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01-05-2020 | Diabetes | Original Article

Unaffected bone mineral density in Danish children and adolescents with type 1 diabetes

Authors: Jens Otto Broby Madsen, Camilla Winther Herskin, Bo Zerahn, Andreas Kryger Jensen, Niklas Rye Jørgensen, Birthe Susanne Olsen, Flemming Pociot, Jesper Johannesen

Published in: Journal of Bone and Mineral Metabolism | Issue 3/2020

Abstract

Aims

Adults with type 1 diabetes mellitus (T1D) have decreased bone mineral density (BMD). Our study aimed at determining BMD and the association to metabolic control in children and adolescents with T1D.

Methods

244 patients (113 girls) with a median age of 14.3 years and T1D duration of 1–16 years were included. A dual-energy X-ray absorptiometry scan assessed BMD Z-scores excluding the head (total body less head, TBLH). TBLH-BMD were then investigated for associations to diabetes relevant variables such as HbA1c, insulin treatment, anthropometry and physical activity.

Results

In all participants the TBLH-BMD Z-score (0.22 ± 0.96) was significantly higher than the references. Separated by sex, TBLH-BMD Z-score in boys (0.11 ± 0.84) was no different from healthy peers whereas TBLH-BMD Z-score was significantly higher in girls (0.36 ± 1.09). The higher TBLH-BMD Z-score in girls were explained by higher BMI Z-scores. Participants with assumed final height (based on age) had an average TBLH-BMD Z-score of 0.78 ± 1.06, significantly higher than references independent of gender, HbA1c, height- and weight Z-scores. Multiple regression analyses showed that TBLH BMD Z-score associated negatively to HbA1c (P = 0.003), pump treatment (P = 0.019) and screen-time (P = 0.005) and positively to weight Z-score (P < 0.001). Physical activity, sex and puberty did not significantly associate to TBLH-BMD Z-score.

Conclusion

Unlike adults with T1D, BMD is not decreased in children and adolescents with T1D and even elevated after attained final height. As HbA1c negatively associates to BMD, decreased BMD may progress over time. Whether changes in microarchitecture or bone metabolism precede changes in BMD needs further investigation.

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Title: Unaffected bone mineral density in Danish children and adolescents with type 1 diabetes
Authors: Jens Otto Broby Madsen
Camilla Winther Herskin
Bo Zerahn
Andreas Kryger Jensen
Niklas Rye Jørgensen
Birthe Susanne Olsen
Flemming Pociot
Jesper Johannesen
Publication date: 01-05-2020
Publisher: Springer Singapore
Keywords: Diabetes
Type 1 Diabetes
Published in: Journal of Bone and Mineral Metabolism / Issue 3/2020
Print ISSN: 0914-8779
Electronic ISSN: 1435-5604
DOI: https://doi.org/10.1007/s00774-019-01058-0

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