Does type 1 diabetes mellitus affect bone quality in prepubertal children?

Type 1 diabetes mellitus [T1DM] in children often starts before the achievement of peak bone mass. This may constitute a landmark in predicting bone fracture risk later in their lives. This study aims to determine the serum levels of bone markers in children with T1DM in combination with their bone mineral density [BMD]. Children diagnosed with T1DM for 3 years or more without signs of puberty were included in the diabetic group. Another group of age-matched healthy non-diabetic controls was recruited froma local school. The serum levels of a group of biochemical markers for bone formation and resorption were determined in both study groups, and BMD was measured by ultrasound absorptiometry. Thirty six children with T1DM and 39 normal children were included in this study. The results showed that 24/36 [66.7%] diabetic children had a Z score below zero. Of these, five scored below -1. In contrast, 12/39 [30.8%] children from the control group had a Z score below zero, but none had a score below -1. Significantly lower levels of osteocalcin and procollagen N-terminal peptide were detected in the diabetic group. The serum levels of bone resorption markers were significantly higher in the diabetic group. T1DM decreases BMD and some bone formation and increases some bone resorption biomarkers. BMD and bone markers are useful diagnostic tools for the early detection of alterations in the bone quality of children with T1DM. This, if treated in a timely manner, may decrease future bone fracture susceptibility

Screening for congenital hypothyroidism North-West region of Saudi arabia

The aim of this study is to demonstrate the prevalence of congenital hypothyroidism [CH] in Madina Al-Munawara region, Kingdom of Saudi Arabia [KSA] and to compare the results with other reported studies. All deliveries conducted at the Ministry of Health Hospitals, Health Centers and Private Hospitals in Madina Al-Munawara region, KSA during the period from 1989 to 1999 were included in this study. Cord blood samples for thyroid stimulating hormone [TSH] measurement was used for screening. Out of 200,040 deliveries 193,613 infants were screened for CH during the study period. Forty-six infants had hypothyroidism with an overall prevalence of 1:4208 live births. Thirty-three [72%] of the diagnosed infants were Saudi and 13 [28%] were not Saudi. The male to female ratio was 1:3. The mean age at the start of treatment was 9 days. The screening program based on the initial measurement of TSH in cord blood is detected by nearly 97% of the total infants born in Madina region over 10 years. The overall prevalence of CH was 1:4208 lower than other local studies. Mental retardation can be prevented by neonatal screening program; however, Neonatologists and Pediatricians should remain vigilant in searching for signs and symptoms of CH