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Bone Mineral Density across the Life-Span in Patients with Type 1 Diabetes

Halper-Stromberg E1,2Gallo T1,3Champakanath A1Taki I1Rewers M1Snell-Bergeon J1Frohnert BI1Shah VN1.

J Clin Endocrinol Metab. 2019 Nov 2. pii: dgz153. doi: 10.1210/clinem/dgz153. [Epub ahead of print]

 

 

Abstract

CONTEXT:

Fracture risk in people with type 1 diabetes (T1D) is higher than their peers without diabetes.

OBJECTIVE:

To compare bone mineral density (BMD) across the life-span in individuals with T1D and age- and sex-matched healthy controls.

DESIGN:

Cross-sectional.

SETTING:

Subjects (5 to 71 years) with T1D and matched controls from ongoing research studies at Barbara Davis Center for Diabetes.

PATIENTS:

or other participants: Participants with lumbar spine BMD by dual x-ray absorptiometry (DXA) were divided into two groups: children ≤20 years and adults > 20 years.

INTERVENTION:

None.

MAIN OUTCOME MEASURES:

Comparison of BMD by diabetes status across age groups and sex using a linear least squares model adjusted for age and body mass index (BMI for adults; and BMI z-score in children).

RESULTS:

Lumbar spine BMD from 194 patients with T1D and 156 controls were analyzed. There was no difference in age- and BMI-adjusted lumbar spine BMD between patients with T1D and controls: among male children (least squares mean [LSM±SEM]; 0.80±0.01 vs 0.80±0.02 gm/cm2, p=0.98) or adults (1.01±0.03 vs 1.01±0.03 gm/cm2, p=0.95) and female children (0.78±0.02 vs 0.81±0.02 gm/cm2, p=0.23) or adults (0.98±0.02 vs 1.01±0.02 gm/cm2, p=0.19). Lumbar spine (0.98±0.02 vs 1.04±0.02 gm/cm2, p=0.05), femoral neck (0.71±0.02 vs 0.79±0.02 gm/cm2, p=0.003), and total hip (0.84±0.02 vs 0.91±0.02, p= 0.005) BMD was lower among postmenopausal women with T1D compared to postmenopausal women without diabetes.

CONCLUSION:

Across age groups, lumbar spine BMD was similar in patients with T1D compared to age- and sex-matched participants without diabetes except postmenopausal females with T1D had lower lumbar spine, femoral neck, and total hip BMD.