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Pediatric Endocrinology Diabetes and Metabolism
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1/2020
vol. 26
 
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abstract:
Original paper

Metabolic bone markers can be related to preserved insulin secretion in children with newly diagnosed type 1 diabetes

Małgorzata Szymańska
1
,
Izabela Michałus
2
,
Marcin Kaszkowiak
3
,
Krystyna Wyka
1
,
Danuta Chlebna-Sokół
2
,
Wojciech Fendler
3, 4
,
Elżbieta Jakubowska-Pietkiewicz
5
,
Wojciech Młynarski
1
,
Agnieszka Szadkowska
6
,
Agnieszka Zmysłowska
6

  1. Department of Paediatrics, Oncology, and Haematology, Medical University of Lodz, Poland
  2. Centre for the Treatment of Osteoporosis and Other Bone Metabolic Diseases in Children, Lodz, Po-land
  3. Department of Biostatistics and Translational Medicine, Medical University of Lodz, Poland
  4. Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
  5. Department of Paediatrics, Neonatal Pathology, and Metabolic Bone Diseases, Medical University of Lodz, Poland
  6. Department of Paediatrics, Diabetology, Endocrinology, and Nephrology, Medical University of Lodz, Poland
Pediatr Endocrinol Diabetes Metab 2020; 26 (1): 10–16
DOI: https://doi.org/10.5114/pedm.2020.94391
Online publish date: 2020/04/25
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Introduction
Type 1 diabetes (T1D) may be associated with numerous complications including bone metabolism disorders. The aim of the study was to evaluate the bone metabolism markers twice in children with a newly diagnosed T1D and after an average of seven months of its duration in relation to parameters of the clinical course of diabetes.

Material and methods
In 100 T1D patients and 52 control subjects, the following bone turnover markers were evaluated: osteocalcin – OC, osteoprotegerin – OPG, sRANKL, and deoxypyridoline in urine – DPD and DXA examination was also performed.

Results
Lower OC concentration at T1D onset in comparison to controls (p < 0.001) and its increase during follow-up (p < 0.001) was ob-served. The OPG concentration was elevated at T1D onset as compared to the control group (p = 0.024) and decreased thereafter (p < 0.001). The s-RANKL level increased during follow-up (p < 0.001) and was lower than in controls (p < 0.001). Urine DPD con-centration also increased during follow-up in the T1D patient group (p < 0.001) and was higher in comparison to the control group (p = 0.021). BMD-TBLH was higher in the control group as compared to patients both at T1D onset (p = 0.025) and in follow-up ob-servation (p = 0.034). Moreover, OPG correlated positively with glycated haemoglobin (HbA1c) (p = 0.004) and negatively with fasting C-peptide level (p = 0.046) and BMI Z-score (p = 0.003), whereas s-RANKL correlated positively with both fasting (p < 0.001) and stimulated C-peptide levels (p < 0.001).

Conclusions
Bone metabolism disorders observed at T1D onset in children and modified after reaching the metabolic control of the disease seem to be most strongly associated with preserved insulin secretion.

keywords:

type 1 diabetes, osteocalcin, osteoprotegerin, s-RANKL, densitometry

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