STUDY TO KNOW EFFECTS ON BONE METABOLISM IN TYPE 1 DIABETIC CHILDREN

Children and adolescents with diabetes mellitus (DM) type 1 demonstrate a significant deterioration of metabolism and bone structure, resulting in a reduction in bone mass and associated risk of complications in the future.

Objective: To observe the effects of diabetes mellitus on bone status of children (9 to 15 years of age) by measuring bone remodeling markers and correlating these parameters with the severity of the disease.

Study Design: Across-sectional study.

Place and Duration:In the Paediatric Department of Services Hospital Lahore in collaboration with physiology department for Six months duration from November 2018 to April 2019.

Method: Sixty children aged 9-15 years were selected. The control group comprised of 30 healthy non-diabetic children. The diabetic group consisted of 30 children suffering from diabetes mellitus type 1. Insulin-like growth factor 1 (IGF-1), growth factor binding protein and Parathyroid hormone (PTH) and bone remodeling were determined by insulin type 3 (IGFBP-3) ELISA. HbA1C values were determined by liquid affinity chromatography. Bone mineral density (Z score) was measured with a bone profile.

Results: The difference between IGF-1, IGFBP-3 and bone mineral density (Z score) levels was not statistically significant in both groups. However, parathyroid hormone levels were expressively lower in diabetic children paralleled to non-diabetic controls (p <0.05). Correlation of parameters with HbA1C levels and bone mineral density was not significant.

Conclusion: Type 1 diabetes mellitus did not significantly affect bone mineral density and serum IGF-1 and IGFBP-3 levels. However, diabetes mellitus produces significantly lower levels of parathyroid hormones, indicating that diabetic children have less bone turnover.

Key words: diabetes mellitus type 1, parathyroid hormone (PTH), IGF, IGFBP-3.