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eISSN: 2083-8441
ISSN: 2081-237X
Pediatric Endocrinology Diabetes and Metabolism
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SCImago Journal & Country Rank
3/2022
vol. 28
 
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abstract:
Original paper

Skeletal status in children and adolescents with new-onset type 1 diabetes: a preliminary study based on bone densitometry and quantitative ultrasound

Francesca Silvestri
1
,
Marco Infante
2, 3, 4
,
Andrea Fabbri
2
,
Carla Ferrara
5
,
Giampiero Ferraguti
6
,
Francesco Costantino
1
,
Elena Ferrari
1
,
Enea Bonci
6
,
Arianna Turchetti
7
,
Claudio Tiberti
6
,
Valeria Tromba
1

1.
Department of Paediatrics, Section of Paediatric Diabetology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
2.
Department of Systems Medicine, Diabetes Research Institute Federation (DRIF), University of Rome Tor Vergata, Rome, Italy
3.
Section of Diabetology, UniCamillus, Saint Camillus International University of Health Sciences, Rome, Italy
4.
Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Rome, Italy
5.
Department of Public Health and Infectious Diseases, Section Health Statistics, Sapienza University of Rome, Rome, Italy
6.
Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
7.
Department of Paediatrics, Centre for Congenital Osteodystrophy, Sapienza University of Rome, Rome, Italy
Pediatr Endocrinol Diabetes Metab 2022; 28 (3): 197–206
Online publish date: 2022/09/16
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Introduction
Type 1 diabetes (T1D) represents a risk factor for bone loss and impaired bone quality.

Material and methods
We conducted an exploratory retrospective cross-sectional study involving youths with new-onset T1D, to investigate the relationship between lumbar spine dual-energy X-ray absorptiometry (DXA) and phalangeal quantitative ultrasound (QUS) measurements, along with their correlation with markers of bone turnover, glucose homeostasis, and residual β-cell function.

Results
17 children and adolescents (8 females) with recent-onset T1D were enrolled into this study. Lumbar spine areal bone mineral density (aBMD) and age-adjusted amplitude-dependent speed of sound (AD-SoS) Z-scores were indicative of low BMD status (≤ −2.0 SD) in 11.7% and 17.6% of participants, respectively. Spearman’s correlation analysis revealed significant inverse correlations between AD-SoS values and circulating levels of β-CrossLaps, alkaline phosphatase, and osteocalcin, along with a significant positive correlation between bone transmission time (BTT) values and fasting plasma C-peptide (FCP) levels. There was no statistically significant correlation between DXA-QUS parameters, fasting plasma glucose (FPG), and glycated haemoglobin (HbA1c). Finally, there was a significant positive correlation between lumbar spine aBMD and BTT values.

Conclusions
Our study suggests that DXA and/or QUS parameters may be altered in a small proportion of T1D children and adolescents at the disease onset. Additionally, residual β-cell function may represent a protective factor against T1D-related detrimental skeletal changes. Large and long-term prospective studies are needed to confirm these preliminary findings since the present study is limited by the retrospective cross-sectional design and by its small sample size.

keywords:

bone mineral density, bone quality, dual-energy X-ray absorptiometry, new-onset type 1 diabetes, quantitative ultrasound


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