ICCBH2015 Poster Presentations (1) (201 abstracts)
Bone status of Indian children and adolescents with type 1 diabetes mellitus
Rubina Mandlik 1 , Lavanya Parthasarathy 1 , Vaman Khadilkar 1 , Shashi Chiplonkar 1 , Supriya Phanse-Gupte 1 , Neha Kajale 1 , Zulf Mughal 2 & Anuradha Khadilkar 1
1Growth and Endocrine Unit, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India; 2Department of Paediatric Endocrinology, Royal Manchester Children’s Hospital, Manchester, UK.
Objective: Aim was to cross sectionally study bone health parameters assessed by DEXA and serum IGF1 concentrations in 6–16 year old children with type 1 diabetes. We hypothesized that height and bone parameters would be impaired in diabetic children compared with contemporary reference population.
Method: Bone mineral content for total body (less head) (TBBMC) and lumbar spine was measured by DXA (n=170, 77 boys). Z-scores for TBBMC for bone area (TBBA), and lumbar spine bone mineral apparent density (LSBMAD) were computed (Bone 2011;48:810-9). Height was measured and converted to Z-score (HAZ). Serum IGF1 concentrations were measured by ELISA.
Result: Mean age was 11.1±3.8 years, duration of diabetes was 2.2±2.5 years and HbA1c was 10.1±1.8%. Diabetic children were shorter and lighter than reference population (HAZ −0.6±1.1 and WAZ −0.6±1.0); Z-scores for HAZ and TBBA for height were < −2SD in 12 and 6% respectively. Duration of diabetes (β=−0.180, P=0.000) and metabolic control (HbA1c; β=−0.096, P=0.052) were significant negative predictors of HAZ and TBBA for height Z. Using the Molgaard et al. (Archives of Disease in Childhood. 1997;76:9–15) approach, children with longer duration of diabetes had lower HAZ (−0.31±0.92 vs −1.28±1.11; P=0.000; ‘short bones’) and TBBA for height Z-scores (0.12±1.62 vs −0.53±0.94; P=0.054; ‘slender bones’). However, the TBBMC for TBBA Z-scores were not significantly affected (−0.12±1.17 vs 0.21±1.32; P>0.05); thus children did not have ‘light bones’. Serum IGF1 Z-scores were lower amongst the group with longer disease duration (−1.58±1.3 vs −2.63±0.7; P=0.037).
Conclusion: Longer duration of diabetes was associated with shorter and slender but appropriately mineralized bones. Small and slender bones in diabetic children may increase risk of fragility fractures in future.
Disclosure: The authors declared no competing interests.
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