Association between disease duration, GH-IGF-1 axis markers, and linear growth in children with type 1 diabetes mellitus: a cross-sectional study

Objective: This single-center cross-sectional study analyzed 250 children and adolescents (aged 5-17 years) with type 1 diabetes mellitus (T1DM) in the Kyrgyz Republic to assess the effect of T1DM duration on anthropometric parameters and key hormonal growth markers (glycated hemoglobin A1c (HbA1c), growth hormone (GH), and insulin-like growth factor 1 (IGF-1) SDS).We hypothesized that longer duration of chronic T1DM and related GH-IGF-1 axis disruption are more strongly associated with linear growth disorders than current glycemic control.Methods: Anthropometric data (SDS height/weight) and hormonal levels were compared across groups categorized by disease duration (newly diagnosed, 1-5 years, and >6 years).Results: Children with T1DM duration over 6 years exhibited markedly lower height SDS compared to both newly diagnosed (p<0.001) and 1-5-year groups (p=0.006).Mean IGF-1 SDS significantly decreased with increasing disease duration (p=0.010),indicating worsening GH-IGF-1 axis dysfunction.Although mean HbA1c improved gradually with duration, the overall level remained suboptimal (10.7%).The duration of the disease ( = -0.338;95%CI -0.204 --0.097, p < 0.001), the age of T1DM manifestation ( = 0.153; 95%CI 0.011 -0.105, p = 0.015), SDS IGF1 ( = -0.245;95% CI 0.046 -0.254, p = 0.012) and SDS weight ( = 0.524; 95% CI 0.484 -0.718, p < 0.001) had a significant effect on the SDS of height, while the other GH variables ( = 0.037; p = 0.558), HbA1c ( = -0.015;p = 0.809) did not make a statistically significant contribution.Conclusions: These findings confirm that longer disease duration is significantly associated with linear growth impairment in children with T1DM, underscoring the need for early and aggressive intervention to minimize cumulative exposure.