Evaluation of bone mineral density in children with type 1 diabetes: A cross-sectional case–control study

Abstract

Objectives: To compare the bone mineral density (BMD) and vitamin D levels of children with type 1 diabetes (T1D) with normal children. Material and Methods: Children with T1D, aged 4–18 years, and age- and gender-matched healthy controls, were recruited. Children with chronic systemic disorders and those taking medications that impair BMD were excluded from the study. Dual-energy X-ray absorptiometry, vitamin D, intact parathyroid hormone, calcium, phosphorus, alkaline phosphatase, osteocalcin, and spot urine deoxypyridinoline crosslinks (Pyrilinks-D)/ creatinine ratio were estimated in both cases and controls. Results: Thirty-seven children with T1D with a mean age of 9.7 ± 2.1 years were enrolled and compared with controls. The bone mineral content (BMC) in cases was 24.5 g (20.3–30.6) and in controls 25.5 g (23.5–26.8) (P = 0.66) and BMD in cases was 0.68 ± 0.165 g/cm2 and in controls 0.69 ± 0.149 g/cm2 (P = 0.76). However, the prevalence of low BMD (BMD <-2 Z-score) was seen in only 3 (8%) cases (P – <0.001). Serum 25-hydroxyvitamin D [25(OH)D] levels were also lower in cases 14.1 ng/mL (12.05–14.75 ng/mL) as compared to controls 15.73 ng/mL (13.1–23.2 ng/mL) (P = 0.01). Thirty-three (89%) cases and 24 (64%) controls had low 25(OH)D levels (<20 ng/mL). There was no significant difference in the bone turnover markers between cases and controls. Conclusion: Children with T1D have similar BMD and lower vitamin D levels compared to healthy children.