Aim

Impaired regulation of glucose metabolism in childhood adversely affects bone health. We assessed the effect of fasting hyperglycemia and insulin resistance on bone turnover markers in prepubertal children with normal glycemia (<100 mg/dL) and fasting hyperglycemia (100-125 mg/dL).

Methods

Glucose, hemoglobin A1c, IGF-I (insulin-like growth factor I), iP1NP (N-terminal propeptide of type I procollagen), CTX-1 (C-terminal telopeptide of type I collagen) and insulin were measured. Bone turnover index (BTI) and HOMA-IR (homeostasis model assessment) were calculated.

Results

Bone resorption marker (CTX) levels were decreased by 26.5% in boys with hyperglycemia, though only 7% in girls. Hyperglycemia had no effect on the bone formation marker iP1NP. IGF-1, the best predictor of bone marker variance accounted for 25% of iP1NP and 5% of CTX variance. Girls presented significantly higher BTI indicating the predominance of bone formation over resorption. Insulin resistance significantly decreased CTX. In girls, HOMA-IR and IGF-1 predicted 15% of CTX variance.

Conslusions

Fasting hyperglycemia and insulin resistance in children impact bone turnover suppressing bone resorption. Hyperglycemia decreased resorption, particularly in boys, while suppression of resorption by insulin resistance was more pronounced in girls. We suggest that the progression of disturbances accompanying prediabetes, may interfere with bone modelling and be deleterious to bone quality in later life.

中文翻译：

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空腹高血糖和胰岛素抵抗对 9-11 岁儿童骨转换标志物的影响

目标

儿童期葡萄糖代谢调节受损会对骨骼健康产生不利影响。我们评估了空腹高血糖和胰岛素抵抗对正常血糖（<100 mg/dL）和空腹高血糖（100-125 mg/dL）的青春期前儿童骨转换标志物的影响。

方法

测量了葡萄糖、血红蛋白 A1c、IGF-I（胰岛素样生长因子 I）、iP1NP（I 型前胶原的 N 端前肽）、CTX-1（I 型胶原的 C 端端肽）和胰岛素。计算骨转换指数（BTI）和HOMA-IR（稳态模型评估）。

结果

患有高血糖症的男孩的骨吸收标志物 (CTX) 水平降低了 26.5%，而女孩仅降低了 7%。高血糖对骨形成标志物 iP1NP 没有影响。IGF-1 是骨标志物变异的最佳预测因子，占 iP1NP 的 25% 和 CTX 变异的 5%。女孩表现出显着更高的 BTI，表明骨形成优于吸收。胰岛素抵抗显着降低 CTX。在女孩中，HOMA-IR 和 IGF-1 预测了 15% 的 CTX 变异。

结论

儿童的空腹高血糖和胰岛素抵抗会影响骨转换，抑制骨吸收。高血糖降低了再吸收，特别是在男孩中，而胰岛素抵抗对再吸收的抑制在女孩中更为明显。我们认为伴随前驱糖尿病的疾病进展可能会干扰骨骼建模，并在以后的生活中对骨骼质量有害。