Lumbar spine bone mineral density in diabetic children with recent onset.
To detect early abnormalities in bone mineralization, the lumbar spine bone mineral density (BMD) of diabetic children with a diabetes onset of less than 5 years and treated with a similar insulin treatment scheme was measured at the level of the lumbar spine by dual-energy X-ray absorptiometry (DEXA), a most sensitive technique for detecting osteopenia in children. Fifteen male and 8 female children and adolescents (mean age +/- SD: 12.5+/-3.7 years), 1-5 years after the clinical onset of their diabetes, were studied. Measurements of the lumbar spine (L1-L4) BMD, expressed in gHA/cm2 and as a z-score for age, were performed with a commercial DEXA apparatus (Hologic QDR 1000 W, Hologic Inc., Waltham, USA). Calcium-phosphorus metabolism was studied by measuring the circulating levels of calcium, phosphorus, alkaline phosphatase, osteocalcin, 25-OH-vitamin D and parathyroid hormone and the urinary excretion of calcium and phosphorus. The mean BMD of the studied group was 0.75 (0.16) gHA/cm2 giving a mean z-score of -0.31+/-0.95. Only 1 of the patients had a BMD lower than -2 SD. No sex difference in BMD z-score existed. BMD SD was positively correlated with height SD (R = 0.56, p < 0.005), but not with the age of the patients, the duration of the disease, the degree of metabolic control or the studied parameters of the calcium-phosphorus metabolism. In conclusion, diabetic children have a normal lumbar spine BMD during the first years of the disease, when a good metabolic control and no abnormalities in the calcium-phosphorus metabolism are present. As in normal children, areal BMD by DEXA is highly dependent on the body height, necessitating corrections if abnormalities in skeletal growth or pubertal development exist.
De Schepper
J
J
Department of Pediatrics, Free University of Brussels, Belgium.
Smitz
J
J
Rosseneu
S
S
Bollen
P
P
Louis
O
O
D015502:Absorptiometry, Photon; D000293:Adolescent; D000328:Adult; D000469:Alkaline Phosphatase / Q000097:blood; D015519:Bone Density; D002112:Calcifediol / Q000097:blood; D002118:Calcium / Q000097:blood / Q000652:urine; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D008159:Lumbar Vertebrae; D008297:Male; D015675:Osteocalcin / Q000097:blood; D010281:Parathyroid Hormone / Q000097:blood; D010758:Phosphorus / Q000097:blood / Q000652:urine
D007328:Insulin; D010281:Parathyroid Hormone; D015675:Osteocalcin; D010758:Phosphorus; D000469:Alkaline Phosphatase; D002112:Calcifediol; D002118:Calcium