Klara Maratova1, Ondrej Soucek2, Jana Matyskova3, Zdenek Hlavka4, Lenka Petruzelkova5, Barbora Obermannova6, Stepanka Pruhova7, Stanislava Kolouskova8, Zdenek Sumnik9. 1. Department of Pediatrics, Second Faculty of Medicine, Charles University in Prague and Motol University Hospital, V Uvalu 84, 150 06 Prague 5, Czech Republic. Electronic address: klara.maratova@fnmotol.cz. 2. Department of Pediatrics, Second Faculty of Medicine, Charles University in Prague and Motol University Hospital, V Uvalu 84, 150 06 Prague 5, Czech Republic. Electronic address: ondrej.soucek@lfmotol.cuni.cz. 3. Department of Pediatrics, Second Faculty of Medicine, Charles University in Prague and Motol University Hospital, V Uvalu 84, 150 06 Prague 5, Czech Republic. Electronic address: jana.matyskova@seznam.cz. 4. Department of Probability and Mathematical Statistics, Faculty of Mathematics and Physics, Charles University in Prague, Sokolovska 49/83, 186 75 Prague 8, Czech Republic. Electronic address: hlavka@karlin.mff.cuni.cz. 5. Department of Pediatrics, Second Faculty of Medicine, Charles University in Prague and Motol University Hospital, V Uvalu 84, 150 06 Prague 5, Czech Republic. Electronic address: lenka.petruzelkova@fnmotol.cz. 6. Department of Pediatrics, Second Faculty of Medicine, Charles University in Prague and Motol University Hospital, V Uvalu 84, 150 06 Prague 5, Czech Republic. Electronic address: barbora.obermannova@fnmotol.cz. 7. Department of Pediatrics, Second Faculty of Medicine, Charles University in Prague and Motol University Hospital, V Uvalu 84, 150 06 Prague 5, Czech Republic. Electronic address: stepanka.pruhova@fnmotol.cz. 8. Department of Pediatrics, Second Faculty of Medicine, Charles University in Prague and Motol University Hospital, V Uvalu 84, 150 06 Prague 5, Czech Republic. Electronic address: stanislava.kolouskova@fnmotol.cz. 9. Department of Pediatrics, Second Faculty of Medicine, Charles University in Prague and Motol University Hospital, V Uvalu 84, 150 06 Prague 5, Czech Republic. Electronic address: zdenek.sumnik@lfmotol.cuni.cz.
Abstract
BACKGROUND: Sarcopenia and osteoporosis are among the late complications of type 1 diabetes (T1D) in adults. Whether and to what extent musculoskeletal impairment is present in childhood and adolescence has yet to be determined. The aim of this study was to assess volumetric bone mineral density (BMD) and dynamic muscle function in adolescents with T1D and to assess the clinical and biochemical predictors of their musculoskeletal system. METHODS: Ninety-five children and adolescents (59 boys and 36 girls, mean age 16.2±1.2years) with T1D were included in this cross-sectional study. Study participants were divided into two groups according to the duration of the disease (<6years and >9years, respectively). Volumetric BMD of the non-dominant tibia was assessed using peripheral quantitative computed tomography (pQCT). Dynamic muscle function was evaluated using jumping mechanography. Gender- and height-specific Z-scores were calculated using published reference data. HbA1c was evaluated retrospectively as an average over the past 5years. RESULTS: Relative muscle power (Pmax/mass) and force (Fmax/body weight) were significantly decreased in T1D subjects (mean Z-scores -0.4±1.0; p<0.001, and -0.3±1.1; p<0.01, respectively). The duration of T1D negatively affected Pmax/mass (p<0.01) but not Fmax/body weight (p=0.54). Patients with T1D had also decreased trabecular BMD, the Strength-Strain Index and cortical thickness (mean Z-scores -0.8±1.3; -0.5±0.8 and -1.1±0.8, respectively, p<0.001 for all) whereas cortical BMD was increased when compared to controls (Z-score 1.2±0.90, p<0.001). No association was observed between the HbA1c and 25-hydroxyvitamin D levels and bone or muscle parameters. CONCLUSION: T1D influences the musculoskeletal system in adolescence. Decreased muscle function could contribute to the osteoporosis reported in adult diabetic patients.
BACKGROUND:Sarcopenia and osteoporosis are among the late complications of type 1 diabetes (T1D) in adults. Whether and to what extent musculoskeletal impairment is present in childhood and adolescence has yet to be determined. The aim of this study was to assess volumetric bone mineral density (BMD) and dynamic muscle function in adolescents with T1D and to assess the clinical and biochemical predictors of their musculoskeletal system. METHODS: Ninety-five children and adolescents (59 boys and 36 girls, mean age 16.2±1.2years) with T1D were included in this cross-sectional study. Study participants were divided into two groups according to the duration of the disease (<6years and >9years, respectively). Volumetric BMD of the non-dominant tibia was assessed using peripheral quantitative computed tomography (pQCT). Dynamic muscle function was evaluated using jumping mechanography. Gender- and height-specific Z-scores were calculated using published reference data. HbA1c was evaluated retrospectively as an average over the past 5years. RESULTS: Relative muscle power (Pmax/mass) and force (Fmax/body weight) were significantly decreased in T1D subjects (mean Z-scores -0.4±1.0; p<0.001, and -0.3±1.1; p<0.01, respectively). The duration of T1D negatively affected Pmax/mass (p<0.01) but not Fmax/body weight (p=0.54). Patients with T1D had also decreased trabecular BMD, the Strength-Strain Index and cortical thickness (mean Z-scores -0.8±1.3; -0.5±0.8 and -1.1±0.8, respectively, p<0.001 for all) whereas cortical BMD was increased when compared to controls (Z-score 1.2±0.90, p<0.001). No association was observed between the HbA1c and 25-hydroxyvitamin D levels and bone or muscle parameters. CONCLUSION: T1D influences the musculoskeletal system in adolescence. Decreased muscle function could contribute to the osteoporosis reported in adult diabeticpatients.
Authors: Gabriel M Pagnotti; Maya Styner; Gunes Uzer; Vihitaben S Patel; Laura E Wright; Kirsten K Ness; Theresa A Guise; Janet Rubin; Clinton T Rubin Journal: Nat Rev Endocrinol Date: 2019-06 Impact factor: 43.330
Authors: David R Weber; Rebecca J Gordon; Jennifer C Kelley; Mary B Leonard; Steven M Willi; Jacquelyn Hatch-Stein; Andrea Kelly; Oksana Kosacci; Olena Kucheruk; Mirna Kaafarani; Babette S Zemel Journal: J Clin Endocrinol Metab Date: 2019-10-01 Impact factor: 5.958
Authors: Athan G Dial; Cynthia M F Monaco; Grace K Grafham; Nadya Romanova; Jeremy A Simpson; Mark A Tarnopolsky; Christopher G R Perry; Evangelia Kalaitzoglou; Thomas J Hawke Journal: Physiol Rep Date: 2020-07