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ORIGINAL ARTICLE
Year : 2020  |  Volume : 33  |  Issue : 2  |  Page : 101-106

Evaluation of bone mineral density in type I diabetic children attending the diabetes clinic of Alexandria University Children’s Hospital


1 Department of Pediatric, Pediatric Endocrinology and Diabetology Unit, Alexandria University, Alexandria, Egypt
2 Department of Pediatric, Alexandria University, Alexandria, Egypt
3 Department of Radiodiagnosis, Alexandria University, Alexandria, Egypt

Correspondence Address:
Shaymaa Elsayed A Meguid
Department of Pediatric Endocrinology and Diabetology, Alexandria University, Alexandria, 21526
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/AJOP.AJOP_25_20

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Introduction Type 1 diabetes mellitus (T1DM) is associated with reduced bone mineral density (BMD). Potential pathogenic mechanisms of T1DM-related bone damage may include the deficiency of insulin and insulin-like growth factors. Early identification of reduced BMD is useful in reducing the bone loss and fracture risk. We can get a quick, noninvasive, and accurate quantitation of bone mass by using dual-energy X-ray absorptiometry (DEXA scan). Aim The aim was to assess BMD in children with T1DM of 5-year duration or more and to evaluate its relation with the glycemic control. Patients and methods This study included 30 children with T1DM attending the diabetic clinic in Alexandria University Children’s Hospital, Egypt. They were compared with 30 apparently healthy children of matched age and sex. Thorough history taking and clinical examination were done with emphasis on age and duration of diabetes and history of fractures. Laboratory investigations were done including renal functions, serum calcium (Ca), phosphorus (P), alkaline phosphatase, and glycosylated hemoglobin (HbA1C). BMD was assessed by DEXA scan at the spine (L2–L4) and at the femur. Results The mean age of the diabetic cases was 12.2 years, with mean of 7.6 years as duration of diabetes. There was no significant difference between the two groups regarding the serum levels of Ca and P, but alkaline phosphatase was significantly higher in diabetic cases than in controls. A total of nine diabetic cases (30%) had low bone density (Z score < −2 SD by DEXA scan). The diabetic cases had lower mean BMD results than in control group. Conclusion Reduced BMD is common in children with T1DM. The authors recommend assessing children with T1DM by DEXA scan for early identification of reduced BMD to reduce the fracture risk.


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