Endocrine Abstracts

Background: Care of patients with diabetes should include an assessment of bone health. It is now clear that patients with type I DM have lower bone mineral density which may be manifested as osteopenia in growing skeleton and higher risk of fractures.

Objective: To assess bone modelling through the measurement of bone formation and resorption indexes in diabetic children and their correlations with metabolic parameters.

Methods: We study 120 patients with type 1 DM (F=68, M=52) follow up diabetic clinic paediatric clinic at Benghazi children hospital, and we divided them to two groups according to duration of disease; group I (diabetic children with <1 year duration of disease) and group II (diabetic children >1 year duration). The following informations were collected gender, age, duration of disease, weight, height measurements were taken, Ca, Po4, ALK, PTH, osteocalcin, B-crosslaps, fasting blood glucose were taken during these visits in all groups and compared them with 99 healthy children (F=44, M=55) as control (group III).

Results: Fasting blood glucose significantly higher in both diabetic groups and s.Ca, s.Po4, PTH, were normal in diabetic groups, ALP levels were high in diabetic groups s.Osteocalcin and s.B-crosslaps values decreased in both diabetic groups. The changes in serum OC levels significantly correlate with changes in B-crosslaps, negative weak correlation between changes in OC levels, B-Crosslaps levels with FBG, NO correlation were found between changes in metabolic bone markers and duration of disease.

Conclusion: Poorly controlled type 1 diabetes mellitus groups are accompanied with low bone formation rate, and metabolic bone markers correlated positively with age but not with the duration of disease, and insulin has anabolic effect on bone, and it is tempting to hypothesize that abnormal insulin levels contribute to abnormalities of bone metabolism.