ESPE2023 Poster Category 1 Diabetes and Insulin (55 abstracts)
Association between osteocalcin and secretory function of islet beta cells in diabetic pediatric population: a pivotal study
Fortunato Lombardo 1 , Stefano Passanisi 1 , Cristina Lombardo 1 , Giuseppina Salzano 1 , Bruno Bombaci 1 , Cecilia Lugarà 1 , Federica D' Amico 1 , Loredana Grasso 2 , M'Hammed Aguennouz 2 , Antonino Catalano 3 & Mariella Valenzise 1
1Unit of Pediatrics, Messina, Italy. 2VEQ and Immunometry, Messina, Italy. 3Unit of Internal Medicine, Messina, Italy
Background: Osteocalcin plays a role in glucose metabolism in mice, but its relevance in human energetic metabolism is controversial. Few data are available on osteocalcin in pediatric patients with T1DM. The aim of our monocenter observational study was to evaluate the role of the main remodelling bone biomarkers in the regulation of glucose metabolism at the time of type 1 diabetes diagnosis and to evaluate their potential relationship with insulin sensitivity and pancreatic β cells secretion.
Material and Methods: Our study population consisted of 29 patients with a mild prevalence of male subjects (51.7%). We evaluated the following biochemical parameters: basal blood glucose, HbA1C, C-PEP, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, thyroid function (fT3 and fT4, TSH), renal and liver function, serum electrolytes, arterial hemogasanalysis and bone remodeling biomarkers (Osteocalcin, CTX, PTH, ALP, 1.25-OH Vit-D)
Results: The mean age of study participants was 8.4 ± 3.7 years. Most patients (62%) were on pre-pubertal stage, and only 3 subjects had completed the pubertal development. HbA1c mean value at the time of diagnosis was 108 ± 24.7 mmol/mol (12.0 ± 2.3%). Less than half of the patients (37.9%) presented DKA at diabetes onset. 6 patients (54.5%) had severe DKA and the remaining 5 patients had moderate or mild DKA. Basal and stimulated serum c-peptide levels were 0.65 ± 0.59 mg/dL and 1.02 ± 0.66 mg/dL, respectively. T1D-specific autoimmunity was present in 86.2% of patients. Other autoimmune diseases were found in only 3 patients (10.3%). In particular, two patients had celiac disease and one female patient was diagnosed with Hashimoto’s thyroiditis concomitantly with diabetes onset. Regarding bone remodeling biomarkers, the following serum levels were detected: ALP 241.5 ± 85.6 IU/L, osteocalcin 56 ± 40.4 ng/mL, CTX 2.3 ± 0.7 mcg/L, PTH 17.5 ± 13.5 pg/mL, and 1,25-OH Vitamin D 23.8 ± 14.7 ng/mL. Low osteocalcin levels were observed in patients with DKA, with a positive correlation between osteocalcin and C-peptide levels (p value = 0,026). No correlation was observed between osteocalcin and other variables (pH, HCO3-, HbA1C, glycemia).
Conclusion: Low osteocalcin levels, observed in our population, could be an indirect expression of a poor pancreatic reserve in diabetic pediatric patients at onset of the disease.
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