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Published on: January 29, 2018
Association between type 1 diabetes mellitus and reduced bone mineral density in children: a meta-analysis
1Department of Translational Medicine Platform, Affiliated Hospital of Hangzhou Normal University, No. 126 Wenzhou Road, Gongshu District, Zhejiang Province, 310000, Hangzhou, China.
Insights
Children with type 1 diabetes mellitus (T1DM) have significantly lower bone mineral density (BMD) Z-scores in their whole body and lumbar spine. This meta-analysis confirms a link between T1DM and reduced bone health in pediatric populations.
Area of Science:
- Pediatric Endocrinology
- Metabolic Bone Disease
- Diabetes Mellitus Research
Background:
- Conflicting reports exist regarding the impact of type 1 diabetes mellitus (T1DM) on bone mineral density (BMD) in children and adolescents.
- Existing cross-sectional studies present a complex picture of T1DM's influence on pediatric bone health.
Purpose of the Study:
- To conduct a meta-analysis to clarify the association between T1DM and BMD in children and adolescents.
- To synthesize findings from multiple cross-sectional studies to determine the overall effect of T1DM on BMD.
Main Methods:
- Systematic literature search of PubMed, Cochrane library, and Web of Science databases.
- Inclusion of 9 cross-sectional studies with data from 1522 children and adolescents.
- Meta-analysis using a random-effects model to calculate pooled weight mean difference (WMD) and 95% confidence intervals (CI).
Main Results:
- A significant decrease in BMD Z-scores was observed in the whole body (WMD: -0.47) and lumbar spine (WMD: -0.41) of children with T1DM.
- Findings were consistent across studies from Asia and South America, but varied in North America and Europe.
- Reductions in BMD Z-scores were independent of age, HbA1c levels, and prepubertal status.
Conclusions:
- Type 1 diabetes mellitus is associated with reduced whole body and lumbar spine BMD Z-scores in children.
- The findings suggest T1DM negatively impacts bone density in pediatric populations.
- Further research may explore mechanisms and long-term implications of T1DM on bone health.
Abstract:
In this meta-analysis, we analyzed 9 cross-sectional studies for an association between type 1 diabetes mellitus (T1DM) and bone mineral density (BMD) in children. We found that BMD Z-scores were significantly reduced in children with T1DM.
Introduction:
Recent cross-sectional studies have examined how T1DM influences bone health in children and adolescents, but the relationship between T1DM and BMD remains unclear due to conflicting reports.
Methods:
In this meta-analysis, we systematically searched PubMed, Cochrane library, and Web of Science databases (for publications through March 12, 2020), and calculated weight mean difference (WMD) along with 95% confidence intervals (CI) using a random-effects model. Heterogeneity was evaluated using the I2 method. The Newcastle-Ottawa Scale was used to assess the quality of the included studies.
Results:
Data were analyzed from 9 eligible studies, including a total of 1522 children and adolescents. These data were tested for an association between T1DM and BMD. This analysis found a significant decrease in BMD Z-score in the whole body (pooled WMD, - 0.47, 95% CI, - 0.92 to - 0.02, I2 = 80.2%) and lumbar spine (pooled WMD, - 0.41, 95% CI, - 0.69 to - 0.12, I2 = 80.3%) in children and adolescents with T1DM, which was consistent in published studies from Asia and South America, but inconsistent in the North America and Europe. Importantly, the differences in BMD Z-scores were independent of age, level of glucose control (HbA1c), and prepubertal stage. Sensitivity analyses did not modify these findings. Funnel plot and the Egger test did not reveal significant publication bias.
Conclusion:
This meta-analysis suggests that T1DM may play a role in decreasing BMD Z-scores in the whole body and lumbar spine in children.
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