{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T15:11:41Z","timestamp":1772118701823,"version":"3.50.1"},"reference-count":47,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2024,1,27]],"date-time":"2024-01-27T00:00:00Z","timestamp":1706313600000},"content-version":"vor","delay-in-days":1152,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,10,18]],"date-time":"2021-10-18T00:00:00Z","timestamp":1634515200000},"content-version":"vor","delay-in-days":321,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100010215","name":"Deutsche Diabetes Gesellschaft","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010215","id-type":"DOI","asserted-by":"publisher"}]},{"name":"German Centre for Diabetes Research","award":["82DZD14A02"],"award-info":[{"award-number":["82DZD14A02"]}]},{"DOI":"10.13039\/501100023448","name":"Robert Koch Institute","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100023448","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100010215","name":"Deutsche Diabetes Gesellschaft","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010215","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["asbmr.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,12,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Type 1 diabetes (T1D) is a known risk factor for fractures, but the underlying pathophysiology is still not fully understood. This study aims to define age peaks and frequent fracture sites of children and young adults with T1D. Additionally, associations of fractures with metabolic and lifestyle factors as well as with additional complications in individuals with T1D were analyzed. A total of 750 individuals with T1D aged \u226425\u2009years with fractures were matched to 3750 patients with T1D without fractures by demographics and insulin regimen. Hemoglobin A1c (HbA1c) values were compared using linear regression, and logistic regression was used to calculate odds ratios (OR) for fractures in individuals with acute complications and diseases. Median (Q1\u2013Q3) age was 12.7 (9.9 to 14.9) years in individuals with fractures and 16.3 (12.6 to 17.8) years in the entire control group with 65% versus 53% males. Peak age for fractures was 7 to &amp;lt;15\u2009years in males and 9 to &amp;lt;11\u2009years in females, which is earlier than reported for the general population. HbA1c (%) was significantly higher in individuals with fractures than in controls (difference of estimated means: 0.26%; 95% confidence interval [CI] 0.07\u20130.46), especially in postpubertal females (0.68; 0.10\u20131.26). Significantly higher odds for fractures were observed in individuals with severe hypoglycemia (OR\u00a0=\u00a01.90; 95% CI 1.47\u20132.47), especially in prepubertal females (OR\u00a0=\u00a02.81; 1.21\u20136.52]) and postpubertal males (2.44; 1.11\u20135.38), celiac disease (2.02; 1.67\u20132.45), and with a history of smoking (1.38; 1.02\u20131.88). The age peak of fractures seems to be earlier in T1D than in the general population. Poor glycemic control is related to fractures, even before puberty. Associations of HbA1c and severe hypoglycemia with fractures highly depend on age and sex. \u00a9 2021 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).<\/jats:p>","DOI":"10.1002\/jbmr.4451","type":"journal-article","created":{"date-parts":[[2021,9,27]],"date-time":"2021-09-27T15:21:12Z","timestamp":1632756072000},"page":"2371-2380","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Bone Fractures in Children and Young Adults With Type 1 Diabetes: Age Distribution, Fracture Location, and the Role of Glycemic Control"],"prefix":"10.1093","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1239-3078","authenticated-orcid":false,"given":"Alexander J","family":"Eckert","sequence":"first","affiliation":[{"name":"German Centre for Diabetes Research (DZD) Neuherberg Germany"},{"name":"Institute of Epidemiology and Medical Biometry, ZIBMT University of Ulm Ulm Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oliver","family":"Semler","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and University Hospital Cologne, Department of Paediatrics University of Cologne Cologne Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dirk","family":"Schnabel","sequence":"additional","affiliation":[{"name":"Centre for Chronic Sick Children, Paediatric Endocrinology, Charit\u00e9 University Medicine Berlin Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katharina","family":"K\u00f6stner","sequence":"additional","affiliation":[{"name":"Social Pediatric Center (SPZ) Garmisch-Partenkirchen German Centre for Paediatric and Adolescent Rheumatology Garmisch-Partenkirchen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donald","family":"Wurm","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Klinikum Saarbr\u00fccken Saarbr\u00fccken Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanne","family":"Bechtold-Dalla Pozza","sequence":"additional","affiliation":[{"name":"Paediatric Endocrinology, iSPZ, Dr. von Haunersches Children's Hospital Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen Munich Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katja","family":"Schaaf","sequence":"additional","affiliation":[{"name":"Department of Paediatric and Adolescent Medicine Elisabeth-Hospital Essen Essen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"H\u00f6rtenhuber","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Kepler University Hospital Linz Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johanna","family":"Hammersen","sequence":"additional","affiliation":[{"name":"Department of Paediatrics University Hospital Erlangen Erlangen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reinhard W","family":"Holl","sequence":"additional","affiliation":[{"name":"German Centre for Diabetes Research (DZD) Neuherberg Germany"},{"name":"Institute of Epidemiology and Medical Biometry, ZIBMT University of Ulm Ulm Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,9,27]]},"reference":[{"key":"2024012713454954300_jbmr4451-bib-0001","first-page":"A-838","article-title":"H\u00e4ufigkeit von Frakturen der langen R\u00f6hrenknochen im Wachstumsalter","volume":"102","author":"Kraus","year":"2005","journal-title":"Dtsch Arztebl"},{"key":"2024012713454954300_jbmr4451-bib-0002","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1097\/BPO.0000000000000595","article-title":"Epidemiology of pediatric fractures presenting to emergency departments in the United States","volume":"36","author":"Naranje","year":"2016","journal-title":"J Pediatr Orthop."},{"key":"2024012713454954300_jbmr4451-bib-0003","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1007\/s11657-016-0294-z","article-title":"Fracture incidence rates in Norwegian children, the Tromso study, fit futures","volume":"11","author":"Christoffersen","year":"2016","journal-title":"Arch Osteoporos."},{"key":"2024012713454954300_jbmr4451-bib-0004","doi-asserted-by":"crossref","first-page":"990","DOI":"10.1007\/s001980200137","article-title":"How many children remain fracture-free during growth? 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