the 24-h urinary growth hormone excretion.
- Prevalence of ICA and anti-GAD, HLA DRB1 / DQA1 / DQB1 Polymorphism in Korean IDDM Patients.
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Yong Soo Park, Jin Ho Shin, Jin Bae Kim, Woong Hwan Choi, You Hern Ahn, Tae Wha Kim, Mok Hyun Kim, Sei Won Yang, Seung Duck Hwang, Hee Bal Rhee
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Korean Diabetes J. 1997;21(3):289-299. Published online January 1, 2001
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Abstract
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- BACKGROUND
Although the HLA class II genes are cleaily associated with insulin-dependent diabetes mellitus(IDDM) in all ethnic. Groups, considerable variation in the associated genotypes is observed among the different ethnic groups. Mathods: In order to estimate what degree genetic and environmental determinants influence the true incidence of IDDM, ICA by imrnunohistochemistry, anti-GAD prevalence by radioimmunoprecipitation and HLA-DRB1, DQAl, and DQB1 polymorphisms after PCR amplification of genomic DNA were analyzed in 131 cases of IDDM, whose age at diagnosis were less than 15. RESULTS: 56% of them(73/131) were anti-GAD positive. 43% IDDM(56/131) were ICA positive. HLA DR3 and DR9 were susceptibility markers, whereas DR2 and DR5 were protective markers. DR3/4,, DR3/9, and DR3/X(X: other than 3, 4) were susceptible genotypes. HLA DQA1*0301 allele was increased, and DQB1*0301 and DQB1*0602 were decreased in IDDM. Not only HLA DQA1 Arg, but also DQBl non-Asp were found to be independent marker for IDDM, but their strength of association was weak. The highest prevalence of anti-GAD was observed in thosc homozygous for DR4(87.5%), exceeding that(47.8%) in those without this allele, and those with one DR4(63.5), whereas the highest prevealence of ICA was found in those homozygous for DR3(10G%), exceeding that in those with one DR3(64.3%) or in those without this allele(36.7%). There was a significant difference in numbers of HLA DQ susceptibility heterodimers in anti-GAD positive or negative patients. Conelusion: The prevalence of islet-specific auto-antibodies were present at comparable sensitivity and specificity in Korean IDDM patients. We could also assess that the immunoenetic markers for IDDM among Caucasians likewise confer disease susceptibility among Koreans. However, different HLA susceptibility alleles and a lower strength of association with known susceptibility markers, presumably because of differences in the genetic make-up of the population or in linkage disequilibrium patterns compared with other racial groups.
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