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Bone Abstracts (2017) 6 P032 | DOI: 10.1530/boneabs.6.P032

ICCBH2017 Poster Presentations (1) (209 abstracts)

Bone health status in Indian children with type 1 diabetes as assessed by peripheral quantitative computer tomography (pQCT)

Rubina Mandlik 1 , Veena Ekbote 1 , Shital Bhor 1 , Neha Kajale 1 , Jwala Pawar 1 , Shriram Narwade 1 , Vaman Khadilkar 1 , Shashi Chiplonkar 1 , Raja Padidela 2 , Zulf Mughal 2 & Anuradha Khadilkar 1

1Hirabai Cowasji Jehangir Medical Research Institute, Pune, Maharashtra, India; 2Royal Manchester Children’s Hospital, Manchester, UK.

Objective: Our earlier study using dual energy x-ray absorptiometry had shown that longer duration of type 1 diabetes (T1DM) in children was associated with small and slender bones. The objective of this study was to assess bone geometry in children and adolescents with T1DM using a pQCT.

Methods: We studied 69 children (8.3 to 18.7 years of age, 29 boys) with T1DM. Anthropometry and biochemical assessments (glycosylated Hb (HbA1c), Vitamin D and PTH) were performed. pQCT (STRATEC XCT-2000) of the radius of non-dominant hand at 4% and 66% was performed, z-scores were computed from data provided by Stratech. Children were classified in tertiles of disease duration (<2.2 years, 2.3 to 4.5 years and > 4.5 years).

Results: The mean height (HAZ), weight and BMI for age Z-scores of children were −0.77±1.5, −0.69±1.1, −0.39±0.8 respectively (p>0.1, between genders). The mean HbA1c was 10.0±2.1. Eighty-three% of children were vitamin D deficient (serum 25 OHD <50 nmol/l) with mean 25 OHD concentrations of 35.8±20.7 nmol/l. The mean PTH concentration was 7.2±4.3 (35% above 7.6 pmol/l). The HAZ was significantly lower in children with disease duration of >4.5 years. The mean trabecular density, total density at 4%, cortical density and strength strain index (SSIPol3) at 66% for age Z-score were −1±1.0 (15% <−2), −0.7±1.0 (7% <−2), −0.1±1.3 (10% <−2) and −1.3±0.71 (20% <−2) respectively, and less than zero (P<0.0001) except for cortical density (P=0.079). When these measurements were assessed across the disease duration, it was found that the SSIPol3 for age z-score was significantly lower (P<0.05) in children with disease duration of >4.5 years (−1.57±0.73) than 2.3–4.5 years (−1.07±0.72) indicating that there may be an increased risk of fracture as the disease duration increases.

Conclusion: Indian children with poorly controlled T1DM had hypovitaminosis D and poor bone health as judged by low trabecular density and SSI. Disease duration is likely to increase the risk of poor bone health because of short stature and lower SSI.

Disclosure: The authors declared no competing interests.

Volume 6

8th International Conference on Children's Bone Health


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