title: Low bone mineral density is associated to poor glycemic control and increased OPG expression in children and adolescents with type 1 diabetes.
abstract: OBJECTIVE
  To investigate early alterations on bone mineral density (BMD) and RANK, RANKL and OPG mRNA expression in peripheral blood leukocytes (PBL) in children and adolescents with type 1 diabetes (T1D) and the relationship with glycemic control and bone biomarkers.
  
  
  METHODS
  This cross-sectional study included 75 children and adolescents with T1D and 100 individuals without diabetes (normoglycemic-NG) aged 6-20 years old. T1D individuals were considered to have good (T1DG) or poor (T1DP) glycemic control according to the values of HbA1c. Phosphorus, magnesium, total and ionized calcium, osteocalcin, alkaline phosphatase and tartaric-resistant acid phosphatase (TRAP) values were determined in blood samples. BMD was measured by DEXA. RANK, RANKL and OPG mRNA expression was measured in PBL by real-time PCR.
  
  
  RESULTS
  Osteocalcin values were decreased in diabetic groups in comparison to NG group (p<0.05), and a negative correlation with both serum glucose (r=-0.265, p<0.01) and Hb1Ac (r=-0.252, p<0.01) in T1D group was found. BMD was lower in diabetic groups in comparison with NG group (p<0.05) and a negative correlation was observed between BMD and both serum glucose (r=-0.357, p<0.01) and HbA1c (r=-0.351, p<0.01) in T1D group. OPG mRNA expression was significantly increased in T1D and T1DP groups in comparison with NG group (p<0.05). In conclusion, children and adolescents with early onset T1D presented low bone mineral density associated to unsatisfactory glycemic control, increased OPG mRNA expression and low osteocalcin concentration.
authors: Department of Clinical and Toxicological Analysis, UFRN, Natal, RN, Brazil. Electronic address: melinaloureiro@yahoo.com.br.
authors: Melina B
authors: MB
authors: Loureiro
authors: Department of Clinical and Toxicological Analysis, UFRN, Natal, RN, Brazil.
authors: Marcela A G
authors: MA
authors: Ururahy
authors: Department of Clinical and Toxicological Analysis, UFRN, Natal, RN, Brazil.
authors: Francisco P
authors: FP
authors: Freire-Neto
authors: Department of Clinical and Toxicological Analysis, UFRN, Natal, RN, Brazil.
authors: Gustavo H M
authors: GH
authors: Oliveira
authors: Department of Clinical and Toxicological Analysis, UFRN, Natal, RN, Brazil.
authors: Valéria M G
authors: VM
authors: Duarte
authors: Department of Clinical and Toxicological Analysis, UFRN, Natal, RN, Brazil.
authors: André D
authors: AD
authors: Luchessi
authors: Department of Clinical Medicine, UFRN, Natal, RN, Brazil.
authors: José
authors: J
authors: Brandão-Neto
authors: Department of Clinical and Toxicological Analyses, University of São Paulo, São Paulo, SP, Brazil.
authors: Rosario D C
authors: RD
authors: Hirata
authors: Department of Clinical and Toxicological Analyses, University of São Paulo, São Paulo, SP, Brazil.
authors: Mario H
authors: MH
authors: Hirata
authors: Department of Radiology, UFRN, Natal, RN, Brazil.
authors: José J
authors: JJ
authors: Maciel-Neto
authors: Department of Pediatrics, UFRN, Natal, RN, Brazil.
authors: Ricardo F
authors: RF
authors: Arrais
authors: Department of Clinical and Toxicological Analysis, UFRN, Natal, RN, Brazil.
authors: Maria G
authors: MG
authors: Almeida
authors: Department of Clinical and Toxicological Analysis, UFRN, Natal, RN, Brazil.
authors: Adriana A
authors: AA
authors: Rezende
mesh_terms: D000293:Adolescent; D000328:Adult; D000469:Alkaline Phosphatase / Q000097:blood; D015415:Biomarkers / Q000097:blood*; D015519:Bone Density; D002118:Calcium / Q000097:blood; D016022:Case-Control Studies; D002648:Child; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000175:diagnosis / Q000209:etiology*; D007003:Hypoglycemia / Q000175:diagnosis / Q000209:etiology*; D007963:Leukocytes, Mononuclear; D008297:Male; D015675:Osteocalcin / Q000097:blood; D053244:Osteoprotegerin / Q000097:blood / Q000235:genetics*; D010758:Phosphorus / Q000097:blood; D053245:RANK Ligand / Q000097:blood / Q000235:genetics; D012333:RNA, Messenger / Q000235:genetics; D060888:Real-Time Polymerase Chain Reaction; D053246:Receptor Activator of Nuclear Factor-kappa B / Q000097:blood / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction; D055815:Young Adult
chemical_list: D015415:Biomarkers; D053244:Osteoprotegerin; D053245:RANK Ligand; D012333:RNA, Messenger; D053246:Receptor Activator of Nuclear Factor-kappa B; C505686:TNFRSF11A protein, human; C506030:TNFRSF11B protein, human; C505688:TNFSF11 protein, human; D015675:Osteocalcin; D010758:Phosphorus; D000469:Alkaline Phosphatase; D002118:Calcium
keywords: Bone metabolism; Diabetic osteopathy; OPG expression; Type 1 diabetes