Physical Activity Increases Bone Mineral Density in Children with Type 1 Diabetes

MAGGIO, ALBANE B. R.1,4; RIZZOLI, RENÉ R.2; MARCHAND, LAETITIA M.1; FERRARI, SERGE2; BEGHETTI, MAURICE3; FARPOUR-LAMBERT, NATHALIE JACQUELINE1

Medicine & Science in Sports & Exercise: July 2012 - Volume 44 - Issue 7 - p 1206–1211
doi: 10.1249/MSS.0b013e3182496a25
Clinical Sciences

Introduction: Osteoporosis is a growing health problem in patients with type 1 diabetes mellitus (T1DM). The aim of this study was to determine the effects of a 9-month weight-bearing physical activity program on bone mineral density (BMD) and bone biomarkers in T1DM compared with healthy children.

Methods: This was a randomized controlled trial including 27 diabetic and 32 healthy children (mean age = 10.5 ± 2.5 yr). Both T1DM and healthy participants were randomized to either an exercise or a control group (i.e., four groups). At baseline and 9 months, total body (TB), lumbar spine (LS2–LS4), femoral neck, and greater trochanter areal BMD (aBMD) and serum bone biomarkers (osteocalcin, type 1 collagen cross-linking) were measured. The intervention consisted of two 90-min sessions per week of weight-bearing physical activity (ball games, jumping, rope skipping, and gymnastics).

Results: Baseline variables were similar among groups. At 9 months, changes in TB (T1DM = 0.035 ± 0.022 g·cm−2, healthy = 0.031 ± 0.017 g·cm−2) and LS2–LS4 (T1DM = 0.046 ± 0.038 g·cm−2, healthy = 0.063 ± 0.034 g·cm−2) aBMD were statistically significant in the intervention groups and of similar magnitude between T1DM and healthy subjects. The level of type 1 collagen cross-linking (T1DM = −0.12 ± 0.32 ng·mL−1, healthy = −0.36 ± 0.11 ng·mL−1) decreased in the intervention groups but was not associated with TB aBMD changes.

Conclusions: Regular weight-bearing physical activity (180 min·wk−1, including ball games, jumping activities, and gymnastics) improves total and LS2–LS4 bone mineral accretion in children with T1DM, in a similar magnitude to healthy subjects. We conclude that children with T1DM should be encouraged to practice regular physical activity to enhance peak bone mass and prevent osteoporosis later in life.

1Pediatric Sports Medicine and Obesity Care Program, Service of Pediatric Specialties, Department of Child and Adolescent, University Hospital of Geneva, Geneva, SWITZERLAND; 2Service of Bone Diseases, Department of Rehabilitation and Geriatrics, University Hospital of Geneva, Geneva, SWITZERLAND; 3Pediatric Cardiology Unit, Service of Pediatric Specialties, Department of Child and Adolescent, University Hospital of Geneva, Geneva, SWITZERLAND; and 4University of Geneva, Geneva, SWITZERLAND

Address for correspondence: Nathalie Jacqueline Farpour-Lambert, M.D., Pediatric Sports Medicine and Obesity Care Program, Service of PediatricSpecialties, Department of Child and Adolescent, University Hospital ofGeneva, 6 rue Willy-Donzé, 1211 Geneva 14, Switzerland; E-mail: nathalie.farpourlambert@hcuge.ch.

Submitted for publication April 2011.

Accepted for publication October 2011.

©2012The American College of Sports Medicine