Bone Mineral Density in Children and Adolescents with Diabetes Mellitus Type 1 of Recent Onset

Abstract.

There is still controversy over the impact of diabetes control and duration on bone mass and growth parameters in children and adolescents with insulin-dependent diabetes mellitus (IDDM). The aim of this study was to assess bone mineral density (BMD) at axial and appendicular sites, in children with noncomplicated IDDM of recent onset, and its relation to metabolic control and auxological parameters (weight, height, and puberal stage). Fifty-five young Spanish IDDM, otherwise healthy patients (26 males, aged (SD 9.7 ± 4.3 years) and 29 females, aged (SD 11.2 ± 3.8 years) were studied. Duration of diabetes was 1–13.8 years. Two hundred eighty-two age-matched, healthy, Spanish children served as controls. HbA₁ was assayed by high pressure liquid chromatography (HPLC) and BMD was measured using dual X-ray absorptiometry (DXA) densitometry at the spine and forearm. Results showed a Gaussian BMD distribution of patients according to sex and age, without sexual-stage differences. There was no correlation between BMD and glycated hemoglobin (average life disease or last HbA₁ values) or duration of the disease; moreover, no differences in bone mass were found between <3 and ≥3 years of disease duration. Diabetes impact index (mean HbA₁× duration of disease in months) showed no significant influence of diabetes control on BMD. We could not demonstrate any impact of diabetes on BMD and growth parameters in children with IDDM of short duration.