Low Bone Mineral Density and Its Predictors in Type 1 Diabetic Patients Evaluated by the Classic Statistics and Artificial Neural Network Analysis  

Oleh:

Eller-Vainicher, Cristina ; Zhukouskaya, Volha V. ; Koritko, Sergei S. ; Cairoli, Elisa

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Diabetes Care vol. 34 no. 10 (Oct. 2011), page 2186-2191.
Topik: DIABETES; Chronic Diabetes Complications; Type 1 Diabetic Patients

Ketersediaan

Perpustakaan FK Nomor Panggil: D05.K Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

OBJECTIVE To investigate factors associated with bone mineral density (BMD) in type 1 diabetes by classic statistic and artificial neural networks. RESEARCH DESIGN AND METHODS A total of 175 eugonadal type 1 diabetic patients (age 32.8 ± 8.4 years) and 151 age- and BMI-matched control subjects (age 32.6 ± 4.5 years) were studied. In all subjects, BMI and BMD (as Z score) at the lumbar spine (LS-BMD) and femur (F-BMD) were measured. Daily insulin dose (DID), age at diagnosis, presence of complications, creatinine clearance (ClCr), and HbA1c were determined. RESULTS LS- and F-BMD levels were lower in patients (-0.11 ± 1.2 and -0.32 ± 1.4, respectively) than in control subjects (0.59 ± 1, P < 0.0001, and 0.63 ± 1, P < 0.0001, respectively). LS-BMD was independently associated with BMI and DID, whereas F-BMD was associated with BMI and ClCr. The cutoffs for predicting low BMD were as follows: BMI <23.5 kg/m2, DID >0.67 units/kg, and ClCr <88.8 mL/min. The presence of all of these risk factors had a positive predictive value, and their absence had a negative predictive value for low BMD of 62.9 and 84.2%, respectively. Data were also analyzed using the TWIST system in combination with supervised artificial neural networks and a semantic connectivity map. The TWIST system selected 11 and 12 variables for F-BMD and LS-BMD prediction, which discriminated between high and low BMD with 67 and 66% accuracy, respectively. The connectivity map showed that low BMD at both sites was indirectly connected with HbA1c through chronic diabetes complications. CONCLUSIONS In type 1 diabetes, low BMD is associated with low BMI and low ClCr and high DID. Chronic complications negatively influence BMD.

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