title: Bone density, body composition, and markers of bone remodeling in type 1 diabetic patients.
abstract: OBJECTIVE
  To assess bone mineral density (BMD), body composition by dual X-ray absorptiometry (DXA), and various biochemical markers of bone growth and resorption in a group of children with type 1 diabetes mellitus (T1DM).
  
  
  METHODS
  The study included 47 patients with T1DM and 30 age- and sex-matched controls. Anthropometric measurements, biochemical markers for bone formation, bone resorption and DXA were done for all patients and controls.
  
  
  RESULTS
  Of our diabetes patients, seven (16.7 %), three (7.3 %), and 17 (41.5%) met diagnostic criteria for osteopenia at the right femur, lumbar spine and total body, respectively. On the other hand, osteoporosis as defined by the WHO criteria was diagnosed in 21 patients (51.2%) at the total body by DXA. Lean body mass and lean fat ratio were lower, while, total fat mass, abdominal fat%, soft tissue fat mass%, and fat/lean ratio were higher in diabetics compared to controls. Also, our patients showed lower serum osteocalcin, osteoprotegerin, procollagen type 1, and higher urinary deoxypyridinoline. Pubertal (diabetics and controls) have higher BMD and BMC than prepubertal.
  
  
  CONCLUSIONS
  Diabetic patients had a low BMD after adjustment (Z score), low bone formation and high bone resorption markers. Diabetes control and increase in BMI leads to a decrease in the incidence of low bone mineral density. Diabetes causes an increase in body fat especially abdominal fat which leads to an increase in insulin resistance and decrease in lean mass.
authors.affiliation: Department of Pediatrics, National Research Center, Cairo, Egypt.
authors.forename: Soha M
authors.initials: SM
authors.lastname: Abd El Dayem
authors.forename: Amal M
authors.initials: AM
authors.lastname: El-Shehaby
authors.forename: Asmat
authors.initials: A
authors.lastname: Abd El Gafar
authors.forename: Ashraf
authors.initials: A
authors.lastname: Fawzy
authors.forename: Hassan
authors.initials: H
authors.lastname: Salama
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D001823:Body Composition; D015519:Bone Density; D016723:Bone Remodeling; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008161:Lumbosacral Region / Q000000981:diagnostic imaging; D008297:Male; D015675:Osteocalcin / Q000097:blood; D010024:Osteoporosis / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology; D011627:Puberty; D055815:Young Adult
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin; D015675:Osteocalcin; C517652:hemoglobin A1c protein, human