Patologìâ (Jun 2020)
Spinal mobility in children with diabetes and factors, which influence it
Abstract
Aim of study: to evaluate spine mobility, as an integral marker of joint mobility, according to the duration of the disease and provision of vitamin D in children with diabetes. Materials and research methods. Overall, 93 children from 11 to 17 years old with insulin-dependent diabetes were examined. According to the duration of the disease, all the children were divided into three groups: the first group consists of 26 children (average age 12.9 ± 0.4 years) with the duration of the disease less than a year, the second group consists of 33 patients (average age 13.8 ± 0.4 years) with the duration of the disease from one to five years, the third group consists of 34 patients (average age 14.3 ± 0.4 years) with the duration of the disease for more than five years. The control group consists of 30 conditionally healthy children that are representative by age and gender. Evaluation of joints motion was performed in all the children with the help of metrical tests. The content of vitamin D and periostin was identified in blood serum by the method of immunoenzyme assay. Results. It was found that in children with diabetes mellitus, compared with the control group, there is a decrease in spine mobility. Starting from the second year of disease, it was noticed that there is gradual decrease of mobility of all parts of the spine. We observed a decrease in blood serum vitamin D levels, which progress with the enlargement of illness duration. In the first year of the disease, vitamin deficiency was only 10 %. At that time, in group 2 in 50 % of children, and in group 3 in 80 % of children there was a decrease in vitamin D level (P < 0.05). Lack of vitamin D sufficiency was accompanied by a deterioration of the overall mobility of the spine. The lowest levels of vitamin D were found in children with high-risk glycemic control. It was determined that the level of periostin tended to increase gradually with the progress of diabetes. Data analysis showed that children with high levels of periostin had low levels vitamin D in blood serum. Conclusions. Children with diabetes are characterized by the deterioration in the functional state of the spine in the form of reduced mobility in all its regions, which progress with an increase in the duration of the disease. One of the mechanisms for the development of the revealed violations is poor compensation for diabetes and vitamin D deficiency.
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