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Low bone mineral density in patients with type 1 diabetes: association with reduced expression of IGF1 , IGF1R and TGF B 1 in peripheral blood mononuclear cells

2015; Wiley; Volume: 32; Issue: 6 Linguagem: Inglês

10.1002/dmrr.2772

1520-7560

Karla Simone Costa de Souza, Marcela Abbott Galvão Ururahy, Yonara Monique da Costa Oliveira, Melina Bezerra Loureiro, Heglayne Pereira Vital da Silva, Raul Hernandes Bortolin, Fabricio Melo dos Santos, André Ducati Luchessi, José Jorge Maciel Neto, Ricardo Fernando Arrais, Rosário Dominguez Crespo Hirata, Maria das Graças Almeida, Mário Hiroyuki Hirata, Adriana Augusto de Rezende,

Parathyroid Disorders and Treatments

Abstract Background The negative effects of type 1 diabetes (T1D) on growth factors of bone metabolism lead to a reduction in bone mineral density. This study aimed to evaluate the association between bone mineral density and insulin‐like growth factor 1 ( IGF1 ), insulin‐like growth factor 1 receptor ( IGF1R ) and transforming growth factor beta 1 ( TGFB1 ) expressions in children and adolescents with T1D. Moreover, the influences of age at diagnosis, time since diagnosis, glycaemic control and albuminuria on bone mineral density were investigated. Methods Eighty‐six T1D children/adolescents (T1D group) and ninety normoglycaemic controls (normoglycaemic group) were included. T1D patients were analysed as a whole and also in subsets of patients with good glycaemic control (glycated hemoglobin concentration ≤7.5%) and with poor glycaemic control (glycated hemoglobin concentration >7.5%). Bone mineral density was assessed by dual energy x‐ray absorptiometry. Glycaemic control, renal function and bone markers were also assessed. IGF1 , IGF1R and TGFB1 expressions were determined in peripheral blood mononuclear cells by real‐time polymerase chain reaction. Results Patients with T1D showed low bone mineral density and poor glycaemic control. Serum total calcium and urinary albumin‐to‐creatinine ratio were higher in patients with poor glycaemic control compared to those with good glycemic control ( p = 0.003 and p = 0.035, respectively). There was a reduction of IGF1 , IGF1R and TGFB1 expressions in the T1D patients and in the subset with poor glycaemic control compared to normoglycaemic controls ( p < 0.05). Conclusions The decreased IGF1 , IGF1R and TGFB1 expressions in the T1D patients, who presented with T1D at an early age, had been diagnosed with T1D for a longer time, had poor glycaemic control and albuminuria may contribute to low bone mineral density. Copyright © 2016 John Wiley & Sons, Ltd.