Unaffected bone mineral density in Danish children and adolescents with type 1 diabetes

Madsen, Jens Otto Broby; Herskin, Camilla Winther; Zerahn, Bo; Jensen, Andreas Kryger; Jørgensen, Niklas Rye; Olsen, Birthe Susanne; Pociot, Flemming; Johannesen, Jesper

doi:10.1007/s00774-019-01058-0

Cited by 14 publications

(15 citation statements)

References 35 publications

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“…All participants were recruited from the diabetes outpatient clinic at the Department of Pediatric and Adolescent medicine at Herlev University Hospital. Recruitment of participants was part of a large study investigating bone health in children and adolescents with T1D duration for more than 1 year and the recruiting process has been described in further detail in a previous publication . The entire cohort comprised 272 children and adolescents aged 3.4 to 20.3 years.…”

Section: Methodsmentioning

confidence: 99%

“…Recently, two Danish studies have demonstrated that bone mineral density (BMD) in children and adolescents with type 1 diabetes (T1D) was not decreased as demonstrated in several studies including adults with T1D . Already from early childhood an increased risk of bone fractures have been reported in individuals with T1D compared with healthy controls .…”

Section: Introductionmentioning

confidence: 99%

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Decreased markers of bone turnover in children and adolescents with type 1 diabetes

et al. 2020

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Background and aim: Adults with type 1 diabetes (T1D) have increased risk of bone fractures and decreased bone mineral density (BMD). Alterations in bone turnover have been suggested as the link between T1D and the impaired bone health. Furthermore, bone turnover has been suggested to have beneficial effects on glucose metabolism. This study aimed at describing bone turnover markers (BTM), and the relationship with glycemic control, in children and adolescents with T1D.Methods: A total of 173 (47% girls) children and adolescents aged 7.7 to 17.5 years with T1D for more than 1 year were included. Participants were evaluated by BMD together with measurements of selected BTM; two formation markers: osteocalcin (OCN) and procollagen type-1 amino-terminal propeptide (P1NP) and one resorption marker, C-terminal cross-linked telopeptide of type-1 collagen (CTX). BTM were converted into Z-scores utilizing new national references.Results: Mean OCN Z-score (−0.68 ± 1.31), P1NP Z-score (−0.33 ± 1.03) and CTX Z-score (−0.43 ± 1.10) were all significantly lower than the reference population (P < .001). No associations were seen between BTM and T1D duration. BMD Z-score was comparable to the reference population and associated with none of individual BTMs. CTX Z-score was negatively associated with HbA1c (P = .007) independent of both exogenous and residual endogenous insulin.Conclusions: Markers of bone formation and resorption were decreased in children and adolescents with T1D. CTX Z-score associated negatively with HbA1c adjusted for insulin treatment and endogenous insulin production indicating a potential

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Decreased markers of bone turnover in children and adolescents with type 1 diabetes

et al. 2020

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“…The most recent, comprehensive meta-analysis including 2,617 children with T1DM showed significantly lower mean total body BMD, lumbar spine BMD, and femur neck BMD (−0.04 kg/cm 2 , −0.02 g/cm 2 and −0.04 g/cm 2 , respectively) compared to 3,851 healthy controls [27]. Some smaller cross-sectional studies in children with T1DM revealed lower total body BMD Z -scores compared to controls [34], lower total body less head (TBLH) BMC and aBMC at the femoral neck, lower tibial cortical vBMD [35], lower total body, and lumbar spine BMC [36] when compared to age-matched reference data. We are aware of only 1 longitudinal study over 10 years in a small group of children with T1DM, revealing a lower total body BMD and lumbar spine BMD, when compared to age-matched reference data [37].…”

Section: Dxa-related Bone Health Results In Children With T1dm the Ro...mentioning

confidence: 99%

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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“…Models with BMD Z‐score as dependent variable were adjusted for HbA1c, age, height‐, and weight Z‐score as numerical variables, according to our previous findings …”

Section: Methodsmentioning

confidence: 99%

“…Alterations in the turnover of bone have been suggested as a cause of both impaired BMD and bone strength . Two recent studies concluded that BMD was not decreased in Danish children and adolescents with T1D . Despite having BMD comparable to healthy peers, markers of both bone formation and bone resorption were significantly decreased in children and adolescents with T1D for more than 1 year .…”

Section: Introductionmentioning

confidence: 99%

Bone turnover markers during the remission phase in children and adolescents with type 1 diabetes

et al. 2019

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Background and aim: In rodents, osteocalcin (OCN) stimulates insulin production and insulin sensitivity, both important factors during partial remission in humans with type 1 diabetes (T1D). However, decreased OCN has been reported in both adult and pediatric T1D. This study aims at investigating bone turnover and partial remission in children and adolescents with recent onset T1D.Subjects and methods: Ninety-nine individuals (33% girls) were recruited within 3 months of T1D onset and examined three times, 6 months apart. Outcome variables were bone formation markers OCN and procollagen type 1 amino-terminal propeptide (P1NP) and the bone resorption marker C-terminal crosslinked telopeptide of type 1 collagen (CTX). Dependent variables included IDAA1c (surrogate marker of partial remission), total body bone mineral density (BMD) and stimulated C-peptide as representative of endogenous insulin production.Results: OCN-and P1NP Z-scores were significantly decreased throughout the study, whereas CTX Z-scores were increased. None of the bone turnover markers changed significantly between visits. Total body BMD Z-score did not change during the study but was significantly higher than the reference population at visit 2 (P = .035). There were no differences in the bone turnover markers for those in partial remission as defined by either C-peptide or IDAA1c at any visit. The individual Abbreviations: BMD, Bone mineral density; BMI, Body mass index; CSII, Continuous subcutaneous insulin infusion; CTX, C-terminal crosslinked telopeptide of type 1 collagen; DXA, Dual-energy X-ray absorptiometry; fBG, fasting blood glucose; IDAA1c, Insulin dose-adjusted HbA1c; MDI, Multiple daily injections; MMTT, Mixed meal tolerance test; OCN, Osteocalcin; P1NP, Procollagen type 1 amino-terminal propeptide; SD, SD; T1D, Type 1 diabetes mellitus; T2D, Type 2 diabetes mellitus; TDD, Total daily insulin dose.

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Unaffected bone mineral density in Danish children and adolescents with type 1 diabetes

Cited by 14 publications

References 35 publications

Decreased markers of bone turnover in children and adolescents with type 1 diabetes

Decreased markers of bone turnover in children and adolescents with type 1 diabetes

Impact of Type 1 Diabetes Mellitus on Bone Health in Children

Bone turnover markers during the remission phase in children and adolescents with type 1 diabetes

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