Study of Bone Mineral Density, Serum Sclerostin, and Parathyroid Hormone Levels in Children and Adolescents with Type 1 Diabetes Mellitus
Keywords:
Bone Mineral Density, Serum Sclerostin, Parathyroid Hormone, T1DMAbstract
Background: Children and adolescents with type 1 diabetes (T1DM) are more probable to have compromised bone health, as changes in bone mineral density (BMD), serum sclerostin, and parathyroid hormone levels may be involved in skeletal issues. The purpose of this study was to evaluate bone mineral state in children and adolescents with type 1 diabetes.
Methods: The present prospective case-control trial was conducted on 75 children and adolescents with ages from 5 to 18 years old, both sexes, having T1DM (Patients group) and 25 healthy children (the control group). Patients were exposed to BMD, serum sclerostin and parathyroid hormone measurement.
Results: 25-hydroxyvitamin D (25 OH vit D), serum ionized calcium (Ca), parathormone hormone (PTH), phosphorus and alkaline phosphatase (ALP) were comparable between both groups. BMD was notably reduced in patients’ group than control group (P<0.05). Sclerostin was significantly elevated in diabetic patients than control group (P<0.001). Level of Sclerostin had a positive correlation with diabetes duration, mean glycosylated hemoglobin per year in the diabetic patients (P <0.001). Sclerostin level stated a negative relation with total body and lumbar BMD Z score (P<0.001).
Conclusions: There was evidence of low BMD in diabetic patients valued by dual-energy X-ray absorptiometry scan, especially in long standing diabetes with poor glycemic control. Diabetic cases with better glycemic control showed better BMD and sclerostin levels.
Downloads
Metrics
References
Sarkar BK, Akter R, Das J, Das A, Modak P, Halder S, et al. Diabetes mellitus: A comprehensive review. J Pharmacogn Phytochem. 2019;28:2362-71.
Leão AAP, Fritz CK, Dias M, Carvalho JAR, Mascarenhas LPG, Cat MNL, et al. Bone mass and dietary intake in children and adolescents with type 1 diabetes mellitus. J Diabetes Complications. 2020;34:107-573.
Weber DR, Gordon RJ, Kelley JC, Leonard MB, Willi SM, Hatch-Stein J, et al. Poor glycemic control is associated with impaired bone accrual in the year following a diagnosis of type 1 diabetes. J Clin Endocrinol Metab. 2019;104:4511-20.
Devaraja J, Jacques R, Paggiosi M, Clark C, Dimitri P. Impact of type 1 diabetes mellitus on skeletal integrity and strength in adolescents as assessed by HRpQCT. JBMR Plus. 2020;40:104-22.
Maratova K, Soucek O, Matyskova J, Hlavka Z, Petruzelkova L, Obermannova B, et al. Muscle functions and bone strength are impaired in adolescents with type 1 diabetes. Bone. 2018;106:22-7.
Fuusager GB, Christesen HT, Milandt N, Schou AJ. Glycemic control and bone mineral density in children and adolescents with type 1 diabetes. Pediatr Diabetes. 2019;20:629-36.
Rasmussen NH, Dal J, de Vries F, van den Bergh JP, Jensen MH, Vestergaard P. Diabetes and fractures: new evidence of atypical femoral fractures? Osteoporos Int. 2020;31:447-55.
Wędrychowicz A, Sztefko K, Starzyk JB. Sclerostin and its significance for children and adolescents with type 1 diabetes mellitus (T1D). Bone. 2019;120:387-92.
Association AD. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes 2020. Diabetes care. 2020;43:14-31.
Crabtree NJ, Arabi A, Bachrach LK, Fewtrell M, El-Hajj Fuleihan G, Kecskemethy HH, et al. Dual-energy X-ray absorptiometry interpretation and reporting in children and adolescents: the revised 2013 ISCD pediatric official positions. J Clin Densitom. 2014;17:225-42.
Kalkwarf HJ, Abrams SA, DiMeglio LA, Koo WW, Specker BL, Weiler H. Bone densitometry in infants and young children: the 2013 ISCD Pediatric Official Positions. J Clin Densitom. 2014;17:243-57.
Neumann T, Lodes S, Kästner B, Franke S, Kiehntopf M, Lehmann T, et al. High serum pentosidine but not esRAGE is associated with prevalent fractures in type 1 diabetes independent of bone mineral density and glycaemic control. Osteoporos Int. 2014;25:1527-33.
García-Martín A, Rozas-Moreno P, Reyes-García R, Morales-Santana S, García-Fontana B, García-Salcedo JA, et al. Circulating levels of sclerostin are increased in patients with type 2 diabetes mellitus. J Clin Endocrinol Metab. 2012;97:234-41.
Daniele G, Winnier D, Mari A, Bruder J, Fourcaudot M, Pengou Z, et al. Sclerostin and insulin resistance in prediabetes: Evidence of a cross talk between bone and glucose metabolism. Diabetes Care. 2015;38:1509-17.
Catalano A, Pintaudi B, Morabito N, Di Vieste G, Giunta L, Bruno ML, et al. Gender differences in sclerostin and clinical characteristics in type 1 diabetes mellitus. Eur J Endocrinol. 2014;171:293-300.
Tsentidis C, Gourgiotis D, Kossiva L, Marmarinos A, Doulgeraki A, Karavanaki K. Sclerostin distribution in children and adolescents with type 1 diabetes mellitus and correlation with bone metabolism and bone mineral density. Pediatr Diabetes. 2016;17:289-99.
Gennari L, Merlotti D, Valenti R, Ceccarelli E, Ruvio M, Pietrini MG, et al. Circulating sclerostin levels and bone turnover in type 1 and type 2 diabetes. J Clin Endocrinol Metab. 2012;97:1737-44.
Kirmani S, Amin S, McCready LK, Atkinson EJ, Melton LJ, 3rd, Müller R, et al. Sclerostin levels during growth in children. Osteoporos Int. 2012;23:1123-30.
Loureiro MB, Ururahy MA, Freire-Neto FP, Oliveira GH, Duarte VM, Luchessi AD, et al. Low bone mineral density is associated to poor glycemic control and increased OPG expression in children and adolescents with type 1 diabetes. Diabetes Res Clin Pract. 2014;103:452-7.
Kumar RA, Kumar CD, Sahoo J. Evaluation of bone mineral density in children with type 1 diabetes: A cross-sectional case–control study. JPED. 2022;20:9-13.
Maddaloni E, D’Eon S, Hastings S, Tinsley LJ, Napoli N, Khamaisi M, et al. Bone health in subjects with type 1 diabetes for more than 50 years. Acta Diabetol. 2017;54:479-88.
Sayarifard F, Safarirad M, Rabbani A, Sayarifard A, Ziaee V, Setoodeh A, et al. Status of bone mineral density in children with type 1 diabetes mellitus and its related factors. Iran J Pediatr. 2017;27:100-40.
Ardawi MS, Rouzi AA, Al-Sibiani SA, Al-Senani NS, Qari MH, Mousa SA. High serum sclerostin predicts the occurrence of osteoporotic fractures in postmenopausal women: The center of excellence for osteoporosis research study. J Bone Miner Res. 2012;27:2592-602.
Downloads
Published
How to Cite
Issue
Section
License

This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.

