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Bone turnover markers during the remission phase in children and adolescents with type 1 diabetes
Author(s) -
Madsen Jens O. B.,
Herskin Camilla W.,
Zerahn Bo,
Jensen Andreas K.,
Jørgensen Niklas R.,
Olsen Birthe S.,
Svensson Jannet,
Pociot Flemming,
Johannesen Jesper
Publication year - 2020
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/pedi.12963
Subject(s) - bone remodeling , medicine , n terminal telopeptide , endocrinology , osteocalcin , bone resorption , bone mineral , type 1 diabetes , type i collagen , population , diabetes mellitus , osteoporosis , alkaline phosphatase , biology , biochemistry , environmental health , enzyme
Abstract Background and aim In rodents, osteocalcin (OCN) stimulates insulin production and insulin sensitivity, both important factors during partial remission in humans with type 1 diabetes (T1D). However, decreased OCN has been reported in both adult and pediatric T1D. This study aims at investigating bone turnover and partial remission in children and adolescents with recent onset T1D. Subjects and methods Ninety‐nine individuals (33% girls) were recruited within 3 months of T1D onset and examined three times, 6 months apart. Outcome variables were bone formation markers OCN and procollagen type 1 amino‐terminal propeptide (P1NP) and the bone resorption marker C‐terminal crosslinked telopeptide of type 1 collagen (CTX). Dependent variables included IDAA1c (surrogate marker of partial remission), total body bone mineral density (BMD) and stimulated C‐peptide as representative of endogenous insulin production. Results OCN‐ and P1NP Z‐scores were significantly decreased throughout the study, whereas CTX Z‐scores were increased. None of the bone turnover markers changed significantly between visits. Total body BMD Z‐score did not change during the study but was significantly higher than the reference population at visit 2 ( P = .035). There were no differences in the bone turnover markers for those in partial remission as defined by either C‐peptide or IDAA1c at any visit. The individual change in CTX Z‐score was negatively associated with the increase of IDAA1c ( P = .030) independent of C‐peptide decline ( P = .034). Conclusion Bone turnover markers indicate increased bone resorption and decreased bone formation during the first year of T1D. The negative association between bone resorption and IDAA1c might represent compensatory mechanisms affecting insulin sensitivity.