ESPE Abstracts (2015) 84 P-2-225

Early Detection of Increased Bone Turnover among Children and Adolescents with Type 1 Diabetes Mellitus

Amina Abdel Wahab, Sonia El Sharkawy, Fadia Attia & Mona Amin


Suez Canal University, Ismaillia, Egypt


Background: Most organs including bone are affected in type 2 Diabetes (T1D) mechanisms. The exact mechanism of bone derangement is still unknown.

Aim of work: i) Assessment of Pyridinoline crosslinks as a bone resorption marker and alkaline phosphatase as a bone formation marker in T1D in children & adolescents. ii) To determine the effect of glycemic control and disease duration on bone turnover.

Subjects and methods: 39 T1D patients, together with 39 age and sex matched non-diabetic healthy controls. The disease duration has to be at least 2 years. Exclusion criteria included autoimmune diseases, renal diseases, hyperparathyroidism, hypertension or medications that interfere with bone metabolism. The study was approved by the Ethical Committee. The entire group was subjected to history taking and through clinical examination. Lab. investigations included: Hb A1C by quantitative colorimetric determination of glycohaemoglobin in whole blood. Parathyroid hormone assayed by ELIZA kits,alkaline phosphatase quantitative determination by kinetic method as per recommendation of German Society for clinical chemistry.Urine sample for pyridinoline cross links (PYD) by ELIZA.

Results: T1D had a mean Hb A1C of 10.7±1.6%, receiving 1.08±0.27 units of insulin per kilogram per day. All had normal parathyroid hormone, while one third of them had high levels of alkaline phosphatase. PYD in diabetics was significantly higher than controls (49.06±9.85 nmol/l vs 13.46±6.69 nmol/l, P=0.001). PYD/creatinine was significantly higher than controls (12.64±4.31 nmol/mmol vs 2.90±1.50 nmol/mmol, P=0.001), In T1D there was no significant correlation between PYD/creatinine or PYD alone and BMI, age, disease duration, Hb A1C or ALP.

Conclusion: Urinary PYD crosslink is markedly higher in diabetics than non-diabetics. Bone turnover (resorption and formation) in T1D is neither dependent on glycaemic control nor on the disease duration.

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