Decreased bone mineral density and bone formation markers - Shortly after diagnosis of clinical type 1 diabetes mellitus

We recently demonstrated that children with type 1 diabetes mellitus (DM) h ave decreased lumbar spine bone mineral density (BMD) as early as four year s after clinical diagnosis of the disease, In order to determine whether os teopenia is already present in patients very early on after diagnosis of cl inical DM, we evaluated the bone mineral status of a group of newly diagnos ed children (5.8 +/- 1.5 mo after diagnosis). We studied 23 prepubertal chi ldren (7 M, 16 F) with a mean chronological age of 9.5 +/- 2.2 yr and a mea n glycosylated hemoglobin of 8.9 +/- 2.4%, Lumbar spine and femoral neck BM D were measured by dual X-ray absorptiometry, while bone turnover was asses sed by the determination of the serum concentration of the carboxyterminal propeptide of type I collagen (PICP) and the carboxy-terminal cross-linked telopeptide of type I collagen (N-telopeptide). Results were compared to th ose of age, height, and pubertal status matched controls, Lumbar spine BMD Z-scores were decreased in patients compared to controls (Z-scores of -0.89 +/- 1,2, with 10. of 22 patients showing values >1 SD below the mean). Whe n lumbar spine Z-scores were analyzed in those patients with <3 months or 2 3 months since diagnosis of DM a significant difference was noticed between groups (-0.648 +/- 1.12 vs -1.267 +/- 1.17; p <0.02), No significant diffe rences were noted in femoral neck BMD and total BMD between groups, Serum P ICP levels were decreased when compared to controls (233.6 +/- 39.3 vs 375. 9 +/- 50.7 mug/l; p <0.002), while serum N-telopeptide concentrations, alth ough increased, were not significantly different (9.3 +/- 1.3 vs 5.7 +/- 1. 5 mug/l) In summary, early on after the diagnosis of type 1 DM, children pr esent with decreased lumbar spine BMD and decreased bone formation markers.