Densidad mineral ósea en la diabetes mellitus infantojuvenil

Résumé

To determine bone mineral density (BMD) at axial and appendicular sites in patients with type 1 diabetes melli-tus and evaluate its relationship with metabolic control and disease duration. Patients and method BMD was measured by dual-energy X-ray absorptio-metry (Hologic QDR-1000) in the lumbar spine (L 1-L 4) and at the distal third forearm in 246 healthy non-diabetic children and adolescents (111 boys, 135 girls, aged 2.820.8 years) and in 45 diabetic patients (18 boys, 27 girls, aged 5.2-19.4 years). The results were expressed as the mean and standard deviation. The differences were tested by analysis of variance or Student's t-test, as appropriate. The relationship between BMD and the remaining variables was studied by simple Pearson's coefficient and partial correlation coefficient. Significance was defined as p < 0.05. Results BMD increased progressively from infancy to adulthood in both populations. Lumbar spine and forearm BMD were significantly lower in diabetic patients than in the healthy non-diabetic children, mainly during pubertal spurt. The greatest differences were found in males and in the trabecular bone. No relationship was found between metabolic control (mean glycosylated hemoglobin, insulin requirement) and duration of diabetes and the BMD in any region studied (p > 0.05). Conclusions Pediatric patients with type 1 diabetes mellitus appear to constitute a population at risk of osteoporosis in adulthood. Diagnosis of osteopenia diagnosis should be established according to densitometric criteria. In this study, metabolic control parameters and duration of diabetes did not enable predetermination of diabetic patients at risk of osteoporosis in adulthood.