Unaffected Bone Mineral Density in Danish Children and Adolescents with Type 1 Diabetes

Overview

Journal J Bone Miner Metab

Specialty Endocrinology

Date 2019 Nov 23

PMID 31754807

Citations 3

Authors

Jens Otto Broby Madsen

Camilla Winther Herskin

Bo Zerahn

Andreas Kryger Jensen

Niklas Rye Jorgensen

Birthe Susanne Olsen

Flemming Pociot

Jesper Johannesen

Affiliations

Soon will be listed here.

Abstract

Aims: Adults with type 1 diabetes mellitus (T1D) have decreased bone mineral density (BMD). Our study aimed at determining BMD and the association to metabolic control in children and adolescents with T1D.

Methods: 244 patients (113 girls) with a median age of 14.3 years and T1D duration of 1-16 years were included. A dual-energy X-ray absorptiometry scan assessed BMD Z-scores excluding the head (total body less head, TBLH). TBLH-BMD were then investigated for associations to diabetes relevant variables such as HbA1c, insulin treatment, anthropometry and physical activity.

Results: In all participants the TBLH-BMD Z-score (0.22 ± 0.96) was significantly higher than the references. Separated by sex, TBLH-BMD Z-score in boys (0.11 ± 0.84) was no different from healthy peers whereas TBLH-BMD Z-score was significantly higher in girls (0.36 ± 1.09). The higher TBLH-BMD Z-score in girls were explained by higher BMI Z-scores. Participants with assumed final height (based on age) had an average TBLH-BMD Z-score of 0.78 ± 1.06, significantly higher than references independent of gender, HbA1c, height- and weight Z-scores. Multiple regression analyses showed that TBLH BMD Z-score associated negatively to HbA1c (P = 0.003), pump treatment (P = 0.019) and screen-time (P = 0.005) and positively to weight Z-score (P < 0.001). Physical activity, sex and puberty did not significantly associate to TBLH-BMD Z-score.

Conclusion: Unlike adults with T1D, BMD is not decreased in children and adolescents with T1D and even elevated after attained final height. As HbA1c negatively associates to BMD, decreased BMD may progress over time. Whether changes in microarchitecture or bone metabolism precede changes in BMD needs further investigation.

Citing Articles

Glycemic control and study of lipid and bone metabolism in type 1 diabetic children.

Calmarza P, Perez-Ajami R, Prieto-Lopez C, Gallego-Royo A, Garcia-Carro C, Lou-Frances G Biomedica. 2024; 44(Sp. 1):171-181.

PMID: 39079139 PMC: 11361410. DOI: 10.7705/biomedica.7132.

Final height in children and adolescents with type 1 diabetes mellitus: A systematic review and meta-analysis.

Hovsepian S, Chegini R, Alinia T, Ghaheh H, Nouri R, Hashemipour M Hormones (Athens). 2023; 23(1):35-48.

PMID: 37914868 DOI: 10.1007/s42000-023-00500-3.

Bone Health in Childhood Chronic Disease.

Weber D Endocrinol Metab Clin North Am. 2020; 49(4):637-650.

PMID: 33153671 PMC: 7664841. DOI: 10.1016/j.ecl.2020.07.002.

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