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25-hydroxyvitamin D status and bone mineral density in Egyptian patients with type 1 diabetes

Background Vitamin D deficiency and diabetes mellitus are two common situations. Type 1 diabetes has been inconsistently associated with low bone mineral density (BMD) and increased fracture risk. Aim To assess serum vitamin D levels in relation to BMD in a sample of young Egyptian patients with type 1 diabetes mellitus. Patients and methods A case–control study was conducted on 90 participants, including 60 patients who were known to have type 1 diabetes and 30 age-matched, sex-matched, and BMI-matched healthy participants. Fasting plasma glucose, postprandial glucose, glycated hemoglobin (HbA1c), serum calcium, serum phosphorus, alkaline phosphatase, 25(OH) vitamin D, and intact parathyroid hormone were measured. Left femur BMD and lumbar spine (L1–L4) BMD were measured by dual-energy radiograph absorptiometry. Results Mean values of vitamin D level and BMD were significantly lower in the patient than the control group. In the patient group, vitamin D deficiency and low BMD were found in 90.7 and 26.7%, respectively. In the patient group, a significant correlation was found between BMD Z-score at lumbar spine and left femur and fasting plasma glucose, postprandial, and HbA1c but not with vitamin D levels. A multivariate regression analysis was performed including different significant parameters, and only HbA1c was significantly correlated with left femur and spine BMD. Conclusion HbA1c is the only predictable variable for reduction of BMD in patients with type 1 diabetes mellitus.