Prevalence and predictors of osteopenia and osteoporosis in adults with Type 1 diabetes.
OBJECTIVE
To determine the prevalence and biochemical/hormonal determinants of osteopenia and osteoporosis in adults with Type 1 diabetes.


METHODS
One hundred and two patients (52 female, 50 male) with Type 1 diabetes aged 20-71 years underwent cross-sectional assessment of biochemical/hormonal markers of bone metabolism, and bone mineral density (BMD) measurement at forearm, hip and spine using dual energy x-ray absorptiometry. BMD data were available for 102 age- and gender-matched population-based control subjects.


RESULTS
After adjusting for age and body mass index (BMI), osteopenia and osteoporosis were more common at the spine in males with Type 1 diabetes than in control subjects (P = 0.030). In Type 1 males, after adjustment for age and BMI, BMD, T- and Z-scores at the hip, femoral neck and spine were lower compared with age-matched control subjects (P < or = 0.048). Female Type 1 patients and control subjects had similar BMDs and T- and Z-scores at all sites. On multiple linear regression analysis, which adjusted for the natural logarithm of the sex hormone binding globulin concentration, smoking status and alcohol consumption, and (for women) menopausal status, each of BMI, serum ionized calcium and serum alkaline phosphatase (negatively) were independently associated with BMD at the hip and femoral neck in Type 1 diabetic subjects.


CONCLUSIONS
Adult males with Type 1 diabetes have reduced bone density at the hip, femoral neck and spine when compared with age-matched control subjects. Impaired bone formation may occur in Type 1 diabetes.
Hamilton
E J
EJ
University of Western Australia, School of Medicine and Pharmacology, Fremantle, Australia.
Rakic
V
V
Davis
W A
WA
Chubb
S A P
SA
Kamber
N
N
Prince
R L
RL
Davis
T M E
TM
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015519:Bone Density / Q000502:physiology*; D001851:Bone Diseases, Metabolic / Q000150:complications* / Q000503:physiopathology; D001862:Bone Resorption / Q000503:physiopathology*; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications* / Q000503:physiopathology; D011237:Predictive Value of Tests; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors; D012737:Sex Factors; D055815:Young Adult
D015415:Biomarkers