Bone metabolism is linked to disease duration and metabolic control in type 1 diabetes mellitus

Abstract

This cross-sectional study analyzed bone mineral density (BMD) in children and adolescents with type 1 diabetes mellitus (DM1) and its relationship with metabolic control, duration of disease and bone markers. Methods: Forty-four children and adolescents with DM1 (age 8.8 ± 4.4 years, disease duration 6.6 ± 3.9 years) and 22 healthy children were assessed for BMD of the lumbar spine (L1–L4) by dual energy X-ray absorptiometry; osteocalcin (OC) and carboxy-terminal telopeptide (CTX) were measured in the study group. Results: The BMD was similar in subjects with (−1.15 ± 1.2 S.D.) and without DM1 (−0.85 ± 0.88 S.D., p = 0.25). After adjustment for weight, height and pubertal development, the BMD was <−2.0 S.D. in only two diabetic patients (4.5%). Bone area (BA) was inversely correlated with the duration of diabetes (p = 0.03) and HbA1c (p = 0.02). In girls, who presented a worse HbA1c than boys (p < 0.01), BMD was inversely correlated with HbA1c (p = 0.05). OC and CTX levels were higher in boys (p < 0.01) and both inversely correlated with pubertal development (p = 0.01), but not with BMD. Conclusions: Children and adolescents with DM1 have normal bone mass in the lumbar spine. However, longer diabetes duration and poor metabolic control may have a negative impact on bone mass, requiring further investigation through longitudinal studies.