Abstract
Background: There is recent considerable evidence supporting vitamin D deficiency role in pathogenesis of type 1 diabetes mellitus (T1DM) resulting in alteration in bone metabolism and structure and higher risk of related complications later in life. Aim: The present study aimed to evaluate alteration of bone status and possible association between 25-hydroxy D3 [25 (OH) D3], parathormone [PTH], insulin growth factor -1 [IGF-1] serum profiles, glycemic control and disease duration with bone mineral density (BMD) in a children and adolescence with uncomplicated T1DM. Methods: Thirty six children and adolescents (mean +/-; SD age, 10.38 +/-; 3.17 years) with T1DM were matched with 15 (8.47 +/-;4.17 years) healthy controls. Serum levels of 25 (OH) D3, PTH, IGF-1 were measured by ELISA while, glycosylated hemoglobin (HbA1c), calcium (Ca), inorganic phosphorus (PO4) by spectrophotometer. Bone quality was determined by dual energy X-ray absorptiometry (DEXA). Results: Children and adolescents with T1DM showed increased serum levels of PO4 and PTH and decreased calcium, IGF-1, 25 (OH) D3 About 52.8% of our patients had insufficient 25 (OH) D3 levels. Abnormal bone status was found in arm, ribs, T-spine, L-spine, leg, total body while head showed normal bone currency. Longer diabetic duration and poor metabolic control had a negative; meanwhile PTH, IGF-1 had a positive impact on bone mass. Conclusions: Given that individuals with T1DM possess multiple risk factors for skeletal fragility, ensuring vitamin D sufficiency throughout childhood and adolescence in this population seems especially warranted.
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