Impact of Type 1 Diabetes Mellitus on Bone Health in Children

Janner, Marco; Saner, Christoph

doi:10.1159/000521627

Cited by 9 publications

(5 citation statements)

References 77 publications

(120 reference statements)

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“…However, a review in children with vitamin D concentrations below 35 nmol/L reports an increase in total body BMC and lumbar spine BMD of ∼2% over a follow-up period of 1–2 years post supplementation [ 28 ]. A review on impact of T1D on bone health in children concluded that low bone turnover status in children with T1D can be explained by several mechanisms including high prevalence of vitamin D deficiency and suggested vitamin D supplementation as one of the standards of care [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Adaptation and validation of an artificial intelligence based digital radiogrammetry tool for assessing bone health of indian children and youth with type-1 diabetes

Oza,

Antani,

Mondkar

et al. 2023

Endocrine

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Background and objectives BoneXpert (BX) is an artificial intelligence software used primarily for bone age assessment. Besides, it can also be used to screen for bone health using the digital radiogrammetry tool called bone health index (BHI) for which normative reference values available are calculated from healthy European children. Due to ethnic difference in bone geometry, in a previous study, we generated reference curves based on healthy Indian children. The objectives of this study were: 1) To assess and compare bone health of Indian children with Type 1 diabetes (T1D) using both European and Indian BHI SDS reference data and 2) To identify determinants of poor bone health in Indian children and youth with T1D by using BHI tool (based on BHI-SDS Indian reference data) of BX. Method The BHI was assessed retrospectively in 1159 subjects with T1D using digitalised left-hand x-rays and SDS were computed using European and Indian data. The demographic, anthropometric, clinical, biochemistry, dual x-ray absorptiometry (DXA) data and peripheral quantitative computed tomography (pQCT) data collection were performed using standard protocols and were extracted from hospital records. Results The BHI correlated well with DXA and pQCT parameters in subjects with T1D. BHI-SDS calculated using Indian reference data had better correlation with height and DXA parameters. 8.6% study participants had low (less than −2) BHI-SDS (Indian), with height SDS having significant effect. Subjects with low BHI-SDS were older, shorter and had higher duration of diabetes. They also had lower IGF1 and vitamin D concentrations, bone mineral density, and trabecular density. Female gender, increased duration of illness, poor glycaemic control, and vitamin D deficiency/insufficiency were significant predictors of poor BHI-SDS. Conclusion Our study highlights the utility of digital radiogrammetry AI tool to screen for bone health of children with T1D and demonstrates and highlights the necessity of interpretation using ethnicity specific normative data.

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Section: Discussionmentioning

confidence: 99%

Adaptation and validation of an artificial intelligence based digital radiogrammetry tool for assessing bone health of indian children and youth with type-1 diabetes

Oza,

Antani,

Mondkar

et al. 2023

Endocrine

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“…The association between T1D and decreased TBS found in this study in both adults and children not only indicates that trabecular bone is damaged by T1D in adults and children, but also indicates that decreased bone quality in T1D can occur before peak bone mass is reached. Therefore, in addition to insulin therapy, healthy lifestyle recommendations, including regular weight-bearing exercise, avoidance of smoking, adequate calcium intake, and vitamin D supplementation if necessary, are essential in the early stage of T1D, including children with T1D [ 54 ]. Finally, TBS was statistically associated with BMI and age; therefore, in the studies that corrected for age and/or BMI, we used the corrected mean.…”

Section: Discussionmentioning

confidence: 99%

Trabecular bone score in type 1 diabetes: a meta-analysis of cross-sectional studies

Pan,

Zhang,

Zhao

2023

J Orthop Surg Res

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Background Bone fragility is a recognized complication of type 1 diabetes (T1D). Thus, lower trabecular bone score (TBS) measurements in T1D patients can be predicted. However, the results of current studies on TBS in patients with T1D are inconsistent. In this context, the present study aimed to test the hypothesis that T1D is associated with lower TBS through a meta-analysis. Methods An electronic search of the literature was conducted using PubMed, Embase and Web of science databases to identify studies related to TBS and T1D, supplemented by an additional manual check of the reference list of relevant original and review articles. All data was analyzed using a random effects model. Results were compared using standardized mean differences (SMD) and 95% confidence intervals (CI). P ≤ 0.05 was considered statistically significant. Review Manager 5.4 software and Stata 17.0 software were used for statistical analysis. Results Seven cross-sectional studies involving 848 participants were included. TBS was lower in T1D patients than in healthy controls on random effects analysis, with no heterogeneity (SMD = − 0.39, 95% CI [− 0.53, − 0.24], P < 0.001; I2 = 0%). In addition, by subgroup analysis, T1D patients were strongly associated with reduced TBS in different regions and age groups, and the results were independent of covariate adjustment. Conclusion This study showed that TBS was lower in patients with T1D than in healthy individuals with normal blood glucose levels, suggesting that TBS may be a useful measure to assess fracture risk in T1D.

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“…The association between T1D and decreased TBS found in this study in both adults and children not only indicates that trabecular bone is damaged by T1D in adults and children, but also indicates that decreased bone quality in T1D can occur before peak bone mass is reached. Therefore, in addition to insulin therapy, healthy lifestyle recommendations, including regular weightbearing exercise, avoidance of smoking, adequate calcium intake, and vitamin D supplementation if necessary, are essential in the early stage of T1D, including children with T1D [40]. Finally, TBS was statistically associated with BMI and age; therefore, in the studies that corrected for age and/or BMI, we used the corrected mean.…”

Section: Discussionmentioning

confidence: 99%

Association between trabecular bone score and type 1 diabetes: A meta-analysis of cross-sectional study

Pan,

Zhang,

Zhao

2023

Preprint

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Background: Bone fragility is a recognized complication of Type 1 diabetes(T1D). Thus, lower trabecular bone score(TBS) measurements in T1D patients can be predicted. However, the results of current studies on TBS in patients with T1D are inconsistent. In this context, the present study aimed to test the hypothesis that T1D is associated with lower TBS through a meta-analysis. Methods: An electronic search of the literature was conducted using PubMed, Embase and Web of science databases to identify studies related to TBS and T1D, supplemented by an additional manual check of the reference list of relevant original and review articles. All data was analyzed using a random effects model. Results were compared using standardized mean differences (SMD) and 95% confidence intervals (CI). P≤0.05 was considered statistically significant. Review Manager 5.4 software and Stata 17.0 software were used for statistical analysis. Results: Seven cross-sectional studies involving 848 participants were included. TBS was lower in T1D patients than in healthy controls on random effects analysis, with no heterogeneity(SMD =-0.39, 95%CI [-0.53, -0.24], P < 0.001; I2=0%). In addition, by subgroup analysis, T1D patients were strongly associated with reduced TBS in different regions and age groups, and the results were independent of covariate adjustment. Conclusion: This study showed that TBS was lower in patients with T1D than in healthy individuals with normal blood glucose levels, suggesting that TBS may be a useful measure to assess fracture risk in T1D.

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Impact of Type 1 Diabetes Mellitus on Bone Health in Children

Cited by 9 publications

References 77 publications

Adaptation and validation of an artificial intelligence based digital radiogrammetry tool for assessing bone health of indian children and youth with type-1 diabetes

Adaptation and validation of an artificial intelligence based digital radiogrammetry tool for assessing bone health of indian children and youth with type-1 diabetes

Trabecular bone score in type 1 diabetes: a meta-analysis of cross-sectional studies

Association between trabecular bone score and type 1 diabetes: A meta-analysis of cross-sectional study

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