Control glucémico y estudio del metabolismo lipídico y del óseo en niños con diabetes de tipo 1
Resumen
Introducción. La diabetes mellitus de tipo 1 se considera una de las enfermedades crónicas más frecuentes de la infancia. Es un factor de gran riesgo de desarrollar enfermedad cardiovascular temprana y afecta también la salud ósea.
Objetivo. Describir las características demográficas y los parámetros bioquímicos de una población de niños con diabetes de tipo 1, supervisados en la unidad pediátrica de diabetes de un hospital español de tercer nivel.
Materiales y métodos. En este estudio retrospectivo, se determinaron los parámetros de control metabólico, lipídico y óseo en 124 niños con diabetes de tipo 1, a los que se hizo seguimiento en la Unidad Pediátrica de Diabetes del Hospital Universitario Miguel Servet de Zaragoza, desde mayo del 2020 hasta julio del 2021.
Resultados. Los niños con diabetes de tipo 1 presentan peor control metabólico de la enfermedad en la pubertad, pero su control lipídico se puede considerar aceptable. Existe una correlación inversa de los marcadores de formación ósea con el tiempo de evolución de la enfermedad, así como con el control metabólico.
Conclusión. Los marcadores de formación ósea se encuentran correlacionados de forma inversa con el porcentaje de hemoglobina glicosilada y con el tiempo de evolución de la diabetes. En estos pacientes, el perfil lipídico y el óseo son más favorables cuando existe un buen control metabólico de la enfermedad.
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Referencias bibliográficas
Karvonen M, Viik-Kajander M, Moltchanova E, Libman I, LaPorte R, Tuomilehto J. Incidence of childhood type 1 diabetes worldwide. Diabetes Mondiale (DiaMond) Project Group. Diabetes Care. 2000;23:1516-26. https://doi.org/10.2337/diacare.23.10.1516
Mamoulakis D, Galanakis E, Bicouvarakis S, Paraskakis E, Sbyrakis S. Epidemiology of childhood type I diabetes in Crete, 1990-2001. Acta Paediatr. 2003;92:737. https://doi.org/10.1080/08035250310002588
Karvonen M, Pitkäniemi J, Tuomilehto J. The onset age of type 1 diabetes in Finnish children has become younger. The Finnish Childhood Diabetes Registry Group. Diabetes Care. 1999;22:1066. https://doi.org/10.2337/diacare.22.7.1066
Dabelea D, Mayer-Davis EJ, Imperatore G. The value of national diabetes registries: SEARCH for Diabetes in Youth Study. Curr Diab Rep. 2010;10:362-9. https://doi.org/10.1007/s11892-010-0135-1
Patterson C, Guariguata L, Dahlquist G, Soltész G, Ogle G, Silink M. Diabetes in the young - A global view and worldwide estimates of numbers of children with type 1 diabetes. Diabetes Res Clin Pract. 2014;103:161-75. http://doi.org/10.1016/j.diabres.2013.11.005
Gale EA. The rise of childhood type 1 diabetes in the 20th century. Diabetes. 2002;51:3353-61 https://doi.org/10.2337/diabetes.51.12.3353
Kavey RE, Allada V, Daniels SR, Hayman LL, McCrindle BW, Newburger JW, et al. Cardiovascular risk reduction in high-risk pediatric patients: A scientific statement from the American Heart Association expert panel on population and prevention science; the Councils on cardiovascular disease in the young, epidemiology and prevention, nutrition, physical activity and metabolism, high blood pressure research, cardiovascular nursing, and the kidney in heart disease; and the Interdisciplinary Working Group on quality of care and outcomes research: Endorsed by the American Academy of Pediatrics. Circulation. 2006;114:2710-38. https://doi.org/10.1161/CIRCULATIONAHA.106.179568
Vurallı D, Jalilova L, Alikaşifoğlu A, Özön ZA, Gönç EN, Kandemir N. Cardiovascular risk factors in adolescents with type 1 diabetes: Prevalence and gender differences. J Clin Res Pediatr Endocrinol. 2024;16:11-20. https://doi.org/10.4274/jcrpe.galenos.2023.2023-12-12
Siminerio LM, Albanese-O’Neill A, Chiang JL, Hathaway K, Jackson CC, Weissberg-Benchell J, et al. Care of young children with diabetes in the child care setting: A position statement of the American Diabetes Association. Diabetes Care. 2014;37:2834-42. https://doi.org/10.2337/dc14-1676
Rewers MJ, Pillay K, de Beaufort C, Craig ME, Hanas R, Acerini CL, et al. Assessment and monitoring of glycemic control in children and adolescents with diabetes. Pediatr Diabetes. 2014;15:102-14. https://doi.org/10.1111/pedi.12190
Schwab KO, Doerfer J, Marg W, Schober E, Holl RW. DPV Science Initiative and the Competence Network Diabetes mellitus. Characterization of 33,488 children and adolescents with type 1 diabetes based on the gender-specific increase of cardiovascular risk factors. Pediatr Diabetes. 2010;11:357-63. https://doi.org/10.1111/j.1399-5448.2010.00665.x
Lachin JM, Bebu I, Nathan DM; DCCT/EDIC Research Group. The beneficial effects of earlier versus later implementation of intensive therapy in type 1 diabetes. Diabetes Care. 2021;44:2225-30. https://doi.org/10.2337/dc21-1331
Gubitosi-Klug RA; DCCT/EDIC Research Group. The diabetes control and complications trial/epidemiology of diabetes interventions and complications study at 30 years: Summary and future directions. Diabetes Care. 2014;37:44-9. https://doi.org/10.2337/dc13-2148
Weber DR. Bone accrual in children and adolescents with type 1 diabetes: Current knowledge and future directions. Curr Opin Endocrinol Diabetes Obes. 2021;28:340-7. https://doi.org/10.1097/MED.0000000000000638
Dabelea D, Bell RA, D’Agostino RB, Imperatore G, Johansen JM, Linder B, et al. Writing Group for the SEARCH for Diabetes in Youth Study Group. Incidence of diabetes in youth in the United States. JAMA. 2007;297:2716. https://doi.org/10.1001/jama.297.24.2716
Kordonouri O, Klingensmith G, Knip M, Holl RW, Aanstoot HJ, Menon PSN, et al. Other complications and diabetes-associated conditions in children and adolescents. Pediatr Diabetes. 2014;15:270-8. https://doi.org/10.1111/pedi.12183
Díaz-Cárdenas C, Wonga C, Vargas-Catalán NA. Grado de control metabólico en niños y adolescentes con diabetes mellitus tipo 1. Rev Chil Pediatr. 2016;87:43-7. https://doi.org/10.1016/j.rchipe.2015.09.002
Plamper M, Gohlke B, Woelfle J, Konrad K, Rohrer T, Hofer S, et al. Interaction of pubertal development and metabolic control in adolescents with type 1 diabetes mellitus. J Diabetes Res. 2017;2017:861576. https://doi.org/10.1155/2017/8615769
Gerhardsson P, Schwandt A, Witsch M , Kordonouri O, Svensson J, Forsander G, et al. The SWEET Project 10-year benchmarking in 19 countries worldwide is associated with improved HbA1c and increased use of diabetes technology in youth with type 1 diabetes. Diabetes Technol Ther. 2021;23:491-9. https://doi.org/10.1089/dia.2020.0618
Schwandt A, Hermann JM, Rosenbauer J, Boettcher C, Dunstheimer D, Grulich-Henn J, et al. Longitudinal trajectories of metabolic control from childhood to young adulthood in type 1 diabetes from a large German/Austrian Registry: A Group-based modeling approach. Diabetes Care. 2017;40:309-16. https://doi.org/10.2337/dc16-1625
Faienza MF, Ventura A, Delvecchio M, Fusillo A, Piacente L, Aceto G, et al. High sclerostin and Dickkopf-1 (DKK-1) serum levels in children and adolescents with type 1 diabetes mellitus. J Clin Endocrinol Metab. 2017;102:1174-81. https://doi.org/10.1210/jc.2016-2371
Homma TK, Endo CM, Saruhashi T, Mori AP, de Noronha RM, Monte O, et al. Dyslipidemia in young patients with type 1 diabetes mellitus. Arch Endocrinol Metab. 2015;59:215-9. https://doi.org/10.1590/2359-3997000000040
Selvaraj M, Prasad HK, White S, Prasanna B, Sangaralingam T. Prevalence and determinants of occurrence of dyslipidemia in subjects with type 1 diabetes mellitus. Indian J Pediatr. 2023;90:118-23. https://doi.org/10.1007/s12098-022-04130-2
Bulut T, Demirel F, Metin A. The prevalence of dyslipidemia and associated factors in children and adolescents with type 1 diabetes. J Pediatr Endocrinol Metab. 2017;30:181-7. https://doi.org/10.1515/jpem-2016-0111
Kershnar AK, Daniels SR, Imperatore G, Palla SL, Petitti DB, Pettitt DJ, et al. Lipid abnormalities are prevalent in youth with type 1 and type 2 diabetes: The search for diabetes in youth study. J Pediatr. 2006;149:314-9. https://doi.org/10.1016/j.jpeds.2006.04.065
Macedoni M, Hovnik T, Plesnik E, Kotnik P, Bratina N, Battelino T, et al. Metabolic control, ApoE genotypes, and dyslipidemia in children, adolescents and young adults with type 1 diabetes. Atherosclerosis. 2018;273:53-8. https://doi.org/10.1016/j.atherosclerosis.2018.04.013
Petitti DB, Imperatore G, Palla SL, Daniels SR, Dolan LM, Kershnar AK, et al. Serum lipids and glucose control: The SEARCH for Diabetes in Youth study. Arch Pediatr Adolesc Med. 2007;161:159-65. https://doi.org/10.1001/archpedi.161.2.159
Frontini MG, Srinivasan SR, Xu J, Tang R, Bond MG, Berenson GS. Usefulness of childhood non-high density lipoprotein cholesterol levels versus other lipoprotein measures in predicting adult subclinical atherosclerosis: The Bogalusa Heart Study. Pediatr. 2008;121:924-9. https://doi.org/10.1542/peds.2007-1472
Dorchy H. Screening for subclinical complications in children and adolescents with type 1 diabetes: Experience acquired in Brussels. Rev Med Brux. 2010;31:S87-108.
Abd-El Dayem SM, El-Shehaby AM, Abd-El Gafar A, Fawzy A, Salama H. Bone density, body composition, and markers of bone remodeling in type 1 diabetic patients. Scand J Clin Lab Invest. 2011;71:387-93. https://doi.org/10.3109/00365513.2011.573574
Maggio AB, Ferrari S, Kraenzlin M, Marchand LM, Schwitzgebel V, Beghetti M, et al. Decreased bone turnover in children and adolescents with well controlled type 1 diabetes. J Pediatr Endocrinol Metab. 2010;23:697-707. https://doi.org/10.1515/jpem.2010.23.7.697
Pater A, Sypniewska G, Pilecki O. Biochemical markers of bone cell activity in children with type 1 diabetes mellitus. J Pediatr Endocrinol Metab. 2010;23:81-6. https://doi.org/10.1515/jpem.2010.23.1-2.81
Madsen JOB, Jørgensen NR, Pociot F, Johannesen J. Bone turnover markers in children and adolescents with type 1 diabetes - A systematic review. Pediatr Diabetes. 2019;20:510-22. https://doi.org/10.1111/pedi.12853
Tsenditis C, Gourgiotis D, Kossiva L, Doulgeraki A, Marmarinos A, Galli-Tsinopoulou A, et al. Higher levels of s-RANKL and osteoprotegerin in children and adolescents with type 1 diabetes mellitus may indicate increased osteoclast signaling and predisposition to lower bone mass: A multivariate cross-sectional analysis. Osteoporos Int. 2016;27:1631-43. https://doi.org/10.1007/s00198-015-3422-5
Onder A, Cetinkaya S, Tunc O, Aycan Z. Evaluation of bone mineral density in children with type 1 diabetes mellitus. J Pediatr Endocrinol Metab. 2013;26:1077-81. https://doi.org/10.1515/jpem-2012-0369
Brandao FR, Vicente EJ, Daltro CH, Sacramento M, Moreira A, Adan L. Bone metabolism is linked to disease duration and metabolic control in type 1 diabetes mellitus. Diabetes Res Clin Pract. 2007;78:334-9. https://doi.org/10.1016/j.diabres.2007.04.009
Madsen JOB, Herskin CW, Zerahn B, Jørgensen NR, Olsen BS, Pociot F, et al. Decreased markers of bone turnover in children and adolescents with type 1 diabetes. J Bone Miner Metab. 2020;38:328-37. https://doi.org/10.1007/s00774-019-01058-0
Vázquez-Gámez MA, Bocio-Núñez J, Bermúdez-de la Vega JA, Bernal-Cerrato S, Giner-García M, Miranda-García MJ, et al. Cambios en la masa ósea en una población infantil con diabetes mellitus tipo 1. Estudio longitudinal. Rev Osteoporos Metab Miner. 2022;14:82-7.
Liu EY, Wactawski-Wende J, Donahue RP, Dmochowski J, Hovey KM, Quattrin T. Does low bone mineral density start in post-teenage years in women with type 1 diabetes? Diabetes Care. 2003;26:2365-9. https://doi.org/10.2337/diacare.26.8.2365
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