Bone mineral density in obese children with prediabetes

Aim: The aim of this study was to evaluate the relationships between bone mineral density (BMD) vs metabolic risk factors in obese adolescents with prediabetes. Materials and Methods: A total of 131 obese children and adolescents, aged 6-18 years of age were enrolled the study. Prediabetes was determined by a fasting blood glucose level of ≥100 to 125 mg/dL or 2-hour oral glucose tolerance test value of ≥140 to 199 mg/dL. Five patients who were diagnosed as having type 2 diabetes were excluded and remaining participants were classified as normal glucose tolerance (NGT) and prediabetic. BMD was measured on calcaneus using quantitative ultrasound. BMD and metabolic parameters were investigated and compared in these two groups. Results: There was no significant difference in BMD between children and adolescents with prediabetes (n=37) or NGT (n=89). The parameters of prediabetes did not affect BMD and these results did not change when we adjusted for weight, height, age, sex, pubertal status. The multivariate linear regression analysis revealed that the only independent factor associated with higher BMD was higher body mass index (BMI) (OR=0.007, 95%CI: 0.002-0.013, p=0.013). No significant associations were found between BMD and waist circumference or biochemical measurements. Conclusion: Plasma glucose within the prediabetic range is not associated with bone mineral density in obese children. Thus, the positive association of BMI with BMD may be by means of alternative pathways.

Prediyabeti olan obez çocukların kemik mineral dansitometreleri

Amaç: Çalışmanın amacı prediyabetik obez çocuk ve ergenlerde kemik mineral dansitometresinin (KMD) metabolik faktörlerle ilişkisini araştırmaktır. Gereç ve Yöntem: Çalışmaya 6-18 yaş arasında 131 adet çocuk ve ergen dahil edildi. Prediyabet kriteri açlık kan glikozunun ≥100-125 mg/dL aralığında olması yada glikoz yükleme testi 2. saat glikoz değerinin ≥140-199 mg/dL arasında olması olarak belirlendi. Bu ölçütlere göre tip 2 diyabet tanısı alan 5 hasta çalışma dışı tutulurken geri kalanlar prediyabet ve normal glikoz toleranslı (NGT) hastalar olmak üzere iki guruba ayrıldılar. KMD kalkaneustan kantitatif ultrason ölçüm cihazı ile yapıldı. Her iki grupta KMD ve metabolik parametreler karşılaştırıldı. Bulgular: KMD yönünden prediyabet (n=37) ve NGT’li hastalar (n=89) arasında anlamlı bir fark yoktu. Prediyabet ölçütleri KMD’yi etkilemiyor; üstelik ağırlık, boy, yaş, cinsiyet ve ergenlik gibi KMD üzerine olası etkileri olabilecek parametrelere göre düzenleme sonrasında bu durum değişmiyordu. Lineer regresyon analizinde beden kitle indeksi (BKİ) ile KMD arasında pozitif ilişki bulundu (OR=0.007, 95%CI: 0.002-0.013, p=0.013). Bel çevresi ve diğer metabolik faktörler ile KMD arasında ise bir ilişki bulunamadı. Sonuç: Prediyabetik aralıktaki glikoz değeri ile KMD arasında herhangi bir ilişki yoktur. Obez çocuklarda fazla BKİ ile KMD arasındaki pozitif korelasyonu açıklayacak bilinen metabolik parametreler dışında alternatif etkenler olabilir.

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