Background/aim: Osteoporosis is a known complication in adults with type 1 diabetes mellitus (T1DM), but whether the bones are affected in children and adolescents with T1DM remains controversial. The study aim was to evaluate bone mineral density (BMD) in children and adolescents with T1DM and identify risk factors associated to lower BMD.
Method: In a single-center cohort of children and adolescents with T1DM, BMD was examined by dual-energy X-ray absorptiometry. Puberty Tanner stage, HbA1c, disease duration and age at diabetes onset were investigated for associations to BMD and its Z-scores using multiple regression.
Results: We included 85 patients, 46 males, with a median (range) age of 13.2 (617) years; disease duration 4.2 (0.415.9) years; last year HbA1c 61.8 (41106) mmol/mol. Boys had a significantly increased mean Z-score, 0.38 (95%CI 0.13;0.62), adjusted for height and BMI. The Z-score of boys increased with increasing Tanner stage. For the whole cohort, a negative correlation between mean latest year HbA1c and BMD Z-score was found, adjusted ß −0.019 (95%CI −0.034; −0.004, P=001). Poor glycaemic control (HbA1c >58mmol/mol) within the latest year was likewise negatively correlated with BMD Z-score, adjusted ß −0.35 (95%CI −0.69; −0.014, P=0.04). Similar negative correlations were found between HbA1c and BMD.
Conclusion: BMD Z-score showed sex differences in children and adolescents with T1DM. Poor glycaemic control within the last year was correlated to decreased BMD and BMD Z-score regardless of sex. Our study suggests that elevated blood glucose levels affects bone health already before adulthood in T1DM patients.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology