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Ann Pediatr Endocrinol Metab. 2018 Sep;23(3):136-140. doi: 10.6065/apem.2018.23.3.136. Epub 2018 Sep 28.

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

Author information

1
Department of Pediatrics, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea.
2
Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea.

Abstract

PURPOSE:

Many studies have reported that patients with type 1 diabetes have reduced bone mineral density (BMD). We assessed bone status in prepubertal children with type 1 diabetes mellitus (type 1 DM) at initial diagnosis and investigated factors associated with BMD.

METHODS:

Prepubertal children (n=29) with newly diagnosed type 1 diabetes from 2006 to 2014 were included. Dual-energy X-ray absorptiometry measured regional and whole-body composition at initial diagnosis. BMD was compared with healthy controls matched for age, sex, and body mass index (BMI).

RESULTS:

The mean age of all subjects (16 boys and 13 girls) was 7.58±1.36 years (range, 4.8-11.3 years). Initial mean glycosylated hemoglobin (HbA1c) level was 12.2%±1.9%. The mean BMD z-scores of lumbar spine, femur neck, and total body were not significantly different between patients and controls. Three patients (10.3%) had low bone density (total body BMD standard deviation score [SDS] < -2.0). To identify determinants of lumbar spine BMD z-score, multivariate regression analysis was performed with stepwise variable selection of age, pubertal status, BMI SDS, insulin like growth factor-1, and HbA1c. Only BMI SDS was significantly correlated with lumbar spine BMD z-score (β=0.395, P=0.023).

CONCLUSION:

Prepubertal children with newly diagnosed type 1 DM had similar bone mass compared to healthy peers. However, patients with low BMI should be carefully monitored for bone density in type 1 DM.

KEYWORDS:

Body mass index; Child; Type 1 diabetes; Bone mineral density

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