Biochemical markers of bone cell activity in children with type 1 diabetes mellitus.
OBJECTIVE
To evaluate bone turnover in children with type 1 diabetes mellitus (DM1) at onset, after 3 and 12 months of treatment, and in children with longer duration of disease, and its association with glycemic control.


METHODS
17 children with DM1 at onset, 30 with DM1 of longer duration and 45 controls participated in the study. Tartrate-resistant acid phosphatase 5b (TRACP5b), crosslinked C-terminal telopeptides of type I collagen (CTX) and osteocalcin (OC) were assessed.


RESULTS
At onset of DM1 osteocalcin (p < 0.0003) and log CTX (p < 0.003) were lower than in controls but returned to reference levels after 3 months of therapy. TRACP5b in children with DM1 increased gradually and after 12 months was higher than at onset (p < 0.03). OC at onset inversely correlated with HbA1c (r = -0.40, p = 0.03). In children with DM1 of longer duration and HbA1c > 6.5%, sex-dependent differences were found in OC and CTX. Girls with HbA1 > 6.5% had lower OC and CTX than controls (p < 0.005, p < 0.003). Inverse correlations were found between HbA1c and OC and CTX (r = -0.50, p = 0.04; r = -0.49, p = 0.03).


CONCLUSIONS
Proper glycemic control has a beneficial influence on bone turnover, which may prevent low bone mass in adulthood.
Pater
Agnieszka
A
Department of Laboratory Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland. agnieszka.chrapkowska@wp.pl
Sypniewska
Grazyna
G
Pilecki
Olgierd
O
D000135:Acid Phosphatase / Q000097:blood; D000293:Adolescent; D015415:Biomarkers / Q000097:blood*; D001786:Blood Glucose / Q000378:metabolism; D001847:Bone Diseases / Q000097:blood* / Q000150:complications; D016723:Bone Remodeling / Q000502:physiology*; D001842:Bone and Bones / Q000378:metabolism*; D002648:Child; D024042:Collagen Type I / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000150:complications; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007527:Isoenzymes / Q000097:blood; D008297:Male; D015675:Osteocalcin / Q000097:blood; D010455:Peptides / Q000097:blood; D012737:Sex Factors; D000071681:Tartrate-Resistant Acid Phosphatase
D000135:Acid Phosphatase; D015415:Biomarkers; D001786:Blood Glucose; D024042:Collagen Type I; D006442:Glycated Hemoglobin; D007527:Isoenzymes; D015675:Osteocalcin; D010455:Peptides; D000071681:Tartrate-Resistant Acid Phosphatase; C052929:collagen type I trimeric cross-linked peptide