Bone metabolism is linked to disease duration and metabolic control in type 1 diabetes mellitus.
This cross-sectional study analyzed bone mineral density (BMD) in children and adolescents with type 1 diabetes mellitus (DM1) and its relationship with metabolic control, duration of disease and bone markers.


METHODS
Forty-four children and adolescents with DM1 (age 8.8+/-4.4 years, disease duration 6.6+/-3.9 years) and 22 healthy children were assessed for BMD of the lumbar spine (L1-L4) by dual energy X-ray absorptiometry; osteocalcin (OC) and carboxy-terminal telopeptide (CTX) were measured in the study group.


RESULTS
The BMD was similar in subjects with (-1.15+/-1.2 S.D.) and without DM1 (-0.85+/-0.88 S.D., p=0.25). After adjustment for weight, height and pubertal development, the BMD was <-2.0 S.D. in only two diabetic patients (4.5%). Bone area (BA) was inversely correlated with the duration of diabetes (p=0.03) and HbA1c (p=0.02). In girls, who presented a worse HbA1c than boys (p<0.01), BMD was inversely correlated with HbA1c (p=0.05). OC and CTX levels were higher in boys (p<0.01) and both inversely correlated with pubertal development (p=0.01), but not with BMD.


CONCLUSIONS
Children and adolescents with DM1 have normal bone mass in the lumbar spine. However, longer diabetes duration and poor metabolic control may have a negative impact on bone mass, requiring further investigation through longitudinal studies.
Brandao
Flavia R
FR
Department of Pediatrics, Federal University of Bahia School of Medicine, Bahia, Brazil.
Vicente
Eliezer J
EJ
Daltro
Carla H
CH
Sacramento
Marisa
M
Moreira
Agnaluce
A
Adan
Luis
L
D015502:Absorptiometry, Photon; D000293:Adolescent; D017668:Age of Onset; D015519:Bone Density; D001842:Bone and Bones / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism* / Q000503:physiopathology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D011627:Puberty; D012016:Reference Values; D013997:Time Factors
D006442:Glycated Hemoglobin