title: Quantitative ultrasound of proximal phalanxes in patients with type 1 diabetes mellitus.
abstract: The influence of duration of diabetes and metabolic control on phalangeal quantitative ultrasound (QUS) was evaluated in a group of children and adolescents with type 1 diabetes. Eighty-six patients (mean age 11.9 years; mean duration 4.3 years) were studied. Daily calcium intake was assessed by means of a questionnaire. Amplitude-dependent speed of sound (AD-SoS) was measured at the phalanxes of the non-dominant hand and expressed as a z-score. Linear and multivariate correlations with duration of diabetes and, short term and long term metabolic control were sought. AD-SoS z-score was -0.43+/-1.4 (95% CI, -0.73; -0.13). Nine subjects had values below -2S.D. Daily calcium intake was 1042+/-456 mg/day; 47 subjects (54.6%) were below the recommended levels. A negative correlation was found between AD-SoS z-score and duration (r, -0.33, P=0.002) or metabolic control (HbA1c-last year r, -0.32, P=0.002; HbA1c-whole duration, r, -0.40; P=0.003). Negative AD-SoS z-scores depended significantly and directly on duration and quality of metabolic control, even when controlled for calcium intake. In conclusion, the architectural organization of bone was impaired in 10.5% patients. Duration of diabetes and poor metabolic control were the main determinants affecting AD-SoS. QUS may be a useful tool in the screening of bone disturbance in young patients with diabetes. Optimization of metabolic control is required to prevent osteoporosis.
authors.affiliation: Faculty of Movement Sciences, University Parthenope, Naples, Italy. giuliana.valerio@univav.it
authors.forename: Giuliana
authors.initials: G
authors.lastname: Valerio
authors.forename: Antonio
authors.initials: A
authors.lastname: del Puente
authors.forename: Pietro
authors.initials: P
authors.lastname: Buono
authors.forename: Antonella
authors.initials: A
authors.lastname: Esposito
authors.forename: Manuela
authors.initials: M
authors.lastname: Zanatta
authors.forename: Enza
authors.initials: E
authors.lastname: Mozzillo
authors.forename: Erika
authors.initials: E
authors.lastname: Moretto
authors.forename: Loredana
authors.initials: L
authors.lastname: Mastidoro
authors.forename: Adriana
authors.initials: A
authors.lastname: Franzese
mesh_terms: D000293:Adolescent; D015519:Bone Density / Q000187:drug effects / Q000502:physiology; D001851:Bone Diseases, Metabolic / Q000175:diagnosis; D002136:Calcium, Dietary / Q000008:administration & dosage / Q000378:metabolism / Q000494:pharmacology; D002648:Child; D003627:Data Interpretation, Statistical; D003922:Diabetes Mellitus, Type 1 / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000503:physiopathology; D005260:Female; D005385:Fingers / Q000000981:diagnostic imaging*; D006442:Glycated Hemoglobin / Q000145:classification / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000235:genetics / Q000378:metabolism / Q000627:therapeutic use; D007558:Italy; D008297:Male; D011795:Surveys and Questionnaires; D013997:Time Factors; D014463:Ultrasonography
chemical_list: D002136:Calcium, Dietary; D006442:Glycated Hemoglobin; D007328:Insulin