Ultrasonographic Bone Evaluation in Young Women with Type 1 Diabetes
Journal Title: Journal of Endocrinology and Diabetes - Year 2018, Vol 5, Issue 2
Abstract
Purpose: A relationship between Type 1 Diabetes Mellitus (T1DM) and an impaired bone quality is well known, although the pathogenesis of this link is not yet clear. In this study we have investigated the bone status in young women with T1DM, using the Bone Quantitative Ultra-Sound ( bQus) at the hand phalanges, a screening tool of osteoporosis. We preferred bQus to DXA because of the young age of the population recruited and the easy accessibility of the device, although, recently, the absence of technology-specific guidelines has created uncertainty respect to the application of bQus results in the management of individual patients in clinical practice. However, in past, studies in vitro showed that bQus parameters were significantly associated with Bone Mineral Density (BMD), bone micro architecture and mechanical indices. In humans, bQus parameters were found to be associated with BMD as well, then this tool could discriminate and screen subjects and predict risk for future fracture. Methods: A consecutive series of 55 young women affected by T1DM were recruited and subjected to phalangeal bQUS. The glycemic control, estimated by HbA1c values, insulin requirement, major risk factors for osteoporosis, chronic diabetic complications and associated autoimmune diseases were evaluated. Bone-QUS data obtained were compared with those of a group of matched healthy controls. Results: The prevalence of osteoporosis in patients group is very small; however T1DM women showed worse ultrasonographic bone parameters than healthy controls. Their data did not correlate to the age of patients, Body Mass Index (BMI), diabetes onset and duration of the disease and not differ in relation to the presence of chronic diabetic complications and autoimmune diseases, kind of insulin administration and cigarette smoking. Instead, significant correlations between ultrasonographic values and HbA1c (negative correlation, p< 0,05), insulin daily requirement (positive correlation, p< 0,02) and calcium dietary intake (positive correlation p< 0,02) were found. Conclusion: This study confirms the bone status alterations in T1DM, even in young women compared with healthy controls. The bone quality is related to the glycemic control and insulin requirement, but not to the diabetes duration. Moreover, a low calcium dietary intake could worsen the bone health status. Then, strategies to prevent and treat osteoporosis in people with diabetes should be applied: a diet rich in calcium, vitamin D supplementation, exercise, healthy lifestyle, bone density test and an effective glycemic control should be encouraged in order to prevent diabetes-induced osteoporosis. The bQUS is a method easily accessible, low-cost, non-invasive, non-ionizing, that could be widely used for osteoporosis screening in young patients with T1DM.
Authors and Affiliations
Borzì G, Russo M, Guardo F, Migliorino V, Frittitta L, Sciacca L, Padova G
Keywords
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- EP ID EP334092
- DOI 10.15226/2374-6890/5/2/00199
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