Abstract
BackgroundVitamin D supplementation in childhood improves the achievement of peak bone mass. We investigated the effect of supplementation with calcitriol on bone turnover in recent-onset type 1 diabetes (T1D). Moreover, the association between osteocalcin and parameters of β-cell function and metabolic control was examined.Methodology/Principal FindingsWe conducted a post-hoc analysis of a double-blind, placebo-controlled study of calcitriol supplementation to preserve β-cell function. 27 recent-onset T1D subjects, mean age 22 years, were randomized to 0.25 µg calcitriol per day or placebo (1∶1) and followed up for one year. Changes in bone formation (osteoclacin) and resorption (beta-CrossLaps) markers, and differences between placebo and calcitriol-treated group were evaluated. At baseline, osteocalcin levels were significantly lower in female than in male patients (P<0.01) while no other metabolic parameters as HbA1c and C-peptide differed between gender. No significant correlations were found in relation to HbA1c, insulin requirement and C-peptide. At 1 year follow-up, no significant differences were observed between calcitriol and placebo groups for osteocalcin and β-CrossLaps. In the placebo group osteocalcin levels were unrelated with parameters of metabolic control, such as C-peptide, insulin requirement or HbA1c. Changes of C-peptide, insulin requirement and HbA1c were not related to osteocalcin levels.ConclusionsSupplementation with 0.25 µg calcitriol per day to patients with new-onset T1D does not affect circulating markers of bone turnover. OC levels were unrelated to β-cell function and other metabolic parameters suggesting that OC is ineffective to control pancreatic function in presence of aggressive autoimmune destruction.
Highlights
In 1948 Albright et al investigated bone development in diabetic children linking for the first time diabetes with bone mass loss [1]
Since several studies have examined the relationship between type 1 diabetes (T1D) and skeletal disorders showing an impaired peak of bone mass and, an increased risk of osteoporosis and fractures [2,3]
Vitamin D deficiency has been associated with T1D [7] and several studies suggest that vitamin D may exert immunomodulatory effects. [7,8]
Summary
In 1948 Albright et al investigated bone development in diabetic children linking for the first time diabetes with bone mass loss [1]. Since several studies have examined the relationship between type 1 diabetes (T1D) and skeletal disorders showing an impaired peak of bone mass and, an increased risk of osteoporosis and fractures [2,3]. Supplementation with vitamin D during early childhood may decrease the risk of developing T1D [10,11]. Contrary to what was expected, we have found that calcitriol supplementation is not effective in improving b-cell function or reducing insulin requirement in patients with newly diagnosed T1D [12]. Vitamin D supplementation in childhood improves the achievement of peak bone mass. We investigated the effect of supplementation with calcitriol on bone turnover in recent-onset type 1 diabetes (T1D). The association between osteocalcin and parameters of b-cell function and metabolic control was examined
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