Bone Mineral Density across the Lifespan in Patients with Type 1 Diabetes

Context: Fracture risk in people with type 1 diabetes (T1D) is higher than their peers without diabetes. Objective: To compare bone mineral density (BMD) across the lifespan in individuals with T1D and age- and sex-matched healthy controls. Design: Cross-sectional. Setting: Subjects (5-71 years) with T1D and matched controls from ongoing research studies at Barbara Davis Center for Diabetes. Patients or other participants: Participants with lumbar spine BMD by dual X-ray absorptiometry (DXA) were divided into 2 groups: children <= 20 years and adults >20 years. Intervention: None. Main outcome measures: Comparison of BMD by diabetes status across age groups and sex using a linear least squares model adjusted for age and body mass index (body mass index (BMI) for adults; and BMI z-score in children). Results: Lumbar spine BMD from 194 patients with T1D and 156 controls were analyzed. There was no difference in age- and BMI-adjusted lumbar spine BMD between patients with T1D and controls: among male children (least squares mean +/- standard error of the mean [LSM +/- SEM]; 0.80 +/- 0.01 vs 0.80 +/- 0.02 g/cm(2), P =.98) or adults (1.01 +/- 0.03 vs 1.01 +/- 0.03 g/cm(2), P =.95), and female children (0.78 +/- 0.02 vs 0.81 +/- 0.02 g/cm(2), P =.23) or adults (0.98 +/- 0.02 vs 1.01 +/- 0.02 g/cm(2), P =.19). Lumbar spine (0.98 +/- 0.02 vs 1.04 +/- 0.02 g/cm(2), P =.05), femoral neck (0.71 +/- 0.02 vs 0.79 +/- 0.02 g/cm(2), P =.003), and total hip (0.84 +/- 0.02 vs 0.91 +/- 0.02, P =.005) BMD was lower among postmenopausal women with T1D than postmenopausal women without diabetes. Conclusion: Across age groups, lumbar spine BMD was similar in patients with T1D compared with age- and sex-matched participants without diabetes, except postmenopausal females with T1D had lower lumbar spine, femoral neck, and total hip BMD.