Tracking of bone mass from childhood to puberty: a 7-year follow-up. The CHAMPS study DK

Rønne, Maria Sode; Heidemann, Malene; Schou, Anders; Laursen, Jens Ole; Bojesen, Anders Bo; Lylloff, Louise; Husby, Steffen; Wedderkopp, Niels; Mølgaard, Christian

doi:10.1007/s00198-018-4556-z

Cited by 7 publications

(5 citation statements)

References 28 publications

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“…As bones are extensively modeled in childhood and adolescence, it may be hypothesized that bones are altered in children with type 1 diabetes. Additionally, as the incidence of type 1 diabetes peaks between the ages of 10 to 14 years, bone effects may occur before the attainment of peak bone mass, which potentially results in diabetic osteopenia . However, there is little knowledge regarding the bones in children and adolescents with type 1 diabetes.…”

Section: Introductionmentioning

confidence: 99%

Glycemic control and bone mineral density in children and adolescents with type 1 diabetes

et al. 2019

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Background/Objective: Fracture risk is increased in patients with type 1 diabetes.We aimed to evaluate bone mineral density (BMD) and to identify risk factors associated to lower BMD in Danish children and adolescents with type 1 diabetes. Methods:In this cross-sectional study BMD Z-score were determined by dual-energy X-ray absorptiometry (DXA) from a cohort of otherwise healthy children and adolescents with type 1 diabetes. Puberty Tanner stage, hemoglobin A1c (HbA1c), disease duration, and age at diabetes onset were investigated for associations to DXA results. Results:We included 85 patients, 39 girls, 46 boys, with a median (range) age of 13.2 (6-17) years; disease duration 4.2 (0.4-15.9) years; HbA1c of the last year 61.8 (41-106) mmol/mol. Our patients were taller and heavier than the background population. When adjusted for increased height SD and body mass index SD, no overall difference in BMD Z-score was found. When stratified by sex, boys had significantly increased adjusted mean BMD Z-score, 0.38 (95% confidence interval [CI]: 0.13;0.62), girls; −0.27 (95% CI: −0.53;0.00). For the whole cohort, a negative correlation between mean latest year HbA1c and BMD Z-score was found, adjusted ß −0.019 (95%CI: −0.034;−0.004, P = 0.01). Poor glycemic control (HbA1c > 58 mmol/mol [7.5%]) within the latest year was likewise negatively correlated with BMD Z-score, adjusted ß −0.35 (95%CI: −0.69;−0.014, P = 0.04). Conclusions:Our study suggests that elevated blood glucose has a negative effect on the bones already before adulthood in patients with type 1 diabetes, although no signs of osteoporosis were identified by DXA. K E Y W O R D S adolescent, bone density, child, diabetes mellitusglycated hemoglobin A, type 1

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Section: Introductionmentioning

confidence: 99%

Glycemic control and bone mineral density in children and adolescents with type 1 diabetes

et al. 2019

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“…Linear bone growth occurs when bone formation exceeds bone resorption at the epiphyseal growth plate due to local bone mass growth. Bone thickening and enlargement occur in the remodeling process of the periosteum and bone marrow cavity (36,37). The vigorous osteogenesis process below the periosteum leads to an increase in bone mass and bone thickening, while the bone dissolution process in the bone marrow cavity leads to an increase in bone absorption and bone marrow cavity enlargement.…”

Section: Rank/rankl/osteoprotegerin (Opg) Signaling Pathway Childhood...mentioning

confidence: 99%

Denosumab in pediatric bone disorders and the role of RANKL blockade: a narrative review

Wang¹,

Tang²,

Shi³

et al. 2023

Transl Pediatr

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Background and Objective: Denosumab is a valuable and safe therapy for skeletal disorders in adults and has received regulatory approval to treat osteoporosis and bone metastases. However, denosumab is not licensed for pediatric use due to a lack of high-quality prospective research on children. This study aimed to describe and discuss the benefits and disadvantages of denosumab in treating bone diseases in children and to summarize the current understanding of the role of denosumab therapy in children.Methods: A narrative review was conducted using the literature retrieved from the PubMed, Embase, and Cochrane Library databases.

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“…The maximal accumulation of aerial BMD (aBMD) at the lumbar spine and at the femoral neck or mid-shaft occurs in the last stages of puberty in both sexes, but especially in boys. 6 Sex steroids can act on the skeleton through direct stimulation of their receptor in bones and indirect activation of the GH-IGF-I axis by oestrogens, leading to triggering of longitudinal bone growth. Beside their bone-anabolic actions, androgens and oestrogens both exert anti-resorptive effects.…”

Section: Definition Of Paediatric Osteoporosismentioning

confidence: 99%

“…5 In children, there is a net increase in bone mass with deposition of bone by osteoblasts being greater than resorption by osteoclasts. 6 In osteoporosis, this balance is disrupted due either to primary genetic causes or the impact of secondary causes, resulting in insufficient bone mass and suboptimal resilience to withstand mechanical stress.…”

Section: Definition Of Paediatric Osteoporosismentioning

confidence: 99%

Management of primary and secondary osteoporosis in children

Sakka

Cheung

2020

Therapeutic Advances in Musculoskeletal

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Osteoporosis in children differs from adults in terms of definition, diagnosis, monitoring and treatment options. Primary osteoporosis comprises primarily of osteogenesis imperfecta (OI), but there are significant other causes of bone fragility in children that require treatment. Secondary osteoporosis can be a result of muscle disuse, iatrogenic causes, such as steroids, chronic inflammation, delayed or arrested puberty and thalassaemia major. Investigations involve bone biochemistry, dual-energy X-ray absorptiometry scan for bone densitometry and vertebral fracture assessment, radiographic assessment of the spine and, in some cases, quantitative computed tomography (QCT) or peripheral QCT. It is important that bone mineral density (BMD) results are adjusted based on age, gender and height, in order to reflect size corrections in children. Genetics are being used increasingly for the diagnosis and classification of various cases of primary osteoporosis. Bone turnover markers are used less frequently in children, but can be helpful in monitoring treatment and transiliac bone biopsy can assist in the diagnosis of atypical cases of osteoporosis. The management of children with osteoporosis requires a multidisciplinary team of health professionals with expertise in paediatric bone disease. The prevention and treatment of fragility fractures and improvement of the quality of life of patients are important aims of a specialised service. The drugs used most commonly in children are bisphosphonates, that, with timely treatment, can give good results in improving BMD and reshaping vertebral fractures. The data regarding their effect on reducing long bone fractures are equivocal. Denosumab is being used increasingly for various conditions with mixed results. There are more drugs trialled in adults, but these are not yet licenced for children. Increasing awareness of risk factors for paediatric osteoporosis, screening and referral to a specialist team for appropriate management can lead to early detection and treatment of asymptomatic fractures and prevention of further bone damage.

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Tracking of bone mass from childhood to puberty: a 7-year follow-up. The CHAMPS study DK

Abstract: Bone mass is highly influenced by pubertal onset, and pubertal stage should be considered when examining children's bone health. Because bone mass indices track from childhood into puberty, children with low bone mass may be at risk of developing osteoporosis later in life.

Cited by 7 publications

References 28 publications

Glycemic control and bone mineral density in children and adolescents with type 1 diabetes

Glycemic control and bone mineral density in children and adolescents with type 1 diabetes

Denosumab in pediatric bone disorders and the role of RANKL blockade: a narrative review

Management of primary and secondary osteoporosis in children

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