Banca de DEFESA: NAIARA VIUDES GARCIA MARTINS NÓBREGA

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
STUDENT : NAIARA VIUDES GARCIA MARTINS NÓBREGA
DATE: 29/01/2024
TIME: 14:00
LOCAL: Sala de Reuniões do Laboratório Interdisciplinar de Biociências – Faculdade de Medicina UnB
TITLE:

"Longitudinal evaluation of bone mass acquisition in children and adolescents with type 1 diabetes mellitus: an eight-year follow-up.

KEY WORDS:

type 1 diabetes mellitus, bone mass acquisition, bone densitometry, anthropometry, pediatrics.

PAGES: 100
BIG AREA: Ciências da Saúde
AREA: Medicina
SUMMARY:

Introduction. Type 1 diabetes mellitus (T1D) is associated with a potential risk of negative interference in various aspects of the patient's osteometabolic physiology. Currently, there are few studies investigating the impact of T1D on bone mass acquisition in children and adolescents. Objective. To study and describe the pattern of bone mass acquisition in children and adolescents with T1D over a eight-year-period, by analyzing the bone mineral density of the lumbar spine and total body using bone densitometry (DXA). Methods. This was a longitudinal and retrospective study evaluating the pattern of bone mass acquisition using DXA in children and adolescents with T1D over an eight-year period, between 2009 and 2017, who were followed up at the Secretaria de Saúde do Distrito Federal. L1L4 lumbar spine Z-score (Zls) and total body Z-score (Ztb) of the same group of patients were evaluated in 2009 and 2017. At the end of the study, the patients were divided into two groups according to the length of time they had had T1D: Group A, with less than 10 years, and Group B, with more than 10 years of diagnosis. Anthropometric data (weight, height, body mass index - BMI), mean glycated hemoglobin (A1c), calcium intake profile, sun exposure, physical activity practice and number of fractures were the other variables assessed and correlated with the patients' bone mass acquisition pattern over the study period. Results. The study cohort consisted of 21 patients (13 females), with a mean age at the first assessment of 10.1 ± 2.9 years, and at the second assessment of 17.9 ± 2.9 years. The average time since diagnosis of T1D at the end of the second assessment was 11.0 ± 2.7 years. Group A (n = 8, 7 females, mean age of 16.5 ± 2.4 years at the end of the assessment period, a diagnosis time of 9.1 ± 0.8 years), presented a height Z-score (Zh) of -0.40 ± 0.60 SD, a BMI Z-score (Zbmi) 0.9 ± 0.6 SD and a mean A1c 8.0 ± 1.4 %. Group B (n = 13, 6 females, mean age of 18.8 ± 2.9 years at the end of the study period, time since DM1 diagnosis of 13.0 ± 2.4 years), presented Zh -0.19 ± 1.25 SD, Zbmi 0.01 ± 0.63 SD and mean A1c 9.2 ± 1.8 %. For the total group, there was a decrease in Zh over time, from 0.35 ± 1.22 to -0.2 ± 1.1 SD (p = 0.000), and an increase in Zbmi from -0.37 ± 0.78 to 0.35 ± 0.87 SD (p = 0.043). There was no change in mean A1c over the period (8.70 ± 1.74% and 8.7 ± 1.7%, respectively, p = 0.902). Over the study period, the Zls of the total group decreased from -0.04 ± 0.95 to -0.43 ± 1.23 SD (p = 0.032). There was no difference in Ztb (p = 0.292). There was no difference in behavior in the pattern of bone acquisition and mass and in the average A1c (p = 0.135) over the period, when comparing groups A and B. In the total group, there was a moderate negative correlation between mean A1c and Zcl (r² = -0.504; p = 0.023). Five patients in the total group had fractures (4 maleS), all traumatic and non-vertebral. None of the patients had clinical osteoporosis. The group of patients with fractures showed greater variation between the beginning and end Zls and Ztb compared to the group without fractures (p = 0.023 and 0.001, respectively). For the total group, there was a positive correlation between the pattern of sun exposure and Zls (p = 0.036). However, there was no difference in the pattern of Zls acquisition between the sexes (p = 0.273), nor was there any correlation between Zls and calcium intake (p = 0.274) or physical activity (p = 0.094). There was no correlation between the total body Z-score and the parameters analyzed. Conclusion. In this eight-year longitudinal cohort, there was a worsening of bone mass in the lumbar spine, a drop in Zh and an increase in Zbmi in children and adolescents with T1D, regardless of gender or disease length. Patients with higher A1c values showed greater impairment in the acquisition of bone mass. The occurrence of bone fractures was associated with greater negative variations in the bone mineral density of the lumbar spine and total body over the period.

COMMITTEE MEMBERS:
Interna - 2329402 - ANGELICA AMORIM AMATO
Externa à Instituição - LUCIANA PINTO VALADARES - SARAH
Presidente - 2189235 - LUIZ CLAUDIO GONCALVES DE CASTRO
Externa ao Programa - 1550653 - NEYSA APARECIDA TINOCO REGATTIERI - null