Evaluation of bone mass and growth in young diabetics

Wiske, Prescott S.; Wentworth, Samuel M.; Norton, James A.; Epstein, Solomon; Johnston, C. Conrad

doi:10.1016/0026-0495(82)90086-5

Cited by 91 publications

(36 citation statements)

References 37 publications

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“…In order to analyze whether the severity of diabetes at the clinical onset could have exerted any effect on the BMD, lumbar BMD z scores were compared between patients presenting with or without DKA at the onset of diabetes, and no differences were found. At variance with previous studies [2, 4, 5, 6, 9, 10, 25], but in agreement with others [3, 8, 12], we found a negative relationship between lumbar BMD z scores and duration of diabetes, indicating, therefore, that the abnormality in BMD may worsen with ongoing disease.…”

Section: Discussioncontrasting

confidence: 56%

“…As can be seen from table 2, the lumbar spine is the most frequently investigated site, since it contains mainly trabecular bone which is metabolically highly active: this site may be very sensitive to derangements occurring in the mineralization process, particularly in young people [23]. At variance with three studies [10, 24, 25], most studies agree on the fact that BMD values in diabetic patients, although in the normal range, were significantly lower than in controls [2, 3, 4, 5, 6, 7, 8, 9]. Our results, too, indicate that the mean BMD z scores at the lumbar site were significantly lower than the mean of the reference value, as the 95% value of the CI of the mean was entirely below 0.…”

Section: Discussionmentioning

confidence: 73%

“…However, the effect of poor metabolic control on the BMD has been excluded by several authors [3, 4, 5, 6, 9, 10, 25], but sustained by Lettgen et al [8]in children and by Olmos et al [12]in adults. The reason of these conflicting results may be explained by the fact that most authors considered the Hb A 1c values present at the time of the study which obviously represent the metabolic control of the last 2–3 months.…”

Section: Discussionmentioning

confidence: 99%

“…Type 1 diabetes mellitus is the most frequent endocrine system disease in childhood which may have negative effects on bone turnover and mineralization. A reduced bone mineral density (BMD) has been variously documented in children and adolescents with type 1 diabetes [2, 3, 4, 5, 6, 7, 8, 9, 10], but there are still conflicting data on whether it may be influenced by duration of the disease or poor metabolic control. Pathogenetic mechanisms leading to diabetic osteopenia have been alternatively ascribed either to a low turnover status, with decreased bone resorption and formation [11, 12, 13], or to a high turnover status, with increased bone resorption, hypercalciuria, and hyperphosphaturia [14, 15, 16].…”

Section: Introductionmentioning

confidence: 99%

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The Lumbar Bone Mineral Density Is Affected by Long-Term Poor Metabolic Control in Adolescents with Type 1 Diabetes mellitus

Valerio

Puente²,

Puente³

et al. 2002

Horm Res Paediatr

112

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Aim: To analyze whether bone mineral density (BMD) and bone resorption status are influenced by long-term metabolic control and duration of disease in adolescents with long-standing type 1 diabetes mellitus. Methods: Twenty-seven adolescents (age 13.1 ± 1.7 years, duration of diabetes 6.9 ± 3.0 years) were studied. The BMD, expressed as z score, was measured at the lumbar spine (L1–L4) using dual-energy X-ray absorptiometry, while the urinary excretion of total deoxypiridinoline (Dpyd), a marker of bone resorption, was measured by immunoassay and was corrected by creatinine (Cr). Linear and multivariate correlations between lumbar BMD z score or Dpyd/Cr excretion and age and disease variables [short-term (Hb A_1clatest) or long-term (Hb A_{1cwholeduration}) metabolic control, duration, ‘diabetes impact index’ (mean Hb A_{1cwholeduration} x duration of disease in months)] were sought. Results: In diabetic subjects the mean BMD z score was –0.44 ± (SD) 1.02 (95% CI: –0.03; –0.84), and the Dpyd/Cr excretion was not increased. A negative correlation was found between lumbar BMD z score and age (r –0.59; p = 0.001), duration (r –0.39; p = 0.04), and the diabetes impact index (r –0.4; p = 0.04). The Dpyd/Cr ratio correlated negatively with age (r –0.40; p = 0.04) and positively with height velocity (r 0.42; p = 0.04). By using multiple linear regression, age showed a significant inverse correlation with lumbar BMD z score (β = –0.39; p = 0.0005). A negative correlation was found between lumbar BMD z score and Hb A_{1cwholeduration} (β = –0.40; p = 0.02) or diabetes impact index (β = –0.001; p = 0.01). Conclusions: Poor metabolic control may expose adolescents with long-standing type 1 diabetes to the risk of developing osteopenia in adult age. Optimization of metabolic control in growing diabetic children may prevent osteoporosis in later life.

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Section: Discussioncontrasting

confidence: 56%

Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Lumbar Bone Mineral Density Is Affected by Long-Term Poor Metabolic Control in Adolescents with Type 1 Diabetes mellitus

Valerio

Puente²,

Puente³

et al. 2002

Horm Res Paediatr

112

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“…Although bone mass has fairly consistently been demonstrated to be decreased in patients with insulin-dependent diabetes mellitus (IDDM) (2)(3)(4)(5)(6), the relationship between bone mass and non-insulin-dependent diabetes mellitus (NIDDM) is still controversial. Heath and coworkers failed to find an increased incidence of fracture in about 1000 diabetic subjects as compared with anon-diabetic population (7).…”

mentioning

confidence: 99%

Total and Regional Bone Mineral Content in Patients with Non-Insulin Dependent Diabetes Mellitus

Okuno

Nishizawà

Sekiya

et al. 1991

Journal of Nutritional Science and Vitaminology, J Nutr Sci Vit

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Summary Total body bone mineral content and bone mineral content in various body sites were measured by dual-photon absorptiometry in 103 patients with non-insulin-dependent diabetes mellitus (NIDDM) and the findings were compared with those for 214 non-diabetic control subjects matched for age and body weight. Neither total body bone mineral content (TBBM) nor the bone mineral density of the third lumbar vertebra (L3 BMD) in the diabetic subjects differed from the values in control subjects of either sex, but the values were significantly decreased in patients diseased for at least five years when compared with control subjects. Regional bone mineral measurement showed prominent bone loss in the truncal site, but no reduction in bone mass was found in the head, pelvis, arms, or legs in either male or female patients. These results suggest that reduced TBBM and L3 BMD are associated with duration of the disease and that a site specific bone defect is present in NIDDM.

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Connective Tissue Disorders in Diabetes

Rosenbloom¹

2004

International Textbook of Diabetes Mellitus

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Connective tissue disorders in diabetes encompass the major long‐term complications, which can be attributed to alternation in the quantity and quality of structural macromolecules of the extracellular matrix. This chapter reviews the abnormalities of interstitial connective tissue involving skeleton, joints, skin, and periarticular tissues that have been considered to be associated with diabetes, including osteopenia in children and adults; hyperostosis; osteoarthritis; rheumatoid arthritis; osteolysis; scleroderma diabeticorum; Dupuytren disease; stiff hand syndrome of Lundbaek; carpal tunnel syndrome; flexor tenosynovitis; adhesive capsulitis of the shoulder and shoulder–hand syndrome; and limited joint mobility (LJM). Despite an extensive literature defining the characteristic features of the six distinct conditions resulting in limitation of hand joint mobility, recognition of the fact that these are different entities, although they may coexist, is often not appreciated. Among these conditions affecting hand joint mobility, LJM is unique in that it can occur in children and adolescents, in whom it was originally described, does not occur in the nondiabetic young population, is an important risk marker for other complications, correlates with long‐term metabolic control, and has markedly decreased in frequency over the past 20 years, presumably as a result of improved control of type 1 diabetes in children.

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Evaluation of bone mass and growth in young diabetics

Cited by 91 publications

References 37 publications

The Lumbar Bone Mineral Density Is Affected by Long-Term Poor Metabolic Control in Adolescents with Type 1 Diabetes mellitus

The Lumbar Bone Mineral Density Is Affected by Long-Term Poor Metabolic Control in Adolescents with Type 1 Diabetes mellitus

Total and Regional Bone Mineral Content in Patients with Non-Insulin Dependent Diabetes Mellitus

Connective Tissue Disorders in Diabetes

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