Bone mineral density at femoral neck and lumbar spine in adults with type 1 diabetes: a meta-analysis and review of the literature

2017 ◽  
Vol 28 (9) ◽  
pp. 2601-2610 ◽  
Author(s):  
V. N. Shah ◽  
K. K. Harrall ◽  
C. S. Shah ◽  
T. L. Gallo ◽  
P. Joshee ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Type 1 Diabetes ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Meta Analysis ◽  
Review Of The Literature ◽  
Mineral Density

scholarly journals Bone Mineral Density and Type 1 Diabetes in Children and Adolescents: A Meta-analysis

2021 ◽  
Author(s):  
Phoebe Loxton ◽  
Kruthika Narayan ◽  
Craig F Munns ◽  
Maria E Craig
Keyword(s):  
Bone Mineral Density ◽  
Type 1 Diabetes ◽  
Lumbar Spine ◽  
Bone Mineral ◽  
Meta Analysis ◽  
Inclusion Criteria ◽  
Mineral Density ◽  
Multiple Modalities ◽  
Meta Regression

<u>Background</u> <p>There is substantial evidence that adults with type 1 diabetes have reduced bone mineral density (BMD), however findings in youth are inconsistent.</p> <p><u>Purpose</u></p> <p>Systematic review and meta-analysis of BMD in youth with type 1 diabetes using multiple modalities: dual energy X-ray absorptiometry (DXA), peripheral quantitative computed tomography (pQCT) and/or quantitative ultrasound (QUS).</p> <p><u>Data Sources</u></p> <p>PubMed, Embase, Scopus and Web of Science from 01/01/1990 to 31/12/2020, limited to humans, without language restriction.</p> <p><u>Study Selection</u></p> <p>Inclusion criteria: cross sectional or cohort studies that included BMD measured either by DXA, pQCT and/or QUS in youth (age <20 years) with type 1 diabetes and matched controls. </p> <p><u>Data extraction</u></p> <p>Total body (TB), lumbar spine (LS) and femoral BMD (DXA); tibia, radius and lumbar spine (pQCT); and phalanx and calcaneum (QUS). Weighted mean difference (WMD) or standardized mean difference (SMD) were estimated and meta-regression was performed using age, diabetes duration and HbA1c as covariates.</p> <p><u>Data Synthesis </u></p> <p>We identified 1300 non-duplicate studies; 46 met the inclusion criteria, including 2617 cases and 3851 controls. Mean age was 12.6 ± 2.3 years. Youth with type 1 diabetes had lower BMD: TB (WMD -0.04 g/cm<sup>2</sup>, 95% CI -0.06 to -0.02, <i>P</i>=0.0006); LS (-0.02 g/cm<sup>2</sup>, -0.03 to -0.0, <i>P = 0.01</i>); femur (-0.04 g/cm<sup>2</sup>, -0.05 to -0.03, <i>P</i><0.00001); tibial trabecular (-11.32 g/cm<sup>3</sup>,-17.33 to -5.30, <i>P</i>=0.0002), radial trabecular (-0.91, -1.55 to -0.27, <i>P=0.005</i>); phalangeal (-0.32, -0.38 to -0.25, <i>P</i><0.00001) and calcaneal (SMD -0.69, -1.11 to -0.26, <i>P</i>=0.001). Using meta-regression TB BMD was associated with older age (coefficient -0.0063, -0.0095 to -0.0031, <i>P</i>=0.002), but not longer diabetes duration or HbA1c.</p> <p><u>Limitations</u></p> <p>Meta-analysis was limited by the small number of studies using QUS and pQCT and lack of use BMD z-scores in all studies. </p> <p><u>Conclusions</u></p> <p>Bone development is abnormal in youth with type 1 diabetes, assessed by multiple modalities. Routine assessment of BMD should be considered in all youth with type 1 diabetes.</p>

Changes in Bone Mineral Density in Young Adults with Type 1 Diabetes Mellitus

2013 ◽  
Vol 20 (3) ◽  
pp. 297-306
Author(s):  
Monica Goia-Socol ◽  
Ileana Duncea ◽  
Gabriela Roman ◽  
Mihai-Andrei Goia-Socol ◽  
Daniel-Corneliu Leucuţa ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Bone Mineral Density ◽  
Type 1 Diabetes ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Type 1 Diabetes Mellitus ◽  
Bone Mineral ◽  
Young Patients ◽  
Mineral Density

Abstract Background and aims: Type 1 diabetes mellitus (T1DM) represents a secondary cause of osteoporosis. Our aim was to determine bone mineral density (BMD) changes in a group of young Romanian adults with T1DM and to analyze the factors related to this disease that could have had an impact on bone mass. Material and Methods: Fifty-two young patients with T1DM were compared to 37 healthy volunteers matched for body mass index (BMI). All subjects had their BMD measured at the hip and lumbar spine. Results: We found no statistically significant differences in BMD between T1DM patients and controls (p=0.618 for lumbar spine, p=0.974 for femoral neck and p=0.883 for total hip). Multiple linear regression models detected BMI (p =0.043), smoking (p=0.001) and milk intake (p=0.004 for lumbar spine) as significant BMD determinants. In contrast, no associations were found between BMD and metabolic control, daily insulin dose or presence of diabetic retinopathy and/or neuropathy. Long diabetes duration was negatively associated with BMD in femoral neck (p=0.012). Conclusions: Although we couldn’t find differences between BMD in T1DM patients and controls, the link between diabetes duration and BMD that we found suggests that even young patients with long standing T1DM should have their BMD measured

scholarly journals Bone Mineral Density and Type 1 Diabetes in Children and Adolescents: A Meta-analysis

2021 ◽  
Author(s):  
Phoebe Loxton ◽  
Kruthika Narayan ◽  
Craig F Munns ◽  
Maria E Craig
Keyword(s):  
Bone Mineral Density ◽  
Type 1 Diabetes ◽  
Lumbar Spine ◽  
Bone Mineral ◽  
Meta Analysis ◽  
Inclusion Criteria ◽  
Mineral Density ◽  
Multiple Modalities ◽  
Meta Regression

<u>Background</u> <p>There is substantial evidence that adults with type 1 diabetes have reduced bone mineral density (BMD), however findings in youth are inconsistent.</p> <p><u>Purpose</u></p> <p>Systematic review and meta-analysis of BMD in youth with type 1 diabetes using multiple modalities: dual energy X-ray absorptiometry (DXA), peripheral quantitative computed tomography (pQCT) and/or quantitative ultrasound (QUS).</p> <p><u>Data Sources</u></p> <p>PubMed, Embase, Scopus and Web of Science from 01/01/1990 to 31/12/2020, limited to humans, without language restriction.</p> <p><u>Study Selection</u></p> <p>Inclusion criteria: cross sectional or cohort studies that included BMD measured either by DXA, pQCT and/or QUS in youth (age <20 years) with type 1 diabetes and matched controls. </p> <p><u>Data extraction</u></p> <p>Total body (TB), lumbar spine (LS) and femoral BMD (DXA); tibia, radius and lumbar spine (pQCT); and phalanx and calcaneum (QUS). Weighted mean difference (WMD) or standardized mean difference (SMD) were estimated and meta-regression was performed using age, diabetes duration and HbA1c as covariates.</p> <p><u>Data Synthesis </u></p> <p>We identified 1300 non-duplicate studies; 46 met the inclusion criteria, including 2617 cases and 3851 controls. Mean age was 12.6 ± 2.3 years. Youth with type 1 diabetes had lower BMD: TB (WMD -0.04 g/cm<sup>2</sup>, 95% CI -0.06 to -0.02, <i>P</i>=0.0006); LS (-0.02 g/cm<sup>2</sup>, -0.03 to -0.0, <i>P = 0.01</i>); femur (-0.04 g/cm<sup>2</sup>, -0.05 to -0.03, <i>P</i><0.00001); tibial trabecular (-11.32 g/cm<sup>3</sup>,-17.33 to -5.30, <i>P</i>=0.0002), radial trabecular (-0.91, -1.55 to -0.27, <i>P=0.005</i>); phalangeal (-0.32, -0.38 to -0.25, <i>P</i><0.00001) and calcaneal (SMD -0.69, -1.11 to -0.26, <i>P</i>=0.001). Using meta-regression TB BMD was associated with older age (coefficient -0.0063, -0.0095 to -0.0031, <i>P</i>=0.002), but not longer diabetes duration or HbA1c.</p> <p><u>Limitations</u></p> <p>Meta-analysis was limited by the small number of studies using QUS and pQCT and lack of use BMD z-scores in all studies. </p> <p><u>Conclusions</u></p> <p>Bone development is abnormal in youth with type 1 diabetes, assessed by multiple modalities. Routine assessment of BMD should be considered in all youth with type 1 diabetes.</p>

scholarly journals Bone mineral density predictors in long-standing type 1 and type 2 diabetes mellitus

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Stefana Catalina Bilha ◽  
Letitia Leustean ◽  
Cristina Preda ◽  
Dumitru D. Branisteanu ◽  
Laura Mihalache ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Mineral Density ◽  
Cross Sectional ◽  
The Impact

Abstract Background Despite the increased fracture risk, bone mineral density (BMD) is variable in type 1 (T1D) and type 2 (T2D) diabetes mellitus. We aimed at comparing independent BMD predictors in T1D, T2D and control subjects, respectively. Methods Cross-sectional case-control study enrolling 30 T1D, 39 T2D and 69 age, sex and body mass index (BMI) – matched controls that underwent clinical examination, dual-energy X-ray absorptiometry (BMD at the lumbar spine and femoral neck) and serum determination of HbA1c and parameters of calcium and phosphate metabolism. Results T2D patients had similar BMD compared to T1D individuals (after adjusting for age, BMI and disease duration) and to matched controls, respectively. In multiple regression analysis, diabetes duration – but not HbA1c- negatively predicted femoral neck BMD in T1D (β= -0.39, p = 0.014), while BMI was a positive predictor for lumbar spine (β = 0.46, p = 0.006) and femoral neck BMD (β = 0.44, p = 0.007) in T2D, besides gender influence. Age negatively predicted BMD in controls, but not in patients with diabetes. Conclusions Long-standing diabetes and female gender particularly increase the risk for low bone mass in T1D. An increased body weight partially hinders BMD loss in T2D. The impact of age appears to be surpassed by that of other bone regulating factors in both T1D and T2D patients.

scholarly journals Bone Mineral Density across the Lifespan in Patients with Type 1 Diabetes

2019 ◽  
Vol 105 (3) ◽  
pp. 746-753 ◽  
Author(s):  
Eitan Halper-Stromberg ◽  
Tyler Gallo ◽  
Anagha Champakanath ◽  
Iman Taki ◽  
Marian Rewers ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Body Mass Index ◽  
Type 1 Diabetes ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Postmenopausal Women ◽  
Age Groups ◽  
Mineral Density ◽  
Age And Sex

Abstract Context Fracture risk in people with type 1 diabetes (T1D) is higher than their peers without diabetes. Objective To compare bone mineral density (BMD) across the lifespan in individuals with T1D and age- and sex-matched healthy controls. Design Cross-sectional. Setting Subjects (5–71 years) with T1D and matched controls from ongoing research studies at Barbara Davis Center for Diabetes. Patients or other participants Participants with lumbar spine BMD by dual X-ray absorptiometry (DXA) were divided into 2 groups: children ≤20 years and adults &gt;20 years. Intervention None. Main outcome measures Comparison of BMD by diabetes status across age groups and sex using a linear least squares model adjusted for age and body mass index (body mass index (BMI) for adults; and BMI z-score in children). Results Lumbar spine BMD from 194 patients with T1D and 156 controls were analyzed. There was no difference in age- and BMI-adjusted lumbar spine BMD between patients with T1D and controls: among male children (least squares mean ± standard error of the mean [LSM ± SEM]; 0.80 ± 0.01 vs 0.80 ± 0.02 g/cm2, P = .98) or adults (1.01 ± 0.03 vs 1.01 ± 0.03 g/cm2, P = .95), and female children (0.78 ± 0.02 vs 0.81 ± 0.02 g/cm2, P = .23) or adults (0.98 ± 0.02 vs 1.01 ± 0.02 g/cm2, P = .19). Lumbar spine (0.98 ± 0.02 vs 1.04 ± 0.02 g/cm2, P = .05), femoral neck (0.71 ± 0.02 vs 0.79 ± 0.02 g/cm2, P = .003), and total hip (0.84 ± 0.02 vs 0.91 ± 0.02, P = .005) BMD was lower among postmenopausal women with T1D than postmenopausal women without diabetes. Conclusion Across age groups, lumbar spine BMD was similar in patients with T1D compared with age- and sex-matched participants without diabetes, except postmenopausal females with T1D had lower lumbar spine, femoral neck, and total hip BMD.

scholarly journals Analysis of bone mineral density and relevant factors in patients with type 1 diabetes

2014 ◽  
Vol 66 (3) ◽  
pp. 1091-1096 ◽  
Author(s):  
Peng Duan ◽  
Ping Tu ◽  
Heping Wu ◽  
Xun Ding ◽  
Jiang Liu ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Type 1 Diabetes ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Plasma Glucose ◽  
Healthy Controls ◽  
Mineral Density ◽  
C Peptide ◽  
Relevant Factors

We investigated changes in bone mineral density (BMD) and relevant factors of BMD in patients with type 1 diabetes (T1D). A total of 47 patients with T1D and 40 healthy controls participated in this study. The waist-to-hip ratio (WHR) and body mass index (BMI) were calculated after physical examination. The lumbar spine (L2-L4) BMD and left femoral neck BMD were examined. Blood samples were collected. The BMI, WHR, fasting C peptide (FCP), postprandial C peptide (2hCP), lumbar spine and left femoral neck BMD of the patients with T1D were significantly lower than those of healthy controls, while the fasting plasma glucose (FPG), postprandial plasma glucose (2hPG) and hemoglobin A1c (HbA1c) were higher (P <0.05). Duration of T1D and HbA1c were negatively correlated with lumbar spine and left femoral neck BMD. The FCP and 2hCP were positively correlated with lumbar spine and left femoral neck BMD.

Bone Mineral Density and Type 1 Diabetes in Children and Adolescents: A Meta-analysis

Diabetes Care ◽  
2021 ◽  
pp. dc203128
Author(s):  
Phoebe Loxton ◽  
Kruthika Narayan ◽  
Craig F. Munns ◽  
Maria E. Craig
Keyword(s):  
Bone Mineral Density ◽  
Type 1 Diabetes ◽  
Children And Adolescents ◽  
Bone Mineral ◽  
Meta Analysis ◽  
Mineral Density
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