status of bone mineral density in children with type 1 diabetes mellitus and its related factors

Background: type 1 diabetes mellitus (dm) causes changes in bone mineral density (bmd). objectives: the aim of this study was to evaluate bmd in children with type 1 dm and predictive factors of bmd loss in these patients. methods: this cross-sectional study was conducted on 112 children with type 1 dm referrtd to children’s medical center in tehran, iran during 2015 and 2016. serum levels of hemoglobin a1c (hba1c), insulin-like growth factor 1 (igf-1), 25-hydroxy vitamin d (25(oh) d), calcium, phosphorus, parathyroid hormone (pth), alkaline phosphates (alp), fasting blood sugar (fbs) was recorded. lumbar spinal bmd (l1-l4) was measured in all patients by dual energy x-ray absorptiometry (dexa). a bmd z-score of ≥ -1 was accepted as normal; between -1 and -2, in the low range of normality; and ≤ -2 , low bmd. bone mineral content (bmc) was calculated by dexa and recorded. results: median age was 12.5 (4 - 14) years. low bmd and bmd in the low range of normality were diagnosed in 17 (15.2%) and 25 (22.3%) of patients, respectively. there was a significant correlation between bmd and patient age (p < 0.001), age of onset of diabetes (p < 0.001), igf-1 (p = 0.002), hba1c (p = 0.001) and pth (p = 0.040) but only hba1c increased level significantly predicted reduction of bmd. conclusions: glycemic control in children with type i diabetes is mainly predictor of changes in bmd and the changes in bmd were observed mainly in older ages and is independent of gender.