ArticleAACE endocrinology and diabetes
Trabecular Bone Score and Bone Turnover Markers Unmask Early Skeletal Fragility in Children and Adolescents With Type 1 Diabetes.
Article in AACE endocrinology and diabetes. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Compromised bone health is a recognized consequence of type 1 diabetes mellitus (T1DM), particularly in adults. Studies that comprehensively assess dual-energy x-ray absorptiometry parameters, trabecular bone score (TBS), and bone turnover markers (BTMs) are scarce in children and adolescents with T1DM. Additionally, the relationship between bone health and corneal nerve abnormalities assessed by corneal confocal microscopy, a surrogate of diabetic microangiopathy, remains unexplored. Methods: Fifty children/adolescents with T1DM and 46 healthy siblings (aged 11-18 years) were enrolled. Participants underwent assessment for relevant biochemical parameters, including 25-hydroxyvitamin D, and dual-energy x-ray absorptiometry for bone mineral content, bone mineral density (BMD) Z-score, total body less head Z-score, TBS, and BTMs, including osteocalcin, procollagen type 1 N-terminal propeptide, and C-terminal telopeptides. Multivariable general linear models adjusted for age, sex, pubertal status (Tanner stage ≥ II), body mass index Z-score, estimated glomerular filtration rate, and 25-hydroxyvitamin D assessed group differences. Results: Bone mineral content, BMD Z-score, total body less head Z-score, and height-adjusted BMD were similar between groups, but TBS was significantly lower in T1DM vs controls (adjusted mean 1.37 [95%CI 1.35-1.39] vs 1.41 [95%CI 1.39-1.43]; Conclusion: Bone microarchitecture and turnover are compromised early in T1DM, preceding detectable changes in conventional BMD. Incorporating TBS and BTMs into bone health assessments may improve early identification of skeletal fragility in this population.
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