Bone mass and structure in adolescents with type 1 diabetes compared to healthy peers

Saha, Marja‐Terttu; Sievänen, Harri; Salo, Matti K.; Tulokas, Sirkku; Saha, Heikki

doi:10.1007/s00198-008-0810-0

Cited by 101 publications

(89 citation statements)

References 33 publications

(44 reference statements)

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“…A negative influence of type 1 diabetes on bone has been observed in a number of case-control studies conducted in adults [2,22] as well as in children and adolescents [1,4,6,[23][24][25], where peripheral and axial DXA and QCT were employed. It has been suggested that observed differences in adults may result from mineralisation disorders, which operate during rapid skeletal development in puberty.…”

Section: Discussionmentioning

confidence: 99%

“…In adults with type 1 diabetes, studies based on measurements at different skeletal sites have shown decreased bone mineral density (BMD) [1,2]. The results and causative factors related to the hypothesised bone mineralisation diminution and bone disturbance in children and adolescents are more equivocal [3][4][5][6][7][8][9]. In adolescents with type 1 diabetes the influence of unsatisfactory metabolic control [1,7,8], disease duration [6][7][8] and high insulin requirement [9] have been postulated.…”

Section: Introductionmentioning

confidence: 99%

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Bone status in adolescents with type 1 diabetes

Chobot¹,

Haffke

Polańska

et al. 2010

Diabetologia

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Aims The aim of the study was to investigate the potential negative impact of type 1 diabetes on bone status of adolescents. Bone status in adolescents with type 1 diabetes was assessed by means of quantitative ultrasound (QUS) and the influence of metabolic control and other diseaserelated and growth variables was analysed. Methods Group I consisted of 99 pubertal (Tanner ≥2) adolescents (49 female No correlation between Ad-SoS SDS and sex, DIR or diabetes duration was observed. The lower Ad-SoS SDS reflects reduced bone status, and the reduction was significantly more marked in those patients whose HbA 1c T was higher than 7.0% when compared with those whose HbA 1c T was lower. Conclusions Bone status of adolescents with type 1 diabetes mellitus assessed with QUS differs from that of healthy peers and is dependent on long-term metabolic control.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Bone status in adolescents with type 1 diabetes

Chobot¹,

Haffke

Polańska

et al. 2010

Diabetologia

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“…Some (45,56) have reported no difference in the BMD between diabetics and controls, whereas others (51,52,53,54,55,57) have documented a decrease in either trabecular and/or cortical BMD at these sites. F/M, female/male; Duration, duration of diabetes in years; Site, skeletal site demonstrating a decreased bone mineral density (BMD); MVC, correlation between BMD and diabetic microvascular complication(s); GC, correlation between BMD and glycaemic control (usually the mean HbA1c); NR, not reported; H, hip; S, spine; TB, total body; Hip*, only site measured; Spine*, only site measured.…”

Section: Quantitative and Structural Bases Of Bone Fragilitymentioning

confidence: 99%

“…A number of studies have documented a smaller crosssectional radial or tibial bone area in T1DM compared to controls (51,56,57), especially during childhood (57,64), but with a normalization with age (65), and reported an association between glycaemic control and decreased bone size (52,54).…”

Section: Bone Size and Microstructurementioning

confidence: 99%

“…A few studies (45,51,52,53,54,55,56,57) have employed peripheral quantitative computer tomography (pQCT) or peripheral DXA (pDXA) to study the BMD of the distal forearm or tibia in T1DM. Some (45,56) have reported no difference in the BMD between diabetics and controls, whereas others (51,52,53,54,55,57) have documented a decrease in either trabecular and/or cortical BMD at these sites.…”

Section: Quantitative and Structural Bases Of Bone Fragilitymentioning

confidence: 99%

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MECHANISMS IN ENDOCRINOLOGY: Mechanisms and evaluation of bone fragility in type 1 diabetes mellitus

Hough

Pierroz²,

Cooper

et al. 2016

European Journal of Endocrinology

131

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Subjects with type 1 diabetes mellitus (T1DM) have decreased bone mineral density and an up to sixfold increase in fracture risk. Yet bone fragility is not commonly regarded as another unique complication of diabetes. Both animals with experimentally induced insulin deficiency syndromes and patients with T1DM have impaired osteoblastic bone formation, with or without increased bone resorption. Insulin/IGF1 deficiency appears to be a major pathogenetic mechanism involved, along with glucose toxicity, marrow adiposity, inflammation, adipokine and other metabolic alterations that may all play a role on altering bone turnover. In turn, increasing physical activity in children with diabetes as well as good glycaemic control appears to provide some improvement of bone parameters, although robust clinical studies are still lacking. In this context, the role of osteoporosis drugs remains unknown.

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Different health behaviours and clinical factors associated with bone mineral density and bone turnover in premenopausal women with and without type 1 diabetes

Kujath

Quinn

Elliott

et al. 2015

Diabetes Metabolism Res

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Background Women with type 1 diabetes (T1DM) have an elevated fracture risk. We therefore compared the associations of health behaviors and clinical factors with bone mineral density (BMD) and bone remodeling between premenopausal women with and without T1DM to inform potential interventions. Methods Participants included women with T1DM (n=89) from the Wisconsin Diabetes Registry Study and age- and race-matched controls without diabetes (n=76). Peripheral (heel, forearm) and central (hip, spine) BMD, markers of bone resorption and formation, bone cell signaling, glycemic control, and kidney function were assessed. Health behaviors and medical history were self-reported. Results In controls, but not in women with T1DM, older age was associated with lower bone resorption (p≤0.006) and formation (p=0.0007). Body mass index (BMI) was positively associated with heel and forearm BMD in both controls and T1DM women (all p<0.0001), but with hip and spine BMD only in controls (p≤0.005). Worse glycemic control during the previous 10 years, greater alcohol intake, history of smoking, and lack of physical activity were associated with poorer bone outcomes only in women with T1DM (all p≤0.002); whereas use of hormonal contraceptives was related to low bone formation in both women with and without T1DM (all p≤0.006). Diabetes duration, insulin dose, residual C-peptide, and kidney function were not associated with bone in T1DM. Conclusions Age and BMI may not predict bone health in T1DM women. However modifiable behaviors such as optimizing glycemic control, limiting substance and hormonal contraceptive use, and increasing physical activity may improve bone health in T1DM women.

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Bone mass and structure in adolescents with type 1 diabetes compared to healthy peers

Cited by 101 publications

References 33 publications

Bone status in adolescents with type 1 diabetes

Bone status in adolescents with type 1 diabetes

MECHANISMS IN ENDOCRINOLOGY: Mechanisms and evaluation of bone fragility in type 1 diabetes mellitus

Different health behaviours and clinical factors associated with bone mineral density and bone turnover in premenopausal women with and without type 1 diabetes

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