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Association between type 1 diabetes mellitus and reduced bone mineral density in children: a meta-analysis

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Abstract

Summary

In this meta-analysis, we analyzed 9 cross-sectional studies for an association between type 1 diabetes mellitus (T1DM) and bone mineral density (BMD) in children. We found that BMD Z-scores were significantly reduced in children with T1DM.

Introduction

Recent cross-sectional studies have examined how T1DM influences bone health in children and adolescents, but the relationship between T1DM and BMD remains unclear due to conflicting reports.

Methods

In this meta-analysis, we systematically searched PubMed, Cochrane library, and Web of Science databases (for publications through March 12, 2020), and calculated weight mean difference (WMD) along with 95% confidence intervals (CI) using a random-effects model. Heterogeneity was evaluated using the I2 method. The Newcastle-Ottawa Scale was used to assess the quality of the included studies.

Results

Data were analyzed from 9 eligible studies, including a total of 1522 children and adolescents. These data were tested for an association between T1DM and BMD. This analysis found a significant decrease in BMD Z-score in the whole body (pooled WMD, − 0.47, 95% CI, − 0.92 to − 0.02, I2 = 80.2%) and lumbar spine (pooled WMD, − 0.41, 95% CI, − 0.69 to − 0.12, I2 = 80.3%) in children and adolescents with T1DM, which was consistent in published studies from Asia and South America, but inconsistent in the North America and Europe. Importantly, the differences in BMD Z-scores were independent of age, level of glucose control (HbA1c), and prepubertal stage. Sensitivity analyses did not modify these findings. Funnel plot and the Egger test did not reveal significant publication bias.

Conclusion

This meta-analysis suggests that T1DM may play a role in decreasing BMD Z-scores in the whole body and lumbar spine in children.

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Author notes

  1. Q. Zhu and J. Xu contributed equally to this work.

Authors and Affiliations

  1. Department of Translational Medicine Platform, Affiliated Hospital of Hangzhou Normal University, No. 126 Wenzhou Road, Gongshu District, Zhejiang Province, 310000, Hangzhou, China

    Q. Zhu

  2. Medical College of Hangzhou Normal University, No.2318 Yuhangtang Road, Yuhang District, Zhejiang Province, 311121, Hangzhou, China

    J. Xu

  3. Department of Neurology, Affiliated Hospital of Hangzhou Normal University, No. 126 Wenzhou Road, Gongshu District, Zhejiang Province, 310000, Hangzhou, China

    M. Zhou

  4. Metabolic Disease Center and Department of Orthopedics, Affiliated Hospital of Hangzhou Normal University, No. 126 Wenzhou Road, Gongshu District, Zhejiang Province, 310000, Hangzhou, China

    X. Lian

  5. Department of Endocrinology, Xinqiao Hospital, Army Medical University, No. 83 Xinqiaozheng road, Shaping District, Chongqing, 400037, China

    J. Xu

  6. Department of Hepatology & Infectious Diseases, Affiliated Hospital of Hangzhou Normal University, No. 126 Wenzhou Road, Gongshu District, Zhejiang Province, 310000, Hangzhou, China

    J. Shi

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  1. Q. Zhu
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Zhu, Q., Xu, J., Zhou, M. et al. Association between type 1 diabetes mellitus and reduced bone mineral density in children: a meta-analysis. Osteoporos Int 32, 1143–1152 (2021). https://doi.org/10.1007/s00198-020-05715-3

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