Low Bone Mineral Density and Its Determinants in Children and Adolescents with Newly Diagnosed Type 1 Diabetes

Presentation Number: MON 635
Date of Presentation: April 3rd, 2017

Hae Sang Lee*1, Jong Seo Yoon1, Cheol Hwan So1, Jung Sub Lim2 and Jin Soon Hwang3
1Ajou University School of Medicine, Suwon, Korea, Republic of (South), 2Korea Cancer Ctr Hosp, Seoul, Korea, Republic of (South), 3Ajou Univ School of Med, Suwon City, Korea, Republic of (South)


Objective: Recently, several studies reported that patients with type 1 diabetes had reduced bone mineral density (BMD). Disease duration, age, and glycosylated hemoglobin (HbA1c) were suggested to impair bone mineralization in type 1 diabetes. Therefore, we aimed to assess bone status in children and adolescents with type 1 diabetes and to investigate factors associated with BMD.

Methods: Fifty-five patients with newly diagnosed type 1 diabetes at Ajou University Hospital from 2006 to 2014 were included in this study. Dual-energy X-ray absorptiometry (DEXA) was performed to measure regional and whole-body composition with Lunar Prodigy at initial diagnosis. The standard deviation scores (SDS) of BMD was calculated using data of healthy Korean children and adolescents after adjusting for height-for-age.

Results: The mean age of all subjects (30 boys and 25 girls) was 10.0 ± 3.1 years (range, 5.0-14.9). Initial mean HbA1c levels were 12.3 ± 2.2 %. There were no significant differences in the BMD SDS between the gender. The mean BMD SDS of total body, lumbar spine, and femur neck were significantly lower than zero (-0.35 ± 1.20, P=0.035, -0.54 ± 0.98, P<0.001, and -0.32 ± 1.16, P=0.043, respectively). Four patients (7.2%) were considered to low bone density (total body BMD SDS < -2.0). To identify determinants of total body BMD SDS, multivariate regression analysis was performed with stepwise variable selection, including age at diagnosis, BMI SDS, IGF-1, and HbA1c. BMI SDS was only significantly correlated with total body BMD SDS (β=0.279, P=0.006).

Conclusion: Children and adolescents with newly diagnosed type 1 diabetes had lower BMD compared to normal Korean population. Also, low BMI may have negative impact on bone mineralization.


Nothing to Disclose: HSL, JSY, CHS, JSL, JSH