Background: Several studies have examined the relationship between type 1 diabetes and bone mass, which reported contradictory data on BMD, bone remodelling markers, and bone quality. Nevertheless an incresead prevalence of osteopenia was observed among patients with duration of disease of >6 years.
Objective and hypotheses: The aim of the study was to investigate the potential negative impact of type 1 diabetes on bone status in a group of children with type 1 diabetes, by evaluating bone geometry, quality, and bone markers.
Method: 51 children (25 m, 26 f), mean age 10.31±3.16 years height SDS, 0.17±0.79; and BMI SDS, 0.48±0.81 with a mean duration of type 1 diabetes of 5.03±3.11 years were studied. Bone geometry was evaluated on digitalized X-rays at the level of the second metacarpal bone. The following parameters were investigated: outer diameter (D), inner diameter (d), cortical area (CA) and medullary area (MA), meanwhile bone quality was evaluated by ultrasound performed at the phalangeal diaphysis of the non-dominant hand and expressed as amplitude dependent speed of sound (Ad-Sos) and bone transmission time (BTT). Bone markers (P1NP and CTX), sclerostin, Dkk-1, PTH, and 25OHD were also assessed. Data were converted to SDS and evaluated according to the bone age. Differences in bone geometry and quality were evaluated against zero, while the biochemical values of the patients were compared with a control group of 40 subjects of normal weight and height, which did not suffer of any chronic diseases.
Results: D (−0.98±0.95), d (−0.34±0.98), CA (−0.88±0.74) and MA (−0.39±0.90) were all significantly smaller than in controls (P<0.01) while Ad-Sos (−0.08±1.06) and BTT (−0.12±0.88) were not significantly reduced. The bone markers were similar in children with type 1 diabetes and controls.
Conclusion: Type 1 diabetic children show a bone of reduced size but with conserved proportion and quality.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology