SUMMARY Growth of 79 children with diabetes was analysed at diagnosis and again after one to 10-7 years of treatment with insulin. Both sexes were tall at onset, whereas at the last observation boys alone showed significant growth retardation. Height standard deviation score (SDS), however, showed no significant fall either in 32 subjects reassessed after five years of disease or in 18 subjects examined at full stature. Skeletal maturity was not significantly impaired after treatment. Pubertal growth spurt was reduced, especially in girls and in subjects with onset of disease at or around puberty. We found no significant correlation between height and height velocity SDS and glycosylated haemoglobin values or secretion of growth hormone during the arginine test. Somatomedin C values were correlated with height velocity SDS in prepubertal boys. The results of this study suggest that there are interferences in the growth of children with diabetes but that they do not seem to have a significant influence on adult height.It is well recognised that growth is seriously impaired in cases of very poorly controlled diabetes.'

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IGF-I, testosterone and estradiol levels were evaluated in 8 girls with androgen insensitivity immediately before and from 1 to 3 months after bilateral gonadectomy. In 6 patients GH secretion was evaluated before and after gonadectomy by means of an arginine test and in 3 a sleep test was also performed. Mean IGF-I level before surgery was significantly higher than that of normal controls (2850 \ m=+-\ 1230 vs 1680 \ m=+-\1040 U/l, p < 0.025). After gonadectomy a significant decrease was evident for testosterone, estradiol and IGF-I levels. A positive correlation between IGF-I and estradiol levels was present before surgery (p < 0.005). The presence of a correlation with estradiol, but not with testosterone, and the knowledge that this syndrome is due to an insensitivity to androgens, but not to estradiol, support the hypothesis that the estradiol level is the major determinant for the control of IGF-I values in these patients. After gonadectomy, a substantial decrease of the 12-h nocturnal GH secretion was evident. Comparison of the nocturnal GH levels before surgery of the 3 patients with those of normal subjects of the same age showed hormonal values higher than 1 sd over the mean values of control subjects. Even if the number of patients studied is too small to draw any definitive conclusion, these data may suggest that sex hormones play a role in the control of IGF-I levels, a function which seems to be mediated through GH secretion.Plasma IGF-I level increase strikingly during pub¬ erty and this change is concomitant with the rise in sex hormone concentrations (1,2). Some investiga¬ tors have described an increase in GH secretion in subjects with normal or precocious puberty (3-7) and a decrease in IGF-I and GH values in children with central precocious puberty after suppression of gonadal sex steroid secretion by GnRH anal¬ ogues (6, 7). Exogenous testosterone administration in¬ creases 24-h GH secretion in boys with short stature and/or delayed sexual development (8) and induces a significantly greater IGF-I rise in prepubertal GH-suflicient than in prepubertal GHdeficient patients (9).Although these data indicate a relationship be¬ tween sex steroid and IGF-I levels, the effects of sex hormones on spontaneous GH secretion is still controversial. Whether the pubertal increase in IGF-I is mediated through enhanced GH secretion is still under discussion (8,10-15).Children submitted to castration provide a good model to assess the role of sex steroids on IGF-I and GH secretion. This study was designed to evaluate the effects of gonadectomy on IGF-I and GH production in a group of 8 children with an¬ drogen insensitivity. Patients and MethodsWe studied 8 girls with a chronological age ranging from 10.5 to 13.2 years (mean ± si) 11.6 ± 1.02) and a bone age from 8.2 to 13.0 years (10.9 ± 2.07).The clinical picture (presence of palpable testes in the labia majora or in the inguinal canal, normal external genitalia, normal male kariotype 46,XY) and the hor-