Growth and Pediatric Endocrine Department, Hirabai Cowasji Jehangir Medical Research Institute, Pune, Maharashtra, India.
Growth and Pediatric Endocrine Department, Hirabai Cowasji Jehangir Medical Research Institute, Pune, Maharashtra, India; School of Health Sciences, Savitribai Phule Pune University, Pune, Maharashtra, India.
J Clin Densitom. 2021 Apr-Jun;24(2):268-274. doi: 10.1016/j.jocd.2020.12.001. Epub 2020 Dec 10.
In children with type 1 diabetes mellitus (T1DM), low trabecular volumetric bone mineral density (Trab vBMD) has been reported. However, studies using the trabecular bone score (TBS) are scarce. The objective of our study was to assess areal bone mineral density at the lumbar spine (LS aBMD), the TBS and Trab vBMD in children with type 1 diabetes in comparison with healthy controls and to assess the relationship of Trab vBMD with TBS.
A total of 205 children were assessed for their LS bone mineral content (BMC) and LS aBMD by dual energy x-ray absorptiometry (DXA) and Trab vBMD at distal radius by peripheral quantitative computed tomography (pQCT). Machine generated Z-scores for both LS aBMD and Trab vBMD were used. The retrospective DXA LS scans in children with T1DM (n=137, age 13.1 ± 3.2 years) and controls (n = 68, age 13.0 ± 2.7 years) were analysed with a research trial version of TBS iNsight software (Medimaps Group). The established TBS cut-offs were used to categorize TBS.
The mean LS BMC, LS aBMD, TBS and Trab vBMDs were lower in children with T1DM. TBS was positively correlated with LS aBMD but not with Trab vBMD in both groups. Distribution of T1DM and control children was similar in the TBS categories. Over a fourth of the T1DM children with low Trab vBMD (below -2 Z score) had normal TBS, while, in children with LS aBMD Z-score > -2 from both groups, >50% had degraded or partially degraded TBS. Degraded TBS was seen in half the control children although none of them had low Trab vBMD.
We found poor correlation between TBS and Trab vBMD in paediatric diabetic and healthy population. Our results also suggest establishing paediatric TBS cut offs in improving the classification of children having degraded trabecular bone.
已有研究报道，1 型糖尿病（T1DM）患儿的骨小梁体积骨密度（Trab vBMD）较低。然而，利用骨小梁评分（TBS）进行的研究较为少见。本研究旨在评估 T1DM 患儿与健康对照者的腰椎（LS）骨矿密度（aBMD）、TBS 和桡骨远端 Trab vBMD，并评估 Trab vBMD 与 TBS 的相关性。
共对 205 名儿童进行了双能 X 线吸收法（DXA）评估的 LS 骨矿含量（BMC）和 LS aBMD 以及外周定量计算机断层扫描（pQCT）评估的桡骨远端 Trab vBMD 检测。使用机器生成的 LS aBMD 和 Trab vBMD 的 Z 分数。回顾性分析了年龄为 13.1±3.2 岁的 137 名 T1DM 患儿（n=137）和年龄为 13.0±2.7 岁的 68 名健康对照者（n=68）的 DXA LS 扫描，分析采用研究试验版本的 TBS iNsight 软件（Medimaps Group）。使用已建立的 TBS 截断值对 TBS 进行分类。
T1DM 患儿的 LS BMC、LS aBMD、TBS 和 Trab vBMD 均较低。两组的 TBS 与 LS aBMD 呈正相关，但与 Trab vBMD 无关。T1DM 患儿和健康对照者的 TBS 分类分布相似。超过四分之一的 Trab vBMD 较低（低于-2 Z 评分）的 T1DM 患儿 TBS 正常，而两组中 LS aBMD Z 评分> -2 的患儿中，超过 50%的患儿 TBS 为受损或部分受损。半数以上的健康对照者的 TBS 受损，但无一人 Trab vBMD 较低。
我们发现儿科糖尿病和健康人群的 TBS 与 Trab vBMD 相关性较差。我们的结果还表明，建立儿科 TBS 截断值有助于改善受损骨小梁的分类。
