Metabolic bone markers can be related to preserved insulin secretion in children with newly diagnosed type 1 diabetes

Szymańska, Małgorzata; Michałus, Izabela; Kaszkowiak, Marcin; Wyka, Krystyna; Chlebna-Sokół, Danuta; Fendler, Wojciech; Jakubowska-Pietkiewicz, Elżbieta; Młynarski, Wojciech; Szadkowska, Agnieszka; Zmysłowska, Agnieszka

doi:10.5114/pedm.2020.94391

Cited by 9 publications

(11 citation statements)

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“…The same group found reduced osteocalcin and CTX in diabetic youth during partial remission [60], indicating that low turnover status persisted during the remission of pancreatic beta-cell function. Consistent with this observation, 2 additional studies in youth with T1DM showed low osteocalcin and P1NP levels [61, 62]. In addition, 1 study linked low P1NP to markers of oxidative stress [62].…”

Section: Mechanisms Affecting Bone Health In T1dmmentioning

confidence: 76%

Impact of Type 1 Diabetes Mellitus on Bone Health in Children

Janner

Saner

2021

Horm Res Paediatr

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This paper gives an overview of the impact of type 1 diabetes on bone health in children and adolescents. First, we analyse studies using DXA (dual x-ray absorptiometry) to assess BMC (bone mineral content) and BMD (bone mineral density). Then, we discuss modern, non-invasive techniques including pQCT (peripheral quantitative computer tomography) and HRpQCT (high-resolution peripheral quantitative computer tomography) for the detailed assessment of bone health aspects including bone mass, bone geometry, bone microarchitecture and bone strength. Thereafter, we explore some of the mechanisms that are responsible for diabetic bone disease in children, like low bone turnover and high sclerostin levels. Finally, we summarise some of the evidence for the importance of microvascular disease in the pathophysiology of diabetic bone disease.

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Section: Mechanisms Affecting Bone Health In T1dmmentioning

confidence: 76%

Impact of Type 1 Diabetes Mellitus on Bone Health in Children

Janner

Saner

2021

Horm Res Paediatr

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“…Since it takes ≥6 months for changes in bone metabolism to become apparent 21 , patients with disease durations of <1 year were excluded from this study. In the previous reports, the association between the duration of diabetes and the complications was compared in tertiles, as the duration of diabetes can show a skewed distribution 22 , 23 .…”

Section: Methodsmentioning

confidence: 99%

Relation between the insulin lowering rate and changes in bone mineral density: Analysis among subtypes of type 1 diabetes mellitus

Suzuki

Urai

Fukuoka

et al. 2022

J of Diabetes Invest

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Aims/Introduction The bone mineral density in patients with type 1 diabetes mellitus is reduced due to impaired insulin secretion. However, it is unclear whether the rate of bone mineral density reduction is affected by the type 1 diabetes mellitus subtype. This study aimed to clarify the difference in bone mineral density across type 1 diabetes mellitus subtypes: slowly progressive (SP), acute‐onset (AO), and fulminant (F). Methods This was a retrospective, single‐center, cross‐sectional study conducted on 98 adult type 1 diabetes mellitus patients. The main outcome included the bone mineral density Z‐score (BMD‐Z) measured at the lumbar spine and femoral neck. Results The lumbar spine BMD‐Z was lower in the acute‐onset than in the slowly progressive subtype ( P = 0.03). No differences were observed when compared with the fulminant subtype. The femoral neck BMD‐Z tended to be higher in the slowly progressive than in the acute‐onset and fulminant subtypes. Multiple regression analyses showed that the lumbar spine BMD‐Z was associated with subtypes (AO vs SP) ( P = 0.01), but not subtypes (F vs SP), adjusted for sex, duration, retinopathy, and C‐peptide immunoreactivity (CPR). When the patients were divided into disease duration tertiles, in the first and second tertiles, the CPR levels were lower in the acute‐onset or fulminant than in the slowly progressive subtype. In contrast, the lumbar spine and femoral neck BMD‐Z differed between the acute‐onset and slowly progressive only in the second tertiles (both P < 0.01), with a similar tendency between the fulminant and slowly progressive subtypes. Conclusions Among the type 1 diabetes mellitus subtypes, bone mineral density undergoes time‐dependent changes, which reveals that the bone mineral density decline follows the impaired insulin secretion. These results provide novel insights into the association between the low insulin exposure duration and bone mineral density.

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“…Consistently, Galluzzi et al [ 57 ] observed significantly higher levels of OPG in children with long-lasting T1DM compared to the controls. In the study by Szymańska et al [ 58 ], OPG levels were higher in T1DM subjects at the onset as compared to the control group, and decreased thereafter, while on the contrary, RANKL levels were lower than in controls but increased during follow-up. The authors speculated that the decreased insulin secretion in patients at the onset of diabetes may result in decreased insulin binding to the OB receptor, leading to a transitory increase of OPG levels in the early stage of diabetes[ 58 ].…”

Section: Factors Influencing Bone Mass Accrual In T1dm Children and Adolescentsmentioning

confidence: 96%

“…In the study by Szymańska et al [ 58 ], OPG levels were higher in T1DM subjects at the onset as compared to the control group, and decreased thereafter, while on the contrary, RANKL levels were lower than in controls but increased during follow-up. The authors speculated that the decreased insulin secretion in patients at the onset of diabetes may result in decreased insulin binding to the OB receptor, leading to a transitory increase of OPG levels in the early stage of diabetes[ 58 ]. Loureiro et al [ 59 ] reported low OPG levels in T1DM children, which were correlated with the metabolic control level.…”

Section: Factors Influencing Bone Mass Accrual In T1dm Children and Adolescentsmentioning

confidence: 96%

Mechanisms of altered bone remodeling in children with type 1 diabetes

Brunetti¹,

Damato²,

Santis³

et al. 2021

WJD

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Bone loss associated with type 1 diabetes mellitus (T1DM) begins at the onset of the disease, already in childhood, determining a lower bone mass peak and hence a greater risk of osteoporosis and fractures later in life. The mechanisms underlying diabetic bone fragility are not yet completely understood. Hyperglycemia and insulin deficiency can affect the bone cells functions, as well as the bone marrow fat, thus impairing the bone strength, geometry, and microarchitecture. Several factors, like insulin and growth hormone/insulin-like growth factor 1, can control bone marrow mesenchymal stem cell commitment, and the receptor activator of nuclear factor-κB ligand/osteoprotegerin and Wnt-b catenin pathways can impair bone turnover. Some myokines may have a key role in regulating metabolic control and improving bone mass in T1DM subjects. The aim of this review is to provide an overview of the current knowledge of the mechanisms underlying altered bone remodeling in children affected by T1DM.

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Metabolic bone markers can be related to preserved insulin secretion in children with newly diagnosed type 1 diabetes

Cited by 9 publications

References 0 publications

Impact of Type 1 Diabetes Mellitus on Bone Health in Children

Impact of Type 1 Diabetes Mellitus on Bone Health in Children

Relation between the insulin lowering rate and changes in bone mineral density: Analysis among subtypes of type 1 diabetes mellitus

Mechanisms of altered bone remodeling in children with type 1 diabetes

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