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

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@article{27a5f430d06b49eca38723087a0de60c,
title = "Unaffected bone mineral density in Danish children and adolescents with type 1 diabetes",
abstract = "Aims: Adults with type 1 diabetes mellitus (T1D) have decreased bone mineral density (BMD). Our study aimed at determining BMD and the association to metabolic control in children and adolescents with T1D. Methods: 244 patients (113 girls) with a median age of 14.3 years and T1D duration of 1–16 years were included. A dual-energy X-ray absorptiometry scan assessed BMD Z-scores excluding the head (total body less head, TBLH). TBLH-BMD were then investigated for associations to diabetes relevant variables such as HbA1c, insulin treatment, anthropometry and physical activity. Results: In all participants the TBLH-BMD Z-score (0.22 ± 0.96) was significantly higher than the references. Separated by sex, TBLH-BMD Z-score in boys (0.11 ± 0.84) was no different from healthy peers whereas TBLH-BMD Z-score was significantly higher in girls (0.36 ± 1.09). The higher TBLH-BMD Z-score in girls were explained by higher BMI Z-scores. Participants with assumed final height (based on age) had an average TBLH-BMD Z-score of 0.78 ± 1.06, significantly higher than references independent of gender, HbA1c, height- and weight Z-scores. Multiple regression analyses showed that TBLH BMD Z-score associated negatively to HbA1c (P = 0.003), pump treatment (P = 0.019) and screen-time (P = 0.005) and positively to weight Z-score (P < 0.001). Physical activity, sex and puberty did not significantly associate to TBLH-BMD Z-score. Conclusion: Unlike adults with T1D, BMD is not decreased in children and adolescents with T1D and even elevated after attained final height. As HbA1c negatively associates to BMD, decreased BMD may progress over time. Whether changes in microarchitecture or bone metabolism precede changes in BMD needs further investigation.",
keywords = "Bone mineral density, HbA1c, Pediatrics, Type 1 diabetes mellitus, Humans, Bone Density/physiology, Child, Preschool, Infant, Male, Absorptiometry, Photon, Diabetes Mellitus, Type 1/diagnostic imaging, Regression Analysis, Exercise, Adolescent, Denmark, Adult, Female, Health Status, Child",
author = "Madsen, {Jens Otto Broby} and Herskin, {Camilla Winther} and Bo Zerahn and Jensen, {Andreas Kryger} and J{\o}rgensen, {Niklas Rye} and Olsen, {Birthe Susanne} and Flemming Pociot and Jesper Johannesen",
year = "2020",
month = may,
doi = "10.1007/s00774-019-01058-0",
language = "English",
volume = "38",
pages = "328--337",
journal = "Journal of Bone and Mineral Metabolism",
issn = "0914-8779",
publisher = "Springer Japan KK",
number = "3",

}

RIS

TY - JOUR

T1 - Unaffected bone mineral density in Danish children and adolescents with type 1 diabetes

AU - Madsen, Jens Otto Broby

AU - Herskin, Camilla Winther

AU - Zerahn, Bo

AU - Jensen, Andreas Kryger

AU - Jørgensen, Niklas Rye

AU - Olsen, Birthe Susanne

AU - Pociot, Flemming

AU - Johannesen, Jesper

PY - 2020/5

Y1 - 2020/5

N2 - Aims: Adults with type 1 diabetes mellitus (T1D) have decreased bone mineral density (BMD). Our study aimed at determining BMD and the association to metabolic control in children and adolescents with T1D. Methods: 244 patients (113 girls) with a median age of 14.3 years and T1D duration of 1–16 years were included. A dual-energy X-ray absorptiometry scan assessed BMD Z-scores excluding the head (total body less head, TBLH). TBLH-BMD were then investigated for associations to diabetes relevant variables such as HbA1c, insulin treatment, anthropometry and physical activity. Results: In all participants the TBLH-BMD Z-score (0.22 ± 0.96) was significantly higher than the references. Separated by sex, TBLH-BMD Z-score in boys (0.11 ± 0.84) was no different from healthy peers whereas TBLH-BMD Z-score was significantly higher in girls (0.36 ± 1.09). The higher TBLH-BMD Z-score in girls were explained by higher BMI Z-scores. Participants with assumed final height (based on age) had an average TBLH-BMD Z-score of 0.78 ± 1.06, significantly higher than references independent of gender, HbA1c, height- and weight Z-scores. Multiple regression analyses showed that TBLH BMD Z-score associated negatively to HbA1c (P = 0.003), pump treatment (P = 0.019) and screen-time (P = 0.005) and positively to weight Z-score (P < 0.001). Physical activity, sex and puberty did not significantly associate to TBLH-BMD Z-score. Conclusion: Unlike adults with T1D, BMD is not decreased in children and adolescents with T1D and even elevated after attained final height. As HbA1c negatively associates to BMD, decreased BMD may progress over time. Whether changes in microarchitecture or bone metabolism precede changes in BMD needs further investigation.

AB - Aims: Adults with type 1 diabetes mellitus (T1D) have decreased bone mineral density (BMD). Our study aimed at determining BMD and the association to metabolic control in children and adolescents with T1D. Methods: 244 patients (113 girls) with a median age of 14.3 years and T1D duration of 1–16 years were included. A dual-energy X-ray absorptiometry scan assessed BMD Z-scores excluding the head (total body less head, TBLH). TBLH-BMD were then investigated for associations to diabetes relevant variables such as HbA1c, insulin treatment, anthropometry and physical activity. Results: In all participants the TBLH-BMD Z-score (0.22 ± 0.96) was significantly higher than the references. Separated by sex, TBLH-BMD Z-score in boys (0.11 ± 0.84) was no different from healthy peers whereas TBLH-BMD Z-score was significantly higher in girls (0.36 ± 1.09). The higher TBLH-BMD Z-score in girls were explained by higher BMI Z-scores. Participants with assumed final height (based on age) had an average TBLH-BMD Z-score of 0.78 ± 1.06, significantly higher than references independent of gender, HbA1c, height- and weight Z-scores. Multiple regression analyses showed that TBLH BMD Z-score associated negatively to HbA1c (P = 0.003), pump treatment (P = 0.019) and screen-time (P = 0.005) and positively to weight Z-score (P < 0.001). Physical activity, sex and puberty did not significantly associate to TBLH-BMD Z-score. Conclusion: Unlike adults with T1D, BMD is not decreased in children and adolescents with T1D and even elevated after attained final height. As HbA1c negatively associates to BMD, decreased BMD may progress over time. Whether changes in microarchitecture or bone metabolism precede changes in BMD needs further investigation.

KW - Bone mineral density

KW - HbA1c

KW - Pediatrics

KW - Type 1 diabetes mellitus

KW - Humans

KW - Bone Density/physiology

KW - Child, Preschool

KW - Infant

KW - Male

KW - Absorptiometry, Photon

KW - Diabetes Mellitus, Type 1/diagnostic imaging

KW - Regression Analysis

KW - Exercise

KW - Adolescent

KW - Denmark

KW - Adult

KW - Female

KW - Health Status

KW - Child

U2 - 10.1007/s00774-019-01058-0

DO - 10.1007/s00774-019-01058-0

M3 - Journal article

C2 - 31754807

VL - 38

SP - 328

EP - 337

JO - Journal of Bone and Mineral Metabolism

JF - Journal of Bone and Mineral Metabolism

SN - 0914-8779

IS - 3

ER -

ID: 58435634