Department of Translational Medicine Platform, Affiliated Hospital of Hangzhou Normal University, No. 126 Wenzhou Road, Gongshu District, Zhejiang Province, 310000, Hangzhou, China.
Medical College of Hangzhou Normal University, No.2318 Yuhangtang Road, Yuhang District, Zhejiang Province, 311121, Hangzhou, China.
Osteoporos Int. 2021 Jun;32(6):1143-1152. doi: 10.1007/s00198-020-05715-3. Epub 2021 Jan 6.
In this meta-analysis, we analyzed 9 cross-sectional studies for an association between type 1 diabetes mellitus (T1DM) and bone mineral density (BMD) in children. We found that BMD Z-scores were significantly reduced in children with T1DM.
Recent cross-sectional studies have examined how T1DM influences bone health in children and adolescents, but the relationship between T1DM and BMD remains unclear due to conflicting reports.
In this meta-analysis, we systematically searched PubMed, Cochrane library, and Web of Science databases (for publications through March 12, 2020), and calculated weight mean difference (WMD) along with 95% confidence intervals (CI) using a random-effects model. Heterogeneity was evaluated using the I method. The Newcastle-Ottawa Scale was used to assess the quality of the included studies.
Data were analyzed from 9 eligible studies, including a total of 1522 children and adolescents. These data were tested for an association between T1DM and BMD. This analysis found a significant decrease in BMD Z-score in the whole body (pooled WMD, - 0.47, 95% CI, - 0.92 to - 0.02, I = 80.2%) and lumbar spine (pooled WMD, - 0.41, 95% CI, - 0.69 to - 0.12, I = 80.3%) in children and adolescents with T1DM, which was consistent in published studies from Asia and South America, but inconsistent in the North America and Europe. Importantly, the differences in BMD Z-scores were independent of age, level of glucose control (HbA1c), and prepubertal stage. Sensitivity analyses did not modify these findings. Funnel plot and the Egger test did not reveal significant publication bias.
This meta-analysis suggests that T1DM may play a role in decreasing BMD Z-scores in the whole body and lumbar spine in children.
本荟萃分析旨在分析 9 项横断面研究，以探讨 1 型糖尿病（T1DM）与儿童骨密度（BMD）之间的关联。我们发现，T1DM 患儿的 BMD Z 评分显著降低。
最近的横断面研究已经研究了 T1DM 如何影响儿童和青少年的骨骼健康，但由于报告相互矛盾，T1DM 与 BMD 之间的关系仍不清楚。
在这项荟萃分析中，我们系统地检索了 PubMed、Cochrane 图书馆和 Web of Science 数据库（截至 2020 年 3 月 12 日的出版物），并使用随机效应模型计算了加权均数差（WMD）及其 95%置信区间（CI）。使用 I ² 方法评估异质性。使用纽卡斯尔-渥太华量表评估纳入研究的质量。
对 9 项符合条件的研究进行了数据分析，共纳入 1522 名儿童和青少年。这些数据用于测试 T1DM 与 BMD 之间的关联。分析发现，T1DM 患儿的全身（汇总 WMD，-0.47，95%CI，-0.92 至-0.02，I=80.2%）和腰椎（汇总 WMD，-0.41，95%CI，-0.69 至-0.12，I=80.3%）的 BMD Z 评分显著降低，这在来自亚洲和南美洲的已发表研究中是一致的，但在北美和欧洲的研究中不一致。重要的是，BMD Z 评分的差异与年龄、血糖控制水平（HbA1c）和青春前期阶段无关。敏感性分析并未改变这些发现。漏斗图和 Egger 检验未显示出显著的发表偏倚。
本荟萃分析表明，T1DM 可能导致儿童全身和腰椎的 BMD Z 评分降低。
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