[Evolution of bone mass in children and adolescents with type 1 diabetes mellitus].

Background And Objective: There is some controversy over bone mineral density (BMD) in children and teenagers with type 1 diabetes mellitus (DM1). We evaluated BMD by dual-energy X-ray absorptiometry (DXA) and correlated it with anthropometric, biochemical and hormonal parameters related to bone metabolism.

Patients And Method: Sixty-six patients with DM1 (26 males and 40 females) aged between 3 and 17 years, and 327 controls with a similar age were studied.

Results: The BMD of all diabetic patients was not different from that of the controls. However, the subgroup of older males (between 15 and 17 years) had a significantly inferior BMD than controls of the same age: mean (standard deviation), 0.888 (0.13) versus 0.994 (0.11) (p = 0.027). BMD was inferior to -1 standard deviation (Z-score) in 21.2% of diabetic children. All the biochemical and hormonal parameters were within the normality rank. There was a negative correlation between the evolution time of the disease and the levels of 25-hydroxycholecalciferol (r = -0.345; p = 0.006). We did not observe any correlation between BMD and the remaining studied parameters.

Conclusions: These results confirm that initially children and adolescents with non-complicated DM1 have no alteration of the bone mass. Yet the BMD physiological increase is smaller in the diabetic population than in controls during the adolescence period, which may cause a lower peak of bone mass in these patients.