Bone mineral density in diabetic children and adolescents: a follow-up study

Salvatoni, Alessandro; Mancassola, Gianmaria; Biasoli, R; Cardani, Roberta; Salvatore, S.; Broggini, M.; Nespoli, Luigi

doi:10.1016/j.bone.2004.01.005

Cited by 42 publications

(30 citation statements)

References 21 publications

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“…However, some studies reported normal hip BMD (22,23), and normal (24) or even increased spine BMD (25). Nevertheless, there is agreement that approximately 40-50% diabetic patients have decreased BMD and this decrease is independent of age, diabetes duration, presence of chronic microvascular complications, and the onset of diabetes (5,6,26), similar to our results. Bone loss was found even in children, at the time of diagnosis (6,27).…”

Section: Discussionsupporting

confidence: 82%

“…Many studies performed to date suggest that type 1 diabetes is associated with alternations in bone turnover, resulting in the development of osteopenia, in both adults (2,3) and children (4,5). The decrease of bone mass in diabetic patients is usually moderate and is not clearly associated with duration (5) or metabolic control of diabetes (5,6), both in shortand long-term evaluation. Some of the earlier studies have suggested that diabetic osteopenia results in the increased fracture rate in type 1 diabetic women (7,8).…”

Section: Introductionmentioning

confidence: 99%

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Bone mineral density and hip structural analysis in type 1 diabetic men

Miazgowski

Pynka²,

Noworyta-Ziętara³

et al. 2007

eur j endocrinol

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Objective: The risk of non-vertebral fractures is increased in men with type 1 diabetes (DM1) but studies have shown only moderately decreased or normal bone mineral density (BMD) in these patients. No previous studies have evaluated hip strength and geometry indices in DM1 patients. This study was therefore designed to characterize associations between BMD, dual X-ray absorptiometry (DXA)-based hip strength indices, metabolic control, and DM1chronic complications. Design and methods: The study was performed on 36 males aged 43.6G5.1 years with long-lasting DM1 and 36 healthy males matched for age, weight, and height. BMD in lumbar spine, total hip, upper and lower part of the femoral neck, hip axis length, cross-sectional area and moment of inertia (CSMI), and glycated hemoglobin (HbA1c) were measured. Results: DM1 men had decreased spine BMD (P!0.05) and normal total hip BMD in comparison with controls. Hip geometry and strength indices were comparable in both groups. However, M1 men had decreased CSMI and upper femur BMD but these differences did not reach statistical significance (PZ0.06). BMD changes and hip strength parameters did not correlate with HbA1c. Conclusions: Middle-aged DM1 men have decreased lumbar spine BMD, normal hip BMD and normal hip strength indices. These changes are not influenced by metabolic control and presence of chronic microvascular complications.

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Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Bone mineral density and hip structural analysis in type 1 diabetic men

Miazgowski

Pynka²,

Noworyta-Ziętara³

et al. 2007

eur j endocrinol

View full text Add to dashboard Cite

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“…On the other hand, some studies have not confirmed a significant decrease in densitometric variables in young patients with diabetes [5,26,27]. However, certain of them indicate the presence of discrete bone mineralisation disorders, such as a decrease of bone formation markers and increase of bone resorption markers [28] or lower bone mineral acquisition [5,26].…”

Section: Discussionmentioning

confidence: 99%

“…However, certain of them indicate the presence of discrete bone mineralisation disorders, such as a decrease of bone formation markers and increase of bone resorption markers [28] or lower bone mineral acquisition [5,26].…”

Section: Discussionmentioning

confidence: 99%

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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“…Longitudinal data on relatively small numbers of patients over 2-4 years revealed disturbed or normal bone development (7,8). A recently published study over a wide time range from 12 to 84 months showed slightly reduced mineralization of the spine independent of metabolic control or microvascular complications (9). The incidence of bone fractures was not increased in a large adult population with type 1 diabetes (10).…”

mentioning

confidence: 95%

Bone Size Normalizes With Age in Children and Adolescents With Type 1 Diabetes

Bechtold¹,

Putzker²,

Bonfig³

et al. 2007

Diabetes Care

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OBJECTIVE -The aim of this study was to establish whether type 1 diabetes has a long-term effect on bone development in children and adolescents.RESEARCH DESIGN AND METHODS -Bone characteristics and muscle crosssectional area (CSA) were analyzed cross-sectionally in 41 (19 female and 22 male) patients and were reevaluated after 5.56 Ϯ 0.4 years using peripheral quantitative computed tomography (pQCT). We hypothesize that bone size and muscle mass normalize with age.RESULTS -At the first evaluation, mean Ϯ SD age was 9.87 Ϯ 2.3 years and disease duration was 4.31 Ϯ 2.9 years. Height was Ϫ0.36 Ϯ 1.9 SD, and BMI was 0.39 Ϯ 0.9 SD. Parameters of bone size were low in the whole patient group (corrected for patient's height). At reevaluation, age was 15.44 Ϯ 2.3 years, and patients had a mean height of Ϫ0.12 Ϯ 0.8 SD. BMI SD had increased to 0.57 Ϯ 1.1. Total and cortical CSA had normalized. Those patients with an increase in total CSA had a significant younger age at disease manifestation and a younger age at initial pQCT measurement. Bone size was well adapted to muscle mass expressed as the ratio of bone mineral content per muscle mass, and a close correlation was shown between the increase in bone size and in muscle CSA (r ϭ 0.46, P ϭ 0.03).CONCLUSIONS -Patients with manifestation of type 1 diabetes at an early age had transient impaired bone development. Within the follow-up period, the greatest increase in bone size was found in these patients. In adolescence, all patients had a normal bone size and appropriate adaptation of bone on muscle. There are still no conclusive data on the relative importance of several diabetesspecific characteristics, such as age at onset, disease duration, and glycemic control or insulin regimen, on bone health (6). Diabetes CareThe majority of earlier studies were cross-sectional using dual-energy X-ray absorptiometry of the spine. In pediatric patients, in particular, this method has l i m i t a t i o n s b e c a u s e o f t h e t w odimensional measurement and therefore height dependency. Longitudinal data on relatively small numbers of patients over 2-4 years revealed disturbed or normal bone development (7,8). A recently published study over a wide time range from 12 to 84 months showed slightly reduced mineralization of the spine independent of metabolic control or microvascular complications (9). The incidence of bone fractures was not increased in a large adult population with type 1 diabetes (10). Therefore, the clinical importance of possibly lower bone mineralization in type 1 diabetes is not clear.The objectives of the present longitudinal study were to evaluate bone mineral density (BMD) and bone size and muscle mass in patients with type 1 diabetes at two time points (5.5 years apart) using peripheral quantitative computed tomography (pQCT). Interpretation of BMD and geometry measurements is incomplete without taking into account muscle mass (11). Therefore, we looked at the ratio between bone mineral content (BMC) and muscle mass (12). RESEARCH DESIGN ANDMETHODS -In a ...

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Bone mineral density in diabetic children and adolescents: a follow-up study

Cited by 42 publications

References 21 publications

Bone mineral density and hip structural analysis in type 1 diabetic men

Bone mineral density and hip structural analysis in type 1 diabetic men

Bone status in adolescents with type 1 diabetes

Bone Size Normalizes With Age in Children and Adolescents With Type 1 Diabetes

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