Body Composition and Regional Adiposity in Adolescents With Type 1 Diabetes: Relation to Insulin Resistance, Glycaemic Control and Vascular Complications

IF 4.6 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes/Metabolism Research and Reviews Pub Date : 2025-04-04 DOI:10.1002/dmrr.70041

Safinaz Adel Elhabashy, Bassma Abdelnasser Abdelhaleem, Sherihane Saieed Madkour, Christein Monir Kamal, Nouran Yousef Salah

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Abstract

Aim

Obesity is increasingly recognized among people with type 1 diabetes mellitus (T1DM). Little is known about the body composition of adolescents with T1DM and its metabolic outcomes. Hence, this study assessed the body composition of adolescents with T1DM and its relationship with glycaemic control, insulin resistance and vascular complications.

Materials and Methods

One hundred twenty adolescents with T1DM were assessed for anthropometric measures, insulin therapy, bioelectrical impedance analysis (BIA), fasting lipids, glycated haemoglobin, with estimated glucose disposal rate (eGDR) calculation. Regional body fat quantification was performed via Magnetic resonance imaging (MRI) 3-T.

Results

Thirty-three adolescents with T1DM were overweight (27.5%), and 8 were obese (6.6%). Adolescents with T1DM having insulin resistance were found to have significantly higher BMI z score, total body fat %, and visceral/subcutaneous fat % than those without insulin resistance (p < 0.05). Moreover, adolescents with T1DM having microvascular complications showed significantly higher total fat % and visceral/subcutaneous fat % than those without microvascular complications (p < 0.05). Visceral fat % and visceral/subcutaneous fat ratio were positively correlated with waist/hip ratio, eGDR and LDL level (p < 0.05). Waist/hip ratio and eGDR were the most significant independent variables associated with visceral fat % and visceral/subcutaneous fat ratio among adolescents with T1DM using multivariate regression analysis.

Conclusions

Overweight and visceral adiposity are frequently encountered among the studied adolescents with T1DM. Visceral adiposity is associated with insulin resistance, hyperlipidaemia and microvascular complications among adolescents with T1DM independent of glycaemic control and insulin dosage.

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1型糖尿病青少年的体成分和局部肥胖：与胰岛素抵抗、血糖控制和血管并发症的关系

目的肥胖在1型糖尿病（T1DM）患者中得到越来越多的认识。对青少年T1DM患者的身体组成及其代谢结果知之甚少。因此，本研究评估了青少年T1DM患者的身体组成及其与血糖控制、胰岛素抵抗和血管并发症的关系。材料与方法对120例T1DM青少年患者进行人体测量、胰岛素治疗、生物电阻抗分析（BIA）、空腹血脂、糖化血红蛋白（gly糖化血红蛋白）评估，并计算葡萄糖处置率（eGDR）。通过磁共振成像（MRI） 3-T进行区域体脂量化。结果青少年T1DM超重33例（27.5%），肥胖8例（6.6%）。有胰岛素抵抗的T1DM青少年BMI z评分、全身脂肪百分比和内脏/皮下脂肪百分比明显高于无胰岛素抵抗的青少年(p <；0.05)。此外，有微血管并发症的青少年T1DM患者的总脂肪百分比和内脏/皮下脂肪百分比明显高于无微血管并发症的青少年(p <；0.05)。内脏脂肪%和内脏/皮下脂肪比与腰臀比、eGDR和LDL水平呈正相关(p <；0.05)。多因素回归分析显示，腰臀比和eGDR是青少年T1DM患者内脏脂肪%和内脏/皮下脂肪比最显著的独立变量。结论超重和内脏肥胖是青少年T1DM患者的常见症状。在青少年T1DM患者中，内脏脂肪与胰岛素抵抗、高脂血症和微血管并发症相关，与血糖控制和胰岛素剂量无关。

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来源期刊

Diabetes/Metabolism Research and Reviews 医学-内分泌学与代谢

CiteScore

17.20

自引率

2.50%

发文量

审稿时长

4-8 weeks

期刊介绍： Diabetes/Metabolism Research and Reviews is a premier endocrinology and metabolism journal esteemed by clinicians and researchers alike. Encompassing a wide spectrum of topics including diabetes, endocrinology, metabolism, and obesity, the journal eagerly accepts submissions ranging from clinical studies to basic and translational research, as well as reviews exploring historical progress, controversial issues, and prominent opinions in the field. Join us in advancing knowledge and understanding in the realm of diabetes and metabolism.