Bone metabolism assessment in diabetes mellitus type 1

Aim. To evaluate the effect of changes occuring in the organism in diabetes mellitus type 1 on the state of bone mineral density and its metabolism parameters; to determine the changes in serum markers of bone remodeling and bone mineral density in this disease. Methods. Bone mineral density (by dual-energy X-ray absorptiometry) and serum markers of bone remodeling (total alkaline phosphatase activity, level of aminoterminal propeptide of type 1 procollagen and C-terminal telopeptide) were examined in 98 patients with diabetes mellitus type 1 and in the control group consisting of 82 subjects. Results. The average concentration of C-terminal telopeptide in the blood serum of patients with type 1 diabetes (0.525±0.03 ng/ml) was significantly higher in comparison to the control group (0.424±0.02 ng/ml; p <0.01). Proximal femoral T-score in type 1 diabetes was significantly lower than the average value in the control group: -1.44±0.15 and -0.49±0.17 (p <0.001). In the femoral neck it was -1.68±0.14 and -0.64±0.18 (p <0.001), in LI-IV zone -2.04±0.16 and -0.73±0.19, respectively (p <0.001). Moderate negative significant correlation was found between T-score (LI-IV) and level of C-terminal telopeptide (r=-0.431, p=0.000). Conclusion. In patients with diabetes mellitus osteopenia is a relatively frequent complication, but bone loss increases with duration and decompensation of the disease; evaluation of bone mineral density and C-terminal telopeptide level (bone resorption marker) promotes detection of bone metabolism abnormalities at any stage of the disease, especially in the long-term course of type 1 diabetes.