Hypercalciuria, Hyperphosphaturia and Growth Retardation in Children with Diabetes Mellitus

Background: Previous studies have demonstrated that patients with insulin-dependent diabetes mellitus (IDDM) have a high prevalence of osteopenia.  Hypercalciuria has also been well documented in human diabetes and many children with insulin-dependent diabetes mellitus have short stature. Objective: To investigate the relationship of hypercalciuria and hyperphosphaturia with growth retardation in patients with IDDM. Methods: Forty patients with IDDM aged between 6 and 12 years whose mean heights were less than their 32 non-diabetic siblings of similar age group were enrolled in this study.  Urinary and plasma calcium, phosphorus and creatinine levels were measured in both groups.  Meanwhile, the height and body weight were determined. Results: Both, the mean height and weight percentiles of subjects with IDDM were significantly less than those of non-diabetic siblings (p<0.001).  The height percentile of children with IDDM had negative correlation (r=-0.75, p<0.001) with the disease duration.  The mean urinary calcium to creatinine (Ca/Cr) and phosphorus to creatinine (P/Cr) ratios were significantly higher in IDDM patients compared to their normal siblings (p<0.001).The growth in the group of diabetic children correlated inversely and significantly (p<0.001) with hypercalciuria and hyperphosphaturia, duration of diabetes and HbA1C level. Conclusion: It is concluded that hypercalciuria and hyperphosphaturia may play a role in growth retardation of diabetic children.