Bone size normalizes with age in children and adolescents with type 1 diabetes.
OBJECTIVE
The aim of this study was to establish whether type 1 diabetes has a long-term effect on bone development in children and adolescents.


METHODS
Bone characteristics and muscle cross-sectional area (CSA) were analyzed cross-sectionally in 41 (19 female and 22 male) patients and were reevaluated after 5.56 +/- 0.4 years using peripheral quantitative computed tomography (pQCT). We hypothesize that bone size and muscle mass normalize with age.


RESULTS
At the first evaluation, mean +/- SD age was 9.87 +/- 2.3 years and disease duration was 4.31 +/- 2.9 years. Height was -0.36 +/- 1.9 SD, and BMI was 0.39 +/- 0.9 SD. Parameters of bone size were low in the whole patient group (corrected for patient's height). At reevaluation, age was 15.44 +/- 2.3 years, and patients had a mean height of -0.12 +/- 0.8 SD. BMI SD had increased to 0.57 +/- 1.1. Total and cortical CSA had normalized. Those patients with an increase in total CSA had a significant younger age at disease manifestation and a younger age at initial pQCT measurement. Bone size was well adapted to muscle mass expressed as the ratio of bone mineral content per muscle mass, and a close correlation was shown between the increase in bone size and in muscle CSA (r = 0.46, P = 0.03).


CONCLUSIONS
Patients with manifestation of type 1 diabetes at an early age had transient impaired bone development. Within the follow-up period, the greatest increase in bone size was found in these patients. In adolescence, all patients had a normal bone size and appropriate adaptation of bone on muscle.
Bechtold
Susanne
S
Division of Pediatric Endocrinology, University Children's Hospital, Lindwurmstrasse 4 in D-80337, Munich, Germany. susanne.bechtold@med.uni-muenchen.de
Putzker
Stefanie
S
Bonfig
Walter
W
Fuchs
Oliver
O
Dirlenbach
Isa
I
Schwarz
Hans Peter
HP
D000293:Adolescent; D015992:Body Mass Index; D015519:Bone Density; D001846:Bone Development; D001842:Bone and Bones / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D002648:Child; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D007332:Insulin Infusion Systems; D008137:Longitudinal Studies; D008297:Male; D012016:Reference Values; D014057:Tomography, X-Ray Computed; D044465:White People
D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin