{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T22:35:29Z","timestamp":1793918129676,"version":"4.8.0"},"reference-count":40,"publisher":"American Diabetes Association","issue":"8","license":[{"start":{"date-parts":[[2021,8,11]],"date-time":"2021-08-11T00:00:00Z","timestamp":1628640000000},"content-version":"vor","delay-in-days":10,"URL":"https:\/\/www.diabetesjournals.org\/content\/license"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,8,1]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>There is substantial evidence that adults with type 1 diabetes have reduced bone mineral density (BMD); however, findings in youth are inconsistent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>To perform a systematic review and meta-analysis of BMD in youth with type 1 diabetes using multiple modalities: DXA, peripheral quantitative computed tomography (pQCT), and\/or quantitative ultrasound (QUS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DATA SOURCES<\/jats:title>\n                    <jats:p>PubMed, Embase, Scopus, and Web of Science from 1 January 1990 to 31 December 2020, limited to humans, without language restriction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>STUDY SELECTION<\/jats:title>\n                    <jats:p>Inclusion criteria were as follows: cross-sectional or cohort studies that included BMD measured by DXA, pQCT, or QUS in youth (aged &amp;lt;20 years) with type 1 diabetes and matched control subjects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DATA EXTRACTION<\/jats:title>\n                    <jats:p>We collected data for total body, lumbar spine, and femoral BMD (DXA); tibia, radius, and lumbar spine (pQCT); and phalanx and calcaneum (QUS). Weighted mean difference (WMD) or standardized mean difference was estimated and meta-regression was performed with age, diabetes duration, and HbA1c as covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DATA SYNTHESIS<\/jats:title>\n                    <jats:p>We identified 1,300 nonduplicate studies; 46 met the inclusion criteria, including 2,617 case and 3,851 control subjects. Mean \u00b1 SD age was 12.6 \u00b1 2.3 years. Youth with type 1 diabetes had lower BMD: total body (WMD \u22120.04 g\/cm2, 95% CI \u22120.06 to \u22120.02; P = 0.0006), lumbar spine (\u22120.02 g\/cm2, \u22120.03 to \u22120.0; P = 0.01), femur (\u22120.04 g\/cm2, \u22120.05 to \u22120.03; P &amp;lt; 0.00001), tibial trabecular (\u221211.32 g\/cm3, \u221217.33 to \u22125.30; P = 0.0002), radial trabecular (\u22120.91 g\/cm3, \u22121.55 to \u22120.27; P = 0.005); phalangeal (\u22120.32 g\/cm3, \u22120.38 to \u22120.25; P &amp;lt; 0.00001), and calcaneal (standardized mean difference \u22120.69 g\/cm3, \u22121.11 to \u22120.26; P = 0.001). With use of meta-regression, total body BMD was associated with older age (coefficient \u22120.0063, \u22120.0095 to \u22120.0031; P = 0.002) but not with longer diabetes duration or HbA1c.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LIMITATIONS<\/jats:title>\n                    <jats:p>Meta-analysis was limited by the small number of studies with use of QUS and pQCT and by lack of use of BMD z scores in all studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Bone development is abnormal in youth with type 1 diabetes, assessed by multiple modalities. Routine assessment of BMD should be considered in all youth with type 1 diabetes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/dc20-3128","type":"journal-article","created":{"date-parts":[[2021,7,20]],"date-time":"2021-07-20T16:20:16Z","timestamp":1626798016000},"page":"1898-1905","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":52,"title":["Bone Mineral Density and Type 1 Diabetes in Children and Adolescents: A Meta-analysis"],"prefix":"10.2337","volume":"44","author":[{"given":"Phoebe","family":"Loxton","sequence":"first","affiliation":[{"name":"School of Women\u2019s and Child\u2019s Health, University of New South Wales, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kruthika","family":"Narayan","sequence":"additional","affiliation":[{"name":"Institute of Endocrinology and Diabetes, The Children\u2019s Hospital at Westmead, Westmead, New South Wales, Australia"},{"name":"Children\u2019s Hospital Westmead Clinical School, University of Sydney, Westmead, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig F.","family":"Munns","sequence":"additional","affiliation":[{"name":"Institute of Endocrinology and Diabetes, The Children\u2019s Hospital at Westmead, Westmead, New South Wales, Australia"},{"name":"Children\u2019s Hospital Westmead Clinical School, University of Sydney, Westmead, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6004-576X","authenticated-orcid":false,"given":"Maria E.","family":"Craig","sequence":"additional","affiliation":[{"name":"School of Women\u2019s and Child\u2019s Health, University of New South Wales, Sydney, New South Wales, Australia"},{"name":"Institute of Endocrinology and Diabetes, The Children\u2019s Hospital at Westmead, Westmead, New South Wales, 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