Muscle Fitness Linked to Bone Health in Youths With T1D

Medscape

2 days ago

Higher muscular fitness, measured through handgrip strength and muscle power, was strongly associated with higher bone mineral content and areal bone mineral density across multiple skeletal regions in children and adolescents with type 1 diabetes (T1D).
METHODOLOGY:
Young patients with T1D exhibit compromised bone strength, demonstrated by reduced areal bone mineral density and bone mineral content, leading to an elevated lifetime risk for fractures.
Researchers in Spain conducted a longitudinal cohort study to examine the association between muscular fitness and bone mineral content and areal bone mineral density outcomes in children and adolescents with T1D.
They included 83 participants (mean age, 13.7 years; 55% boys; mean diabetes duration, 5.8 years) who had been diagnosed with T1D for more than 6 months; participants were followed up for 2 years, with evaluations conducted annually.
Muscular fitness parameters assessed were handgrip strength, one-repetition maximum strength, and muscle power, measured using a digital dynamometer and other methods.
Outcomes of interest were bone mineral content and areal bone mineral density, assessed using dual-energy x-ray absorptiometry whole-body scans across multiple body regions (total body less head, arms, legs, pelvis, and spine).
TAKEAWAY:
Significant positive longitudinal associations were observed between muscular fitness parameters and bone mineral content for the total body less head (beta coefficient, 16.713, 19.535, and 28.179 for handgrip strength, repetition maximum strength, and muscle power, respectively; P <.05 for all); the associations persisted for other regions of the body as well.
<.05 for all); the associations persisted for other regions of the body as well. Significant associations were also found between muscular fitness parameters and areal bone mineral density for all body regions.
When standardised reference data from the general population were used, youths who had higher z scores of handgrip strength showed higher z scores of bone mineral content (beta coefficient, 0.194; 95% CI, 0.088-0.300) and areal bone mineral density (beta coefficient, 0.350; 95% CI, 0.210-0.490) in the total body less head region.
IN PRACTICE:
"The findings support current clinical guidelines recommending regular monitoring of bone health in youth with type 1 diabetes via DXA [dual-energy x-ray absorptiometry]. They also reinforce existing recommendations advocating at least three days per week of muscle-strengthening activities, as a critical component of care for this population," the authors wrote.
SOURCE:
This study was led by Jacinto Muñoz-Pardeza, Navarrabiomed, Hospital Universitario de Navarra, Universidad Pública de Navarra, IdiSNA, Pamplona, Spain. It was published online on June 05, 2025, in The Journal of Clinical Endocrinology & Metabolism .
LIMITATIONS:
Dual-energy x-ray absorptiometry scans were used to monitor bone mineral content and areal bone mineral density, which limited the measurement of geometric or microarchitectural properties. The analysis was limited to whole-body scans and excluded the hip and lumbar spine regions. Lean mass was not included as a covariate because of multicollinearity with BMI. Moreover, the analyses did not account for participants' fracture histories, which may have confounded the associations.
DISCLOSURES:
This study was supported by grants from the Instituto de Salud Carlos III - ERDF. One author was granted fellowship from the funding institute of this study. Other authors reported having no conflicts of interest.