The relation of serum Cystatin-C and bone metabolism in children and adolescent with type 1 diabetes mellitus

Type-1 diabetes mellitus is one of the most common chronic diseases of childhood. In the present study, the effect of type-1 diabetes on bone metabolism was investigated.A total of 66 type-1 diabetes patients who had a mean age of 14,13±3,06 and followed for at least 5 years, and 29 healthy children who had a mean age of 12,81±3,11 included in the study. The mean of lumber vertebra and femur neck region and bone mineral density were measured with Dual energy X-ray absorptiometry. In addition, serum cystatin-C, bone specific alkaline phosphatase, osteocalcin, ß-crosslab, pyridinoline, deoxypyridinoline, and hydroksyproline were measured.The measurement of lumber vertebral region revealed normal in 70.4 % of the patients, while was osteopenic in the remaining 29,6 % of patients. The measurement of femur neck region revealed normal in 77,3 % of the patients, while was osteopenic in the remaining 22,7 % of patients. Since none of them had history of bone fracture, they were not accepted as osteoporosis.Osteoblastic and osteoclastic biochemical markers were found to be low in osteopenic patients compared to those non-osteopenic ones. However, this difference was not statistically significant. Whereas serum bone specific alkaline phosphatase and osteocalcin were correlated well with femur neck region bone mineral density Z-score, lumber vertebral region bone mineral density Z-score had not similar correlation. On the other hand, while the osteoclastic markers were not correlated with lumber vertebral region bone mineral density Z-score, well correlation was found between femur neck region bone mineral density and urine deoxypyridinoline. Although it was not statistically significant, serum cystatin-C level was low in osteopenic patients in the present study.As a result, osteopenia is found in a significant number of patients with type-1 diabetes mellitus. Therefore, in children and adolescents with type 1 diabetes, osteopenia should be kept in mind due to it potential risk of bone fracture in the older age. We think that exercise calcium and vitamin D replacement may be beneficial when necessary.