ICEECE2012 Poster Presentations Paediatric endocrinology (47 abstracts)
Effect of calcitriol on bone metabolism in adolescents with type 1 diabetes
N. Napoli 1 , R. Strollo 1 , D. Pitocco 2 , C. Bizzarri 3 , E. Maddaloni 1 , D. Maggi 1 , S. Manfrini 1 , A. Schwartz 4 , P. Pozzilli 1 & IMDIAB group 1,
1Univesity Campus Bio-Medico, Rome, Italy; 2Catholic University, Rome, Italy; 3Bambino Gesù Children’s Hospital, Rome, Italy; 4Univesity of California, San Francisco, CA, USA.
Vitamin D supplementation in childhood improves the achievement of peak bone mass. We investigated the effect of calcitriol on bone turnover in recent-onset type 1 diabetes (T1D). Moreover, the association between osteocalcin (OC) and metabolic control was examined.
We conducted a post-hoc analysis of a double-blind, placebo-controlled study of calcitriol supplementation to preserve β-cell function. Twenty-seven recent-onset T1D, mean age 25.6 years (range 10–35) were randomized to calcitriol (0.25 μg/die) or placebo (1:1) and followed-up for 1 year. Changes in bone formation (OC) and resorption (β-CTx) markers, and differences between placebo and calcitriol-treated group were evaluated.
At T1D diagnosis, OC levels were lower in females than in males (P<0.01). No significant correlations were found in relation to HbA1c, insulin requirement and C-peptide. At 1 year follow-up, OC levels were increased (11%) in the placebo group while dropped by 25% in the calcitriol group, but their levels were not significantly different compared to diagnosis. By stratifying patients according to age, we found that at 1 year follow-up as compared to diagnosis, calcitriol-treated patients ≥18 years of age (n=6) showed significant 61% drop of OC (P=0.04) and a 67% reduction in β-CTx (P=0.09). In the same subgroup, OC tended to be lower (P=0.08) and β-CTx were significantly reduced (P=0.03) compared to placebo. Differences were not significant in patients >18 years of age (n=13). In the placebo group, OC levels were inversely related to C-peptide (r=−0.79; P<0.01) and tended to be positively related to insulin requirement (r=0.59; P=0.07). Baseline OC levels were inversely related to C-peptide changes from baseline (r=−0.68; P=0.03).
Our preliminary data suggest that calcitriol decreases bone remodeling in T1D adolescents and may preserve bone mass. After 1 year of insulin treatment in the placebo group, OC was negatively associated with C-peptide, thus questioning the role of OC as stimulator for β-cells.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This work was supported, however funding details unavailable.
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Endocrine Abstracts
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