Abstract
To investigate bone health and body composition in young women with long-duration type 1 diabetes (T1D) in relation to matched controls. Twenty-three Swedish women, age 19.2–27.9 years, with a T1D duration of 10 years or more were recruited from the Swedish National Diabetes Registry (NDR). An age-, gender- and geography-matched control group was recruited. Bone mass and body composition were assessed by dual-energy X-ray absorptiometry and peripheral quantitative computed tomography. Data was retrieved from the NDR and SWEDIABKIDS registries. T1D individuals had a mean diabetes duration of 19 years. T1D individuals had reduced lean mass (40.0 ± 6.1 kg vs. 43.9 ± 4.9 kg) and were shorter (1.66 ± 0.06 m vs. 1.71 ± 0.06 m) although comparable BMI. Subjects with T1D had lower muscle area (P = 0.0045). No differences were observed for fractures; physical activity; total, lumbar spine or femur areal bone mineral density. The cortical bone strength strain index was lower for TD1 patients (1875 ± 399 mm3 vs. 2277 ± 332 mm3). In conclusion, young women with long-term diabetes duration showed reduced cortical bone strength, decreased periosteal circumference, endosteal circumference and altered body composition. These factors contribute to the health burden of TD1, which warrants further attention for advancing bone health in women with T1D.
Highlights
Abbreviations BMC Bone mineral content BMD Bone mineral density aBMD Areal bone mineral density body mass index (BMI) Body mass index dual-energy X-ray absorptiometry (DXA) Dual-energy X-ray absorptiometry peripheral quantitative computed tomography (pQCT) Peripheral quantitative computed tomography type 1 diabetes (T1D) Type 1 diabetes type 2 diabetes (T2D) Type 2 diabetes NDR National Diabetes Registry SWEDIABKIDS The Swedish Paediatric National Diabetes Registry for Children 0–18 years strength strain index (SSI) Strength strain index
In comparison with the control group, the cortical bone area was lower in the T1D group, albeit that this difference was not evident when data was adjusted for height
The main findings were that T1D individuals had changed body composition with reduced lean mass comparable BMI
Summary
Abbreviations BMC Bone mineral content BMD Bone mineral density aBMD Areal bone mineral density BMI Body mass index DXA Dual-energy X-ray absorptiometry pQCT Peripheral quantitative computed tomography T1D Type 1 diabetes T2D Type 2 diabetes NDR National Diabetes Registry SWEDIABKIDS The Swedish Paediatric National Diabetes Registry for Children 0–18 years SSI Strength strain index. The risk of cardiovascular complications accelerates during adolescence, especially amongst women[5]. Female adolescents have a higher risk for diabetes ketoacidosis, dyslipidaemia and weight problems, Scientific Reports | (2020) 10:22367. Body composition of women with T1D compared with that of controls has shown a higher fat mass in the former[8]. The treatment of children with T1D in Sweden has been regulated since 1982 by national guidelines, which thereafter have been regularly updated. The last version, from 2018, coincides with the guidelines of the International Society of Paediatric and Adolescent Diabetes (www.ispad.org). The original Swedish guidelines stated that the treatment should aim for normoglycaemia, with the ultimate goal of preserving a high quality of life and preventing acute and future vascular health complications. Besides social and psychological consequences, metabolic disturbances can affect multiple organs and body tissues[9]
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