Does low bone mineral density start in post-teenage years in women with type 1 diabetes?
OBJECTIVE
Type 1 diabetes has been associated with decreased bone mineral density (BMD). However, the natural history and etiopathogenesis of osteoporosis in type 1 diabetes are not clear. The aims of this study were to assess BMD in a cohort of young women with type 1 diabetes compared with nondiabetic control subjects and to evaluate the possible association of BMD with diabetes duration, HbA(1c), and biomarkers of bone metabolism.


METHODS
BMD was measured by dual-energy X-ray absortiometry scan in 39 teenage (age 13-19 years) and 33 post-teenage females (age 20-37 years) with type 1 diabetes and 91 female age-matched control subjects. Serum osteocalcin, IGF-I, IGF binding protein-3 (IGFBP-3), HbA(1c), and urine N-telopeptides were measured.


RESULTS
After adjustment for age and BMI, BMD values were significantly lower at the femoral neck and lateral spine in women with type 1 diabetes older than age 20 years compared with control subjects but not in the case subjects younger than age 20 years, nor at the anterio-posterior spine, wrist, or whole body. No association was found between BMD and diabetes duration or glycemic control. IGF-I, IGFBP-3, osteocalcin, and N-telopeptides were similar in diabetic subjects and control subjects.


CONCLUSIONS
This study indicates that women with type 1 diabetes exhibit BMD differences early in life with significant differences already present in the post-teenage years. Lower hip BMD in these young women may explain, in part, the higher incidence of hip fracture experienced in postmenopausal women with type 1 diabetes.
Liu
Emily Y
EY
The Women and Children's Hospital of Buffalo, Division of Endocrinology/Diabetes, Buffalo, New York 14222, USA.
Wactawski-Wende
Jean
J
Donahue
Richard P
RP
Dmochowski
Jacek
J
Hovey
Kathleen M
KM
Quattrin
Teresa
T
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D015519:Bone Density; D001842:Bone and Bones / Q000378:metabolism*; D015331:Cohort Studies; D003094:Collagen / Q000652:urine; D024042:Collagen Type I; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology* / Q000378:metabolism / Q000503:physiopathology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006620:Hip Fractures / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D015675:Osteocalcin / Q000097:blood; D010024:Osteoporosis / Q000453:epidemiology / Q000503:physiopathology; D010455:Peptides / Q000652:urine
D003094:Collagen; D024042:Collagen Type I; D006442:Glycated Hemoglobin; D018972:Insulin-Like Growth Factor Binding Protein 3; D007334:Insulin-Like Growth Factor I; D015675:Osteocalcin; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide