Decreased Bone Mineral Densities (BMD) and Bone Formation Markers During the First Year After Diagnosis of Insulin Dependent Diabetes Mellitus (IDDM) in Children. 431

Abstract

We have recently demonstrated that children and adolescents with IDDM present with decreased lumbar spine BMD as early as 5 years after diagnosis. The purpose of this study was to evaluate the bone mineral status in a group of newly diagnosed children (9.0±1.9 months after diagnosis). We studied 10 children (5 males and 5 females) with a mean chronological age of 9.9±1.7 years and a mean glycosilated hemoglobin of 8.6±0.8%. Lumbar spine and femoral neck BMD were measured by dual X-Ray absorptiometry, while bone turnover was asssessed by the determination of the serum concentrations of the carboxy-terminal propeptide of type 1 procollagen (PICP) and the carboxy-terminal cross-linked telopeptide of type 1 collagen (ICTP). Results were compared to those of age, height, weight and pubertal status matched controls. Lumbar spine BMD Z-scores were decreased in our patients when compared to controls (Z-scores were -1.5±0.3, with eight out of ten patients showing values >1SD below the mean). No significant differences were noted in femoral neck BMD and total bone mineral content between groups. Serum PICP levels were decreased when compared to controls(233.6±39.3 vs 375.9±50.7 ug/L; p< 0.002), while serum ICTP concentrations, although increased, were not significantly different(9.3±1.3 vs 5.7±1.5 ug/L). However, PICP and ICTP did not correlate with the lumbar spine Z-score. In summary, early after diagnosis IDDM children present with decreased lumbar spine BMD and decreased bone formation markers.