Osteoprotegerin, Insulin Like Growth Factor-1 and Bone Changes in Prepubertal Males With Type 1 Diabetes Mellitus

Abstract

Background: In this study we aimed to evaluate osteoprotegerin (OPG) and insulin like growth factor-1 (IGF-1) serum levels in prepubertal T1DM male children and their relation to bone density.

Methods: Study included Thirty-five prepubertal T1DM male patients (mean age of 11.20 2.10 years). Patients were assessed for serum levels of OPG, IGF-1, glycosylated hemoglobin (HbA1c), parathormone hormone (PTH), and 25-dihydroxyvitamin D (25-OH-D). Bone quality was determined by measuring bone broadband ultrasound attenuation (BUA) at calcaneous. The data were compared with those of 28 age (mean age of 10.90 2.30) and body-size matched healthy boys representing a control group.

Results: Both serum levels of OPG and HbA1c levels were significantly higher in T1DM patients than in controls (p < 0.0001) while both IGF-1 serum levels and Z-score BUA were significantly lower in patients than in controls (p < 0.001 and < 0.0001 respectively). OPG showed moderate positive correlation with HbA1c (%) (r = 0.67, p < 0.0001) and strong negative correlation between OPG and IGF-1 (r = -0.78, p < 0.001). While there was fair negative correlation IGF-1 and HbA1c (r = -0.47, p < 0.01). Z-score BUA moderate negative correlation with OPG (r = -0.72, p < 0.01), and correlation was moderately positive with IGF-1 (r = 0.60, p < 0.001) while showed fair negative correlation with HbA1c (r = -0.48, p < 0.01).

Conclusions: Patients with T1DM are at risk to have lower bone mass, which may be attributed to increased OPG serum levels mediated by low IGF-1 production. All these factors showed association to poor glycemic control.




doi:10.4021/ijcp25w