The Lumbar Bone Mineral Density Is Affected by Long-Term Poor Metabolic Control in Adolescents with Type 1 Diabetes mellitus
| Autor: | Enza Mozzillo, Antonio del Puente, Giuliana Valerio, P Buono, Antonella Esposito-del Puente, Adriana Franzese |
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| Přispěvatelé: | Valerio, G, DEL PUENTE, Antonio, Esposito del Puente, A, Buono, P, Mozzillo, E, Franzese, Adriana |
| Jazyk: | angličtina |
| Rok vydání: | 2002 |
| Předmět: |
Blood Glucose
Male Deoxypyridinoline medicine.medical_specialty Adolescent Endocrinology Diabetes and Metabolism Pyridinium Compounds Disease Bone resorption chemistry.chemical_compound Endocrinology Lumbar Absorptiometry Photon Bone Density Internal medicine medicine Humans Bone Resorption Child Dual-energy X-ray absorptiometry Bone mineral Glycated Hemoglobin Type 1 diabetes medicine.diagnostic_test business.industry Body Weight medicine.disease Body Height Spine Diabetes Mellitus Type 1 chemistry Metabolic control analysis Pediatrics Perinatology and Child Health Female business Biomarkers |
| Popis: | Aim: To analyze whether bone mineral density (BMD) and bone resorption status are influenced by long-term metabolic control and duration of disease in adolescents with long-standing type 1 diabetes mellitus. Methods: Twenty-seven adolescents (age 13.1 ± 1.7 years, duration of diabetes 6.9 ± 3.0 years) were studied. The BMD, expressed as z score, was measured at the lumbar spine (L1–L4) using dual-energy X-ray absorptiometry, while the urinary excretion of total deoxypiridinoline (Dpyd), a marker of bone resorption, was measured by immunoassay and was corrected by creatinine (Cr). Linear and multivariate correlations between lumbar BMD z score or Dpyd/Cr excretion and age and disease variables [short-term (Hb A1clatest) or long-term (Hb A1cwholeduration) metabolic control, duration, ‘diabetes impact index’ (mean Hb A1cwholeduration x duration of disease in months)] were sought. Results: In diabetic subjects the mean BMD z score was –0.44 ± (SD) 1.02 (95% CI: –0.03; –0.84), and the Dpyd/Cr excretion was not increased. A negative correlation was found between lumbar BMD z score and age (r –0.59; p = 0.001), duration (r –0.39; p = 0.04), and the diabetes impact index (r –0.4; p = 0.04). The Dpyd/Cr ratio correlated negatively with age (r –0.40; p = 0.04) and positively with height velocity (r 0.42; p = 0.04). By using multiple linear regression, age showed a significant inverse correlation with lumbar BMD z score (β = –0.39; p = 0.0005). A negative correlation was found between lumbar BMD z score and Hb A1cwholeduration (β = –0.40; p = 0.02) or diabetes impact index (β = –0.001; p = 0.01). Conclusions: Poor metabolic control may expose adolescents with long-standing type 1 diabetes to the risk of developing osteopenia in adult age. Optimization of metabolic control in growing diabetic children may prevent osteoporosis in later life. |
| Databáze: | OpenAIRE |
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