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

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

doi:10.1007/s00774-019-01058-0

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

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

6 Citations (Scopus)

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.

Original language	English
Journal	Journal of Bone and Mineral Metabolism
ISSN	0914-8779
DOIs	https://doi.org/10.1007/s00774-019-01058-0
Publication status	Published - 1 May 2020

Keywords

Bone mineral density
Pediatrics
Type 1 diabetes mellitus
HbA1c

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1007/s00774-019-01058-0

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@article{192361bc12d14d84b7844589160f11b5,

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, Pediatrics, Type 1 diabetes mellitus, HbA1c",

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,

day = "1",

doi = "10.1007/s00774-019-01058-0",

language = "English",

journal = "Journal of Bone and Mineral Metabolism",

issn = "0914-8779",

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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 - 2020/5/1

Y1 - 2020/5/1

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 - Pediatrics

KW - Type 1 diabetes mellitus

KW - HbA1c

U2 - 10.1007/s00774-019-01058-0

DO - 10.1007/s00774-019-01058-0

M3 - Journal article

C2 - 31754807

SN - 0914-8779

JO - Journal of Bone and Mineral Metabolism

JF - Journal of Bone and Mineral Metabolism

ER -

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

Abstract

Keywords

UN SDGs

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