Osteoprotegerin serum levels in children with type 1 diabetes: a potential modulating role in bone status
Osteoprotegerin serum levels in children with type 1 diabetes: a potential modulating role in bone status
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DOI：
10.1530/eje.1.02052
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发表时间：
2005-12-01
影响因子：
5.8
通讯作者：
Chiarelli, F
中科院分区：
文献类型：
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作者：
Galluzzi, F;Stagi, S;Chiarelli, F
目的：儿童和青少年1型(胰岛素依赖型)糖尿病(T1 DM)表现出多种骨代谢和骨结构障碍，导致日后骨量减少及其相关并发症的风险增加。核因子-kappa B配体(RANKL)/骨保护素(OPG)系统的改变与几种代谢性骨疾病有关，其特征是破骨细胞分化和激活增加以及骨吸收增强。设计：我们旨在评估一组无微血管并发症的青春期前T1 DM儿童的OPG水平，并探讨OPG水平与骨状态和血糖控制之间的可能关系。方法：26名青春期前T1 DM儿童，中位年龄9.9岁，范围4.1-13.1岁。年)进行了研究。所有患者均检测血清OPG、Hb A1c、甲状旁腺激素(PTH)和25-二羟基维生素D(25-D)水平。骨质量通过测量超声波在跟骨部位的衰减(宽带超声衰减(BUA))来确定。结果：与对照组相比，T1 DM儿童的Z-Score BUA明显降低(学生t检验，P<；0.0001)。糖尿病儿童的血浆骨钙素水平显著高于对照组(学生t检验，P<；0.0001)。在T1 DM儿童中，Z-Score BUA值与OPG(学生t检验，r=-0.62；P=0.001)和HbA1c(r=-0.59，P=0.007)呈显著相关。骨钙素水平与糖化血红蛋白呈显著正相关(r=0.56P=0.008)。在包括年龄、糖尿病病程、体力活动的多元回归分析中。钙摄入量、平均HbA1c和Z-Score BUA仅HbA1c预测血清OPG水平(β0.67；P=0.003)。血清OPG浓度与跟骨BUA和HbAlc值相关。OPG可作为T1 DM儿童骨量减少的新指标。
Objective: Children and adolescents with type 1 (insulin-dependent) diabetes mellitus (T1DM) show several impairment of bone metabolism and structure, resulting in a higher risk of decreased bone mass and its related complications later in life. Alterations of the nuclear factor-kappa B ligand (RANKL)/osteoprotegerin (OPG) system have been implicated in several metabolic bone diseases characterized by increased osteoclast differentiation and activation and enhanced bone resorption.Design: We aimed to assess OPG levels and to investigate the possible relation between OPG levels, bone status and glycemic control in a group of prepubertal children with T1DM without microvascular complications.Methods: Twenty-six prepubertal T1DM children (median age 9.9 years, range 4.1-13.1. years) were studied. In all patients, serum OPG, hemoglobin (Hb)A1c, parathyroid hormone (PTH) and 25-dihydroxyvitamin D (25-D) levels were evaluated. Bone quality was determined by measuring the attenuation of ultrasound waves by bone (broadband ultrasound attenuation (BUA)) at the calcaneal site. The data were compared with those of a group of 45 age-, sex-and body-size-matched healthy children.Results: Children with T1DM showed a reduced Z-score BUA in comparison with the control group (Student's t-test, P < 0.0001). Plasma OPG levels were significantly higher in diabetic children than in controls (Student's t-test, P < 0.0001). In T1DM children, Z-score BUA values displayed a significant correlation with OPG (Student's t-test, r = -0.62; P = 0.001), and HbA1c (r = -0.59; P = 0.007). OPG levels were significantly correlated with HbA1c (r = 0.56; P = 0.008). In a multiple regression analysis including age, duration of diabetes, physical activity. calcium intake, mean HbA1c and Z-score BUA, only HbA1c significantly predicted serum OPG levels (beta 0.67; P = 0.003).Conclusions: Prepubertal children with T1DM have a significant increase of OPG levels. OPG serum concentrations are correlated to calcaneal BUA and HbAlc values. OPG could be a new marker of reduced bone mass in children with T1DM.