Skip to main content
Log in

Evaluation of bone mineral density in children with diabetes mellitus

  • Original Article
  • Published:
The Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Multiple studies have documented reduction in peripheral bone mass in children with insulin dependent diabetes mellitus (IDDM). In this study, the bone mineral density (BMD) of the lumbar vertebrae (L2–L4) was measured by dual photon absorptiometry in 14 female and 16 male diabetic patients of age 11 to 16 years with varying clinical duration. Twenty three children between 11 to 16 years with normal anthropometric measurements between 10th and 97th percentile and no known history of metabolic bone disease served as a control group. BMD values, weight, height, body mass index, metabolic, biochemical and growth parameters of the study group were compared with those of the control group. BMD (L2 AP 0.732±0.15 gm/cm2, L2 lateral 0.534 ±0.09 gm/cm2in the study group and 0.812±0.63 gm/cm2 and 0.619±0.20 gm/cm2 in the control group) and osteoccalcin (10.10±3.40 ng/ml and 23.12±2.74 ng/ml in diabetes and control respectively) levels were significantly lower in diabetic patients (p<0.05, p<0.01 respectively). Within the study group BMD correlated positively with age but not with the duration of the disease nor with the level of metabolic control.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Marvin EL, Vincenza CB, Louis VA. Effects of diabetes mellitus in juvenile and adult onset diabetes.N Engl J Med 1976; 294: 241–245.

    Article  Google Scholar 

  2. Stephan WP, David PM, Danial F, An DT, Gerald WO, Ben HB. Bone mineral density of the lumbar vertebrae in children and adolescents with insulin-dependent diabetes mellitus.J Pediatr 1992; 120: 541–545.

    Article  Google Scholar 

  3. Stephan WP, David PM, Daniel F, Judy LP, Margaret GM, Ben HB. Spinal bone mineral density in children aged 5.00 through 11.99 years.AJDC 1990; 144: 1346–1348.

    Google Scholar 

  4. Siu LH, Solomon E, Conrad CJ. A prospective study of bone mass in patients with type 1 diabetes.J Clin Endocrinol Metab 1985; 60: 74–80.

    Google Scholar 

  5. Catherine G, Pierre B, Louis D, Pierre C, Pierre JM, Pierre DD. Measurement of bone mineral content of the lumbar spine by dual energy X-ray absorptiometry in normal children. Correlations with growth parameters.J Clin Endocrinol Metab 1990; 70: 1330–1333.

    Google Scholar 

  6. Hosada K, Kanzaki S, Eguchi Het al. Secretion of osteocalcin and its propeptide from human osteoblastic cells: dissociation of the secretory patterns of osteocalcin and its propeptide.J Bone Miner Res 1993; 8: 553–565.

    Article  Google Scholar 

  7. Rio DL, Carrascosa A, Pons F, Gusinye M, Yeste D, Domenech MF. Bone mineral density of lumbar spine in white mediterranean Spanish children and adolescents: Changes related to age, sex, and puberty.Pediatr Res 1994; 35: 362–366.

    Article  PubMed  Google Scholar 

  8. Waud CE, Markes SC, Lev R, Baran DT. Bone mineral density in the femur and lumbar vertebrae decreases after twelve weeks of diabetes in spontaneously diabetic prone BB/Worcester rats.Calcif Tissue Int 1994; 54: 237–240.

    Article  PubMed  CAS  Google Scholar 

  9. Roe TF, Mora S, Costin Get al. Vertebral bone density in insulin dependent diabetic children.Metabolism 1991; 40: 967–971.

    Article  PubMed  CAS  Google Scholar 

  10. Scott D, Robins SP, Nicol P, Chen XB, Buchan W. Effects of low phoshate intake on bone mineral metabolism and microbial protein systhesis in lambs.Exp Physicol 1994; 79 (2): 183–187.

    CAS  Google Scholar 

  11. Bouillon R. Diabetic bone disease. Low turnover osteoporosis related to decreased IGF-1 production.Verh K Acad Geneeskd Belg 1992; 54 (4): 365–391.

    PubMed  CAS  Google Scholar 

  12. Juul A, Dagaard P, Blum FWet al. Serum levels of Insulin-like growth factor (IGF) Binding protein-3 (IGFBP-3) in healthy infants, children and adolescent. The relation to IGF-1, IGF-II, IGFBP-1, IGFBP-2, age, sex, body mass index, and pubertal maturation.J Clin Endoc Metab 1995; 80 (8): 2534–2542.

    Article  CAS  Google Scholar 

  13. McNair P, Madsbad S, Christensen MSet al. Hypoparathyroidism in diabetes mellitus.Acta Endocronologica 1981; 96: 81–86.

    CAS  Google Scholar 

  14. McNair P, Madsbad S, Christensen MS, Christensen C, Faber OK, Binder C, Transbol I. Bone mineral loss in insulin treated diabetes mellitus: studies on pathogenesis.Acta Endocrinol 1979; 90: 463–467.

    PubMed  CAS  Google Scholar 

  15. Hough FS. Alterations of bone and mineral metabolism in diabetes mellitus.SAMJ 1987; 80: 120–126.

    Google Scholar 

  16. Heath H, Lambert PW, Service FJ. Calcium homeostasis in diabetes mellitus.J Clin Endocrinol Metab. 1979; 49: 462–466.

    Article  PubMed  CAS  Google Scholar 

  17. Rosenbloom AL, Lezotte CD, Weber FT, Gudat Jet al. Diminution of bone mass in childhood diabetes.Diabetes 1977; 26: 1052–1055.

    Article  PubMed  CAS  Google Scholar 

  18. Forest MG. Adrenal steroid excess.Clinical Paediatric Endocrinology. Brook (ed), Blackwell science. Third Edition 1995; p. 499–535.

  19. Johnston CC, Slemenda CW, Melton JL. Clinical use of bone densitometry.N Eng J Metabol 1991; 324 (16): 1105–1109.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ersoy, B., Gökşen, D., Darcan, S. et al. Evaluation of bone mineral density in children with diabetes mellitus. Indian J Pediatr 66, 375–379 (1999). https://doi.org/10.1007/BF02845528

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02845528

Key words

Navigation