Bone mineral acquisition in adolescents with type 1 diabetes
Bone mineral acquisition in adolescents with type 1 diabetes
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DOI：
10.1016/j.jpeds.2004.06.070
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发表时间：
2004-11-01
影响因子：
5.1
通讯作者：
Murray, MA
中科院分区：
文献类型：
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作者：
Moyer-Mileur, LJ;Dixon, SB;Murray, MA
目的追踪青少年1型糖尿病(DM)患者的骨矿物质获取情况。研究设计对象为12~18岁的青少年，糖尿病患者(n=42)和健康地区参考者(n=199)。在12个月的时间里，采用外周定量计算机断层扫描(PQCT)和双能X线骨密度仪(DEXA)测量脊柱和全身(WB)，测量人体测量学和生活方式问卷。记录前12个月的病程、胰岛素用量、肾功能和糖化血红蛋白(HbAlc)。糖尿病患者在基线和12个月时具有较低的胫骨、脊柱和WB骨特征，但肌肉质量(LBM)和骨矿含量(BMC)/LBM较低。胫骨皮质骨和WB BMC/LBM的年增长较低，且与HbAlc水平呈负相关(R=-0.36~-0.51)，而脊柱面积和密度以及WBLBM较大，并由青春期驱动的生长预测。总体而言，糖尿病组的WBBMC/LBM降低了8.5%，这表明骨矿物质沉积不能充分适应肌肉的增长。结论青少年1型糖尿病患者尽管发育和成熟正常，但骨量和骨尺寸仍然较小。代谢控制不良似乎会对骨矿物质的获取产生负面影响。
Objective To track bone mineral acquisition in adolescents with type 1 diabetes (DM).Study design Subjects were adolescents, ages 12 to 18 years, with DM (n = 42) and a healthy regional reference (n = 199). Measurements of tibia bone characteristics by peripheral quantitative computed tomography (pQCT) and spine and whole body (WB) by dual-energy x-ray absorptiometry (DEXA), anthropometrics, and lifestyle questionnaires were obtained during a 12-month period. Disease duration, insulin dose, renal function, and glycosylated hemoglobin (HbAlc) values for the previous 12 months were recorded.Results Body size and maturation were similar between groups. DM had lower tibia, spine, and WB bone characteristics but greater muscle mass (LBM) and lower bone mineral content (BMC)/LBM at baseline and 12 months. Annual gains for tibia cortical bone and WB BMC/LBM were lower and inversely related to HbAlc levels (R = -0.36 to -0.51), whereas spine area and density and WBLBM were greater and were predicted by pubertal-driven growth. Overall, the DM cohort had 8.5% less WB BMC/LBM, suggesting that bone mineral deposition was not adequately adapted to muscle gains.Conclusions Adolescents with type 1 diabetes continue to have smaller bone mass and bone size despite normal growth and maturation. Poor metabolic control appears to negatively influence bone mineral acquisition.