engleski

Bone mineral density in children and young adults with type 1 diabetes mellitus.

Type 1 diabetes mellitus (T1DM) is considered a risk factor for skeletal integrity and osteoporosis development in adults. Inadequate control of diabetes leads to mineral disorders and impairment of bone mass. However, decreased bone mass in children with T1DM could not be confirmed by all investigators. Objective. To study relationship of bone mass in T1DM young patients with sex, age, disease duration, body mass index z-score (BMIS) and disease control as assessed by mean HbA1c (3-8 measurements in the last two years). Subjects and Methods. This study comprised 61 children and young adults (31 m, 30 f) with T1DM. Mean age was 15.2 years (7-27) and disease duration 6.9 years (2.1-18.5). Bone mass was measured by DEXA at L1-L4 and z-score less than &#8211; 2 was considered decreased. Adequate metabolic control was considered if HbA1c was 8% or less. Standard statistical package was used for data analyses. Results. No difference between sexes existed for the assessed parameters. For the entire patient group BMI z-score mean was 0.18 (-1.4 &#8211; 2.0), BMD z-score mean &#8211; 0.379 (-3.0 &#8211; 3.3), and HbA1c mean 8.96 % (6.09 &#8211; 14.0). Statistically significant positive correlation was found only between z-scores for BMD and BMI (r=0.384, p<0.005). No correlation existed between BMD z-scores and age, disease duration or HbA1c. Also no difference for the investigated parameters was found between groups of patients with HbA1c less than 8% (n=22) and patients with HbA1c equal or greater than 8.1% (n=39). Four patients (4/61 ; 2 f, 2 m) had decreased BMD z-scores (-2.3, -2.5, -2.5, -3.0) and HbA1c moderately high (8.4 %, 8.8%) and increased (12.7%, 14%). Disease duration for the four patients was not particularly long (2.2, 7.0, 8.7, 10.5 years). Conclusions. In our patients with T1DM no relationship existed for BMD z-score and age, sex, disease duration and degree of disease control, but only between z-scores for BMD and BMI. This indicates positive association of bone mass and body mass during growth and development. In all four patients with decreased BMD satisfactory metabolic control could not be achieved. Further investigation in a larger group of T1DM young patients might enable elucidation of the effect of disease control and BMD.

bone; diabetes mellitus 1

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