ESPE Abstracts

Background: Recent studies have shown a new link between skeleton, fat tissue, and insulin action. However, clinical data are still limited, especially in children.

Objective: The aim of the presented study was to investigate the relationship between bone and fat hormones and glucose metabolism in children with type 1 diabetes mellitus (T1DM) and obesity.

Methods: Forty-six T1DM children, mean age 12.2±4.6 years, mean BMI 20.0±4.7 kg/m², 16 obese children, (age 11.3±3.8 years and BMI 27.2±7.3 kg/m²), and 11 control, healthy children, (11.5±5.0 years), BMI 19.0±2.8 kg/m² were included into the study. Fasting blood samples for measurement of bone derived osteocalcin (OC) and receptor activator of nuclear factor NF-κB ligand (RANKL), fat tissue-derived leptin and adiponectin, as well as vitamin D, lipid profile, glucose, HbA1c concentrations were taken at 0800 h. Hormones were measured by immunochemistry, vitamin D by HPLC and other parameters by routine chemistry methods. Statistical analysis was performed in all groups using ANOVA with post-hoc Turkey test and multiple regression analysis.

Results: There were significant differences regarding leptin, HbA1c, LDL-cholesterol, HDL-cholesterol/total cholesterol levels among groups P<0.001 (Table 1). In T1DM, multiple regression analysis adjusted for age and BMI showed negative correlation between OC and leptin (r=−0.37, P=0.02) and HbA1c (r=−0.4, P=0.01), and positive correlation between OC and HDL/TC (r=0.3, P=0.02). In contrary, serum RANKL correlated positively with adiponectin (r=0.3, P=0.04). Moreover, vitamin D correlated negatively with HbA1c (r=−0.3, P=0.03). In obese patients strong correlation between adiponectin and HbA1c (r=−0.8, P=0.02) has been found. In control group only positive correlation between OC and vitamin D (r=0.7, P=0.03) was noted.

Conclusion: It is suggested that cross-talk between bone and fat tissue in pediatric patients depends on insulin action.