Biochemical Markers of Bone Cell Activity in Children with Type 1 Diabetes Mellitus

Aims: To evaluate bone turnover in children with type 1 diabetes mellitus (DM1) at onset, after 3 and 12 months of treatment, and in children with longer duration of disease, and its association with glycemic control. Patients and Methods: 17 children with DM1 at onset, 30 with DM1 of longer duration and 45 controls participated in the study. Tartrate-resistant acid phosphatase 5b (TRACP5b), crosslinked C-terminal telopeptides of type I collagen (CTX) and osteocalcin (OC) were assessed. Results: At onset of DM1 osteocalcin (p <0.0003) and log CTX (p <0.003) were lower than in controls but returned to reference levels after 3 months of therapy. TIZACP5b in children with DM1 increased gradually and after 12 months was higher than at onset (p <0.03). OC at onset inversely correlated with HbA(1c) (r = -0.40, p = 0.03). In children with DM1 of longer duration and HbA(1c) >6.5%, sex-dependent differences were found in OC and CTX. Girls with HbA(1c) >6.5% had lower OC and CTX than controls (p <0.005, p <0.003). Inverse correlations were found between HbA(1c) and OC and CTX (r = -0.50, p = 0.04; r = -0.49, p = 0.03). Conclusions: Proper glycemic control has a beneficial influence on bone turnover, which may prevent low bone mass in adulthood.