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Glycemic control and bone age are independently associated with muscle capillary basement membrane width in diabetic
Insights
Muscle capillary basement membrane width in young patients with insulin-dependent diabetes mellitus correlates with age and glycemic control during postpuberty. These findings highlight the impact of diabetes duration and control on microvascular changes in adolescents.
Area of Science:
- Endocrinology
- Diabetology
- Pediatrics
Background:
- Insulin-dependent diabetes mellitus (IDDM) can lead to microvascular complications.
- Muscle capillary basement membrane width (CBMW) is a potential marker for microvascular changes.
- Understanding factors influencing CBMW in youth is crucial for predicting long-term outcomes.
Purpose of the Study:
- To investigate the relationship between CBMW and glycemic control, bone age, chronologic age, and diabetes duration in young IDDM patients.
- To analyze these relationships across different pubertal stages.
Main Methods:
- Study included 92 young patients (7-20 years) with IDDM undergoing muscle biopsy.
- Subjects were categorized into prepubertal, pubertal, and postpubertal groups based on Tanner stage.
- Correlations between CBMW and clinical/biochemical parameters (HbA1c, bone age, age, diabetes duration) were assessed.
Main Results:
- No significant correlations were found in prepubertal and pubertal groups, likely due to small sample sizes.
- In postpubertal subjects, CBMW correlated with age, bone age, and postpubertal diabetes duration.
- CBMW showed stronger correlations with mean HbA1c values from the preceding 1-2 years compared to HbA1c at biopsy.
Conclusions:
- CBMW is associated with age, bone age, and glycemic control in postpubertal adolescents with IDDM.
- Glycemic control, particularly over the 1-2 years preceding biopsy, significantly influences CBMW.
- The differing regression slopes of CBMW on HbA1c across pubertal stages suggest dynamic changes during development.
Abstract:
This study was undertaken to examine the possible relationships between muscle capillary basement membrane width (CBMW) and glycemic control, bone age, chronologic age, and duration of diabetes in young patients with insulin-dependent diabetes mellitus (IDDM) during different stages of pubertal development. We studied 49 males and 43 females (age, 7-20 yr) with IDDM for up to 16 yr for whom bone age and glycosylated hemoglobin (HbA1c) data were available at the time of right quadriceps muscle biopsy. Based on pubic hair Tanner stage, subjects were assigned to prepubertal (Tanner I), pubertal (Tanner II and III), and postpubertal (Tanner IV and V) groups. In 30 pubertal and prepubertal subjects, none of the variables studied was significantly correlated with CBMW. This is attributable in part to the small number of subjects in each group. In 62 postpubertal subjects, CBMW was correlated with age (r = .27, P = .03), bone age (r = .43, P = .0005), and postpubertal duration of diabetes (r = .38, P = .003) but not total duration of diabetes. In the postpubertal subjects, CBMW was correlated with HbA1c at the time of biopsy (r = .31, P = .01) but correlated more strongly with the mean of HbA1c values obtained during the 1- and 2-yr periods before biopsy (r = .37, P = .01, and r = .54, P = .03, respectively). An analysis of covariance revealed that the slopes for the regression of loge CBMW on HbA1c differed significantly (P = .02) among the three groups.(ABSTRACT TRUNCATED AT 250 WORDS)