Evolution of bone mass in children and adolescents with type 1 diabetes mellitus

BACKGROUND AND OBJECTIVE: There is some controversy over bone mineral density (BMD) in children and teenagers with type I diabetes mellitus (DM1). We evaluated BMD by dual-energy Xray absorptiometry (DXA) and correlated it with anthropometric, biochemical and hormonal parameters related to bone metabolism. PATIENTS AND METHOD: Sixty-six patients with DM1 (26 males and 40 females) aged between 3 and 17 years, and 327 controls with a similar age were studied. RESULTS: The BMD of all diabetic patients was not different from that of the controls. However, the subgroup of older males (between 15 and 17 years) had a significantly inferior BMD than controls of the same age: mean (standard deviation), 0.888 (0.13) versus 0.994 (0.11) (p = 0.027). BMD was inferior to -1 standard deviation (Z-score) in 21.2% of diabetic children. All the biochemical and hormonal parameters were within the normality rank. There was a negative correlation between the evolution time of the disease and the levels of 25-hydroxycholecalciferol (r = -0.345; p = 0.006). We did not observe any correlation between BMD and the remaining studied parameters. CONCLUSIONS: These results confirm that initially children and adolescents with non-complicated DM1 have no alteration of the bone mass. Yet the BMD physiological increase is smaller, in the diabetic population than in controls during the adolescence period, which may cause. lower peak of bone mass in these patients.