THE RELATIONSHIP BETWEEN HAND GRIP STRENGTH AND HAND BONE MINERAL DENSITY IN CHILDREN WITH INSULIN DEPENDENT DIABETES MELLITUS

We thought that grip strength in patients with IDDM would be associated with hand BMD of patients and we thought that patients with IDDM have lower hand BMD than normal subjects.Therefore in this study, the evaluation of the relationship between hand grip strength and hand bone mineral density in healthy children and in children with insulin dependent diabetes mellitus was studied. The hand grip strength, hand and axial bone mineral density of patients were also compared to age-matched healthy controls. We studied 31 consecutive outpatients with insulin dependent diabetes mellitus defined in accordance to the World Health Organization criteria, who attended to the diabetic outpatient clinic. Thirty two healthy children were included as control group. There were no differences in the age, body mass index, bone age, serum Ca and P levels between the diabetic patients and the controls (p > 0.05). There were no significant differences between the groups in hand grip strength, total hand and axial bone mineral density (p > 0.05). There were significant correlations between hand grip strength and hand bone mineral density r = 0.824, p = 0.000), axial bone mineral density (r = 0.714, p = 0.000), bone age (r = 0.830, p = 0.000) and duration of insulin dependent diabetes mellitus in the diabetic group (r = 0.463, p = 0.009). When linear multiple regression analysis was performed hand grip strength and bone age were independent predictors of hand BMD (p < 0.05). We found that hand grip strength significantly correlated with the hand and axial bone mineral density in patients with insulin dependent diabetes mellitus. We suggest that strengthening exercises should be encouraged to increase bone mineral density in these patients.