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

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 DMI (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 carboxyterminal 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 BNID was <-2.0 S.D. in only two diabetic patients (4.5%). Bone area A (BA) was inversely correlated with the duration of diabetes (p = 0.03) and HbAlc (p = 0.02). In girls, who presented a worse A HbAlc than boys (p < 0.01), BMD was inversely correlated with HbAlc (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 DMI 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. (c) 2007 Elsevier Ireland Ltd. All rights reserved.