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Summary: In this meta-analysis, we analyzed 9 cross-sectional studies for an association between type 1 diabetes mellitus (T1DM) and bone mineral density (BMD) in children. We found that BMD Z-scores were significantly reduced in children with T1DM. Introduction: Recent cross-sectional studies have examined how T1DM influences bone health in children and adolescents, but the relationship between T1DM and BMD remains unclear due to conflicting reports. Methods: In this meta-analysis, we systematically searched PubMed, Cochrane library, and Web of Science databases (for publications through March 12, 2020), and calculated weight mean difference (WMD) along with 95% confidence intervals (CI) using a random-effects model. Heterogeneity was evaluated using the I2 method. The Newcastle-Ottawa Scale was used to assess the quality of the included studies. Results: Data were analyzed from 9 eligible studies, including a total of 1522 children and adolescents. These data were tested for an association between T1DM and BMD. This analysis found a significant decrease in BMD Z-score in the whole body (pooled WMD, − 0.47, 95% CI, − 0.92 to − 0.02, I2 = 80.2%) and lumbar spine (pooled WMD, − 0.41, 95% CI, − 0.69 to − 0.12, I2 = 80.3%) in children and adolescents with T1DM, which was consistent in published studies from Asia and South America, but inconsistent in the North America and Europe. Importantly, the differences in BMD Z-scores were independent of age, level of glucose control (HbA1c), and prepubertal stage. Sensitivity analyses did not modify these findings. Funnel plot and the Egger test did not reveal significant publication bias. Conclusion: This meta-analysis suggests that T1DM may play a role in decreasing BMD Z-scores in the whole body and lumbar spine in children. [ABSTRACT FROM AUTHOR]

To urge nations worldwide to implement robust measures for enhancing human development and mitigating the pressures exerted on the planet by human activities in pursuit of sustainable development, this study encompasses 154 countries globally, using the seven major regions as focal points. Leveraging the Planetary Pressure Adjusted Human Development Index (PHDI) proposed by the United Nations Development Programme on December 15, 2020, as a metric for human development levels, this paper aims to standardize and internationally compare human development data from 1990 to 2021. Subsequently, employing the Theil index, the study assesses the global human development status across the seven regions to analyze spatial disparities in PHDI. Lastly, a comprehensive Generalized Diese Index Method (GDIM) is constructed to accurately reflect absolute and latent factors, dissecting the driving forces impacting global PHDI. The study explores critical pathways for high-quality human development within the harmonious coexistence between humanity and nature. It validates the robustness of GDIM results through a stepwise regression. Research findings indicate varying levels of PHDI development across regions, with a distinct spatial hierarchy evolving: higher human development levels in Europe and Eastern Europe, favorable levels in North and South America, similar levels in Oceania and Asia, and significant improvement potential in Africa. As globalization progresses, overall differences in PHDI gradually decrease; however, disparities persist between and within regions. Economic, technological, and per capita welfare effects consistently positively drive PHDI. In contrast, environmental pressure effects, social effects, per capita value-added effects, and output carbon intensity effects consistently exert hostile driving forces. Population size effects on PHDI show a fluctuating trend. Moreover, in terms of cumulative contribution values, the top three contributors to driving forces are economic, technological, and per capita welfare effects., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)