Background: There is still small clinical data regarding the influence of IDDM on bone structure, density and biochemical markers of bone turnover.
Objective and hypotheses: To evaluate the potential role of OPG/sRANKL system in adolescents with IDDM and the influence of age, sex, metabolic control, diabetes duration and age of onset.
Method: Serum concentration of OPG and total sRANKL in 60 children (25 boys and 33 girls) with IDDM since 5.09 years±3.95 (1.011.8), aged 15.03±1.95 (11.417.8), age of diagnosis IDDM 9.98±3.90 (2.517.0), HbA1c in last year-7.8±1.7 (5.113.6). Control group consists of 17 age and sex matched healthy children. OPG and total sRANKL (free and bound) were measured by EIA and ELISA commercial kits respectively.
Results: Both serum OPG, tsRANKL and OPG/tsRANKL ratio were insignificantly lower in diabetic children. OPG concentration in IDDM boys was significantly lower than in control group of boys. Negative correlation was observed between OPG concentration and the age of onset of diabetes and positive with diabetes duration. There was no influence of age and tendency to positive correlation with metabolic control. Statistical analysis across tertiles showed that higher levels of OPG (third and/or second vs first tertiles) was associated with the earlier age of diagnosis, longer diabetes duration and poor metabolic control. tsRANKL did not correlate with sex, metabolic control, diabetes duration and age of onset. However, a negative correlation between serum tsRANKL and age was observed. The OPG/tsRANKL ratio values depend only on the age of IDDM children (positive correlation). There were no correlations with sex, metabolic control, diabetes duration and age of onset.
Conclusion: OPG/tsRANKL system may be use as prediction marker of bone and cardiovascular system status in children and adolescents with IDDM but precise reference data for children considering age, sex and puberty status should be determined first.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology