Evaluation of bone mineral status in prepuberal children with newly diagnosed type 1 diabetes

Roh, Jung Gi; Yoon, Jong Seo; Park, Kyu Jung; Lim, Jung Sub; Lee, Hae Sang; Hwang, Jin Soon

doi:10.6065/apem.2018.23.3.136

Cited by 9 publications

(7 citation statements)

References 34 publications

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“…Multiple studies have shown that the prevalence of low BMI (underweight) is higher than that of high BMI (overweight/obese) among young children. [ 18 19 20 21 ] This is in keeping with our finding, as the percentage of underweight children was approximately 3 times the amount of those who were either overweight or obese. More so, many studies outlined the significant effect of BMI on BMD.…”

Section: Discussionsupporting

confidence: 89%

The Association of Extreme Body Weight with Bone Mineral Density in Saudi Children

Milyani

Kabli

Al-Agha

2022

Annals of African Medicine

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Objective: The objective to investigate the effect of extreme body weight; obesity and undernutrition, on bone mineral density (BMD). Methodology: This study is a descriptive cross-sectional study carried between January and June of 2019, and included 224 children and adolescents without any comorbidities or chronic disease. Important data collected included anthropometrics, past medical and surgical history, history of medication intake, level of physical activity and pubertal assessment. Data entry and analysis were conducted using Statistical Package for Social Sciences version 24. Results: Gender distribution showed 48.2% were male and 51.8% were female. The mean age was 9.98 ± 3.5 years. Mean weight was 34.89 ± 18.2 kg. Mean BMD z-score was − 1.64 ± 1.4. Weight was considered to significantly correlate with BMD stature at a P = 0.014. Subjects who were underweight showed a lower mean BMD z-score of <−2 than those who were overweight/obese (mean BMD z-score = −1.60). Conclusion: Both extremes of weight are considered a significant risk factor for the development of low BMD in children. We recommend the early recognition of weight aberrations and consequent aggressive intervention with strict lifestyle modifications to promote the development of maximum peak bone mass.

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Section: Discussionsupporting

confidence: 89%

The Association of Extreme Body Weight with Bone Mineral Density in Saudi Children

Milyani

Kabli

Al-Agha

2022

Annals of African Medicine

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“…The finding of apparent ‘catch up’ bone accrual in the participants achieving target glycemic control is similar to what was reported in a prior longitudinal study in a prevalent cohort of children with ‘satisfactory’ control [17]. A second, smaller cross-sectional study did not identify deficits in aBMD at T1D diagnosis in prepubertal children compared with controls [18].…”

Section: Skeletal Findings With Respect To Timing Of Type 1 Diabetes ...supporting

confidence: 85%

Bone accrual in children and adolescents with type 1 diabetes: current knowledge and future directions

Weber¹

2021

Current Opinion in Endocrinology, Diabetes &Amp; Obesity

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Purpose of review Skeletal fragility is now recognized as a significant complication of type 1 diabetes (T1D). Many patients with T1D develop the disease in childhood and prior to the attainment of peak bone mass and strength. This manuscript will review recent studies investigating the effects of T1D on skeletal development. Recent findings Mild-to-moderate deficits in bone density, structure, and mineral accrual were reported early in the course of T1D in some but not all studies. Childhood-onset disease was associated with a more severe skeletal phenotype in some adult studies. Lower than expected bone mass for muscle size was been described. Hemoglobin A1c was negatively associated with bone density and structure in several studies, though the mechanism was not clear. Summary The use of advanced imaging techniques has shown that the adverse effects of T1D on the developing skeleton extend beyond bone density to include abnormalities in bone size, shape, microarchitecture, and strength. Despite these gains, a uniform understanding of the pathophysiology underlying skeletal fragility in this disorder remains elusive. Longitudinal studies, especially in association with interventions to reduce hyperglycemia or improve muscle strength, are needed to inform bone healthcare in T1D.

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“…T1D by DXA and have reported normal [22][23][24][25][26] or low lumbar spine BMD, 10,[12][13][14][15][16][17]19,20 but these studies had heterogeneous study populations, limiting direct comparison between them, as highlighted in our recent systematic review. 2 Our study cohort had lower right femoral neck BMD similar to previous studies in young adults.…”

Section: Multiple Studies Have Examined Bone Parameters In Children Withmentioning

confidence: 90%

“…DXA studies in adults with T1D have shown low total body, hip and lumbar spine BMD. 6,8,9 Results with DXA are less reproducible between pediatric studies due to its dependency on bone size, with some studies reporting low [10][11][12][13][14][15][16][17][18][19][20] whereas others report normal [21][22][23][24][25][26][27] total, lumbar spine and hip BMD. Only few pediatric studies have looked at pQCT parameters in children with T1D but the focus was on either radius [28][29][30] or tibia.…”

Section: Introductionmentioning

confidence: 99%

Childhood type 1 diabetes is associated with abnormal bone development

et al. 2022

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Objective: To describe bone mineral density (BMD), bone structure, and fracture prevalence in adolescents with type 1 diabetes (T1D) and explore their associations with glycemic control and microvascular complications.Research design and methods: Cross sectional study of 64 adolescents (38 males) with T1D duration >10 years who underwent dual-energy X-ray absorptiometry (DXA), peripheral quantitative computed tomography (pQCT), fracture survey, plantar fascia thickness, and microvascular complications assessment.Results: Mean age was 16.6 ± 2.1 years, diabetes duration 12.8 ± 2.2 years and HbA1c 8.9 ± 1.7% (74 mmol/mol). Fracture prevalence was 50%. DXA areal BMD (Z-score) was reduced for femoral neck (À0.5 ± 1.3, p = 0.008) and arm (À0.4 ± 1.0, p < 0.001), while total areal BMD and lumbar spine BMD were normal. In pQCT (Z-score), trabecular volumetric BMD (vBMD) was reduced for tibia (À0.4 ± 0.8, p < 0.001) and radius (À0.8 ± 1.4, p < 0.001) whereas cortical vBMD was increased at both sites (tibia: 0.5 ± 0.6, p < 0.001, radius: 0.7 ± 1.5, p < 0.001). Muscle crosssectional area (CSA) was reduced for upper (À0.6 ± 1.2, p < 0.001) and lower (À0.4 ± 0.7, p < 0.001) limbs. DXA total areal BMD was positively correlated with BMI (p < 0.01) and age at T1D diagnosis (p = 0.04). Lower radial bone CSA, total and lumbar spine BMD were associated with autonomic nerve dysfunction. HbA1c, diabetes duration, fracture history and other microvascular complications were not significantly associated with bone parameters.Conclusions: Adolescents with childhood-onset T1D have site-specific bone deficits in upper and lower limbs but normal total and lumbar spine BMD. T1D appears to have differential effects on trabecular and cortical bone compartments. Future longitudinal analysis is warranted to examine whether these changes translate in to increased fracture risk.The study results were presented in an oral session at 45th Annual meeting of the

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Evaluation of bone mineral status in prepuberal children with newly diagnosed type 1 diabetes

Cited by 9 publications

References 34 publications

The Association of Extreme Body Weight with Bone Mineral Density in Saudi Children

The Association of Extreme Body Weight with Bone Mineral Density in Saudi Children

Bone accrual in children and adolescents with type 1 diabetes: current knowledge and future directions

Childhood type 1 diabetes is associated with abnormal bone development

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