Frequency of glutamic acid decarboxylase autoantibodies in Mexican diabetic children.

OBJECTIVE: Use radio binding assay (RBA) to quantify the frequency of autoantibodies to glutamic acid decarboxylase in Mexican children with type 1 diabetes mellitus (DM 1). RESEARCH DESIGN AND METHODS: GAD antibodies were measured in 140 mestizo children with DM 1, 66 female (47.14%) and 74 male (52.8%); age 11.7 +/- 3.55 years, and range 1.10 to 18.5 years. Most patients were treated with intermediate acting insulin, and some with the former combined with regular insulin. Mean disease duration was 3.11 +/- 2.94 years, and range 1 month to 14.5 years. Once the signed written consent was obtained, a 5.0-mL blood sample was drawn, immediately centrifuged, and the serum was kept frozen to -20 degrees C until RBA evaluation was performed with a commercial kit. RESULTS: The anti-GAD was positive in 76 DM 1 patients (54.28%) with values from 1.11 to 156.73 U/mL, and negative in 64 (45.71%). In 19 positive anti-GAD patients, the test was repeated and levels were found between 1.38 and 156.62 U/mL. An initial control group consisting of 25 healthy non-related volunteers matched by sex and age, showed negative anti-GAD for all. CONCLUSIONS: The frequency of anti-GAD in these patients was lower than that of the DM 1 European patients, but similar to that of Asians. This supports the heterogeneity of the etiopathogenic factors of DM 1 in different ethnic groups.

[Final results of the administration of biosynthetic growth hormone. Preliminary report]. / Resultado final de la administración de hormona de crecimiento biosintética. Informe preliminar.

From March, 1987 to November, 1995, we have included 89 growth hormone-deficient children for treatment for their low height with the biosynthetic growth hormone; 23 of them have concluded treatment. Without taking into account the etiological factor of their deficiency, 6 girls and 17 boys during different lapses had modified their initial height and the scores of the standard deviation as groups, range from 113.11 +/- 14.83 cm and -5.12 +/- 1.21 to 139.11 +/- 8.96 cm. and -2.68 +/- 1.17 in the girls, and from 128.46 +/- 12.49 cm and -4.13 +/- 1.35 to 158.61 +/- 6.47 cm and -1.76 +/- 0.9 in the boys, respectively. These results between the initial height and the score of the standard deviation compared with the final height and the standard deviation score, showed a statistically significant difference of p < 0.001 both in girls and boys. Two girls and 3 boys developed hypothyroidism during the treatment, without any other side effect. We concluded that early and prolonged biosynthetic growth hormone administration in growth hormone-deficient children might produce a final adult height similar to the normal population standards.

Lipoprotein(a) levels in children and adolescents with diabetes.

OBJECTIVE: To determine lipoprotein(a) in children and adolescents with IDDM and assess its relation with Lp(a) levels in their first degree relatives. RESEARCH DESIGN AND METHODS: In a cross-sectional study we included 141 IDDM patients, (58 male and 83 female) with mean ages 12.2 +/- 2.8 and 12.6 +/- 3.1 years, respectively. Patients with microalbuminuria, hepatopathy, thyroid dysfunction, infectious disease, acute decompensation or surgery three months prior to the study, were excluded. Clinical history, physical examination, blood chemistry, glycosilated hemoglobin, microalbuminuria and lipid profile including total cholesterol triglycerides, HDL-C, Apo A-I, Apo B and Lp(a) were determined. Parents and non-diabetic siblings were also studied when feasible. RESULTS: Mean plasma concentration of total cholesterol, HDL-C and Apo A-I were significantly higher in diabetic boys compared to their non-diabetic sibs. Mean Lp(a) plasma values and the prevalence of Lp(a) > 30 mg/dL were similar in the IDDM patients, their healthy sibs and parents. Hypercholesterolemia and hypertriglyceridemia were more frequent among the IDDM patients. No correlation was found between HbA1, and Lp(a) concentrations. However, a correlation was observed between Lp(a) plasma concentrations of parents and their diabetic and healthy offspring. CONCLUSION: Diabetes mellitus does not seem to affect Lp(a) levels. These data are consistent with a genetic regulation of Lp(a) plasma levels.

[Biosynthetic growth hormone in the treatment of low stature in Turner syndrome]. / Hormona de crecimiento biosintética en el tratamiento de la talla baja del síndrome de Turner.

Fifteen patients with Turner's syndrome with ages between 6.8 to 13.2 years were treated with biosynthetic growth hormone due to their low height. Twelve of them had a 45XO karyotype and three were mosaics; none had a Y line. They started with 0.7 IU/kg/week which were increased to 1.0 IU/kg/week if no height gain was observed during three months. The 15 patients have completed one year of treatment, 8 of them for two years. The height velocity increased significantly (p < 0.001) from 0.24 +/- 0.10 cm/month before treatment (mean +/- SD) to 0.48 +/- 0.09 in the first 12 months of treatment (height increased from 119.1 +/- 8.79 to 124.9 +/- 8.70). In the eight cases who have reached 24 months of treatment, the height velocity increased from 0.27 +/- 0.07 cm/month to 0.47 +/- 0.09 and 0.54 +/- 0.10 at 12 and 24 months respectively (p < 0.001 and p < 0.01 versus the pretreatment gain); height increased from 116.8 +/- 7.0 cm to 122.0 +/- 7.45 and 129.0 +/- 7.18. We found no adverse effects in the patients. It is concluded that the biosynthetic growth hormone treatment in Turner's syndrome can improve low height.

[Metabolic control and the prevalence of dyslipidemia in children and adolescents with insulin-dependent diabetes mellitus]. / El control metabólico y la prevalencia de dislipidemia en niños y adolescentes con diabetes mellitus insulino-dependiente.

Cholesterol, triglycerides and lipoprotein levels were assayed in serum of 152 children and teenagers with IDDM and in 228 non-diabetic siblings. A poor control of diabetes, reflected by high levels of glycosylated hemoglobin and/or high fasting blood glucose, was associated with statistically significant increases in total cholesterol, LDL-cholesterol and triglycerides, and a reduction in HDL-cholesterol. Mean total cholesterol levels in diabetic patients (171 +/- 33 mg/dL for males and 199 +/- 53 mg/dL for females) were statistically higher than those in their siblings (158 +/- 30 mg/dL and 164 +/- 33 mg/dL respectively). The prevalence of hypercholesterolemia (HC) and hypertriglyceridemia (HTG) were higher in the diabetic patients but statistically significant exclusively in females (prevalences of 40% vs 12% for HC and 30% vs 9% for HTG with a p value < 0.005). The diabetic patients in good metabolic control had similar lipid levels to those of their non-diabetic siblings. These data support the hypothesis that poor control of blood glucose is associated with atherogenic lipid profiles. The prevalence of hypercholesterolemia is impressively high in our diabetic population and indicates that all IDDM patients should have a serum lipid and lipoprotein analysis done annually; blood glucose control and dietary guidelines should be improved in these cases.