Adolescent Girls With Type 1 Diabetes Develop Changes in Bone Prior to Evidence of Clinical Neuropathy
Authors' conclusion
Our study defines early deficits in trabecular bone microarchitecture, decreased cortical porosity in the tibia, and suppression of biomarkers of bone turnover in adolescent girls with T1D, prior to the onset of symptomatic peripheral neuropathy. These findings inform our understanding of the rapid progression of skeletal disease in young girls with T1D and suggests that early detection and management strategies may help to prevent fracture and related comorbidities later in life.
Study context
- Population
- Adolescent girls with T1D and associated controls
- Participants
- 21 vs 12
- Exposure
- Adolescent girls with T1D vs controls
- T1Dn = 21
- Controlsn = 12reference
- Outcome
- Bone microarchitecture by high-resolution peripheral quantitative CT, adjusted for body size
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
- Lower with T1D
- trabecular bone volume fraction, distal radius −14.6%; P-adj = .095
- Lower with T1D
- trabecular bone volume fraction, tibia −12.8%; P-adj = .017
- Decreased with T1D
- trabecular thickness, radius −8.3%; P-adj = .007
- Decreased with T1D
- trabecular thickness, tibia −7.5%; P-adj = .034
- Increased with T1D
- cortical BMD, tibia 8.6%; P-adj = .024
- Decreased with T1D
- cortical porosity, tibia 52.9%; P-adj = .012
Observational data: associations, not effects.
Further findings
| Outcome | T1D | Estimate | P value |
|---|---|---|---|
| Circulating bone turnover markersLower with T1D | osteocalcin −30% | P = 0.057 | |
| Circulating bone turnover markersLower with T1D | CTX −36% | P = 0.035 | |
| Clinical diabetic peripheral neuropathy (Michigan Neuropathy Screening Instrument) | 9.5% |
Bone density by DXA
- No significant differences in bone density by DXA
Clinical diabetic peripheral neuropathy (Michigan Neuropathy Screening Instrument)
- Neuropathy status failed to explain the T1D-associated changes in bone
Original publication
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