Does type 1 diabetes mellitus affect bone quality in prepubertal children?

ObjectivesType 1 diabetes mellitus (T1DM) in children often starts before the achievement of peak bone mass. This may constitute a landmark in predicting bone fracture risk later in their lives. This study aims to determine the serum levels of bone markers in children with T1DM in combination with their bone mineral density (BMD).MethodsChildren diagnosed with T1DM for 3 years or more without signs of puberty were included in the diabetic group. Another group of age-matched healthy non-diabetic controls was recruited from a local school. The serum levels of a group of biochemical markers for bone formation and resorption were determined in both study groups, and BMD was measured by ultrasound absorptiometry.ResultsThirty six children with T1DM and 39 normal children were included in this study. The results showed that 24/36 (66.7%) diabetic children had a Z score below zero. Of these, five scored below −1. In contrast, 12/39 (30.8%) children from the control group had a Z score below zero, but none had a score below −1. Significantly lower levels of osteocalcin and procollagen N-terminal peptide were detected in the diabetic group. The serum levels of bone resorption markers were significantly higher in the diabetic group.ConclusionT1DM decreases BMD and some bone formation and increases some bone resorption biomarkers. BMD and bone markers are useful diagnostic tools for the early detection of alterations in the bone quality of children with T1DM. This, if treated in a timely manner, may decrease future bone fracture susceptibility.