Beyond overweight, visceral adiposity is associated with estimation of cardiovascular risk in patients living with type 1 diabetes: findings from the SFDT1 cohort.

IF 8.5 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Diabetology Pub Date : 2025-06-14 DOI:10.1186/s12933-025-02789-3

Laurence Salle, Jean-Baptiste Julla, Guy Fagherazzi, Pierre Gourdy, Erika Bezerra Parente, Hélène Hanaire, Sopio Tatulashvili, Emmanuel Disse, Sylvia Franc, Samy Hadjadj, Etienne Larger, Caroline Sanz, Patricia Vaduva, René Valero, Amélie Bonnefond, Emmanuel Cosson, Gloria A Aguayo, Jean-Pierre Riveline

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引用次数: 0

Abstract

Introduction & objectives: As in the general population, people living with type 1 diabetes (PWT1D) are faced with overweight and obesity, which contribute to cardiovascular (CV) risk. However, the role of visceral adiposity, due to its adverse metabolic profile, should also be addressed in PWT1D. We aimed to assess the 10-year CV risk of PWT1D according to body mass index (BMI) and waist-to-height ratio (WHtR), a parameter for estimating visceral adiposity.

Methods: In this cross-sectional study, PWT1D in primary CV prevention from the SFDT1 cohort were categorized by BMI status, either normal (18.5-24.9 kg/m²) or overweight/obesity (≥ 25 kg/m²), and by WHtR according to the validated threshold of 0.5. The 10-year CV risk was estimated using the Steno Type 1 Risk Engine and classified into three categories: low (< 10%), intermediate (10-20%) and high (> 20%). The distribution of CV risk was assessed using density plots. In multivariable analysis, the association between BMI, WHtR, and high estimated 10-year CV risk was studied using spline regression models with sex stratification. Thresholds were determined by the Receiver Operating Characteristic (ROC) curve.

Results: The study included 1,482 patients; 49.9% had a normal BMI, and 50.1% a BMI ≥ 25 kg/m². The proportion of patients with high CV risk was higher in PWT1D with overweight/obesity (12% vs. 7%) and in those with WHtR ≥ 0.5 (13% vs. 4%). BMI was significantly associated with high CV risk in men (p = 0.001) but a non-significant trend was found in women (p = 0.053). WHtR was significantly associated with high CV risk in both men (p < 0.001) and women (p = 0.046). The BMI threshold associated with high CV risk was 24.9 kg/m² for men, and the WHtR threshold was 0.5 for both men and women.

Conclusion: In PWT1D in condition of primary CV prevention, visceral adiposity, assessed by WHtR, is a more robust marker of estimated 10-year CV risk than overweight/obesity status in both men and women.

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SFDT1队列研究发现，除了超重，内脏脂肪还与1型糖尿病患者心血管风险的估计相关。

与一般人群一样，1型糖尿病（PWT1D）患者面临超重和肥胖，这有助于心血管（CV）风险。然而，由于其不利的代谢特征，内脏脂肪的作用也应该在PWT1D中得到解决。我们的目的是根据体重指数（BMI）和腰高比（WHtR）评估PWT1D的10年CV风险，WHtR是估计内脏脂肪的参数。方法：在这项横断面研究中，SFDT1队列中原发性CV预防的PWT1D按BMI状态分类，正常（18.5-24.9 kg/m2）或超重/肥胖（≥25 kg/m2），并根据验证阈值0.5的WHtR进行分类。使用Steno 1型风险引擎估计10年CV风险，并将其分为三类：低（20%）。使用密度图评估CV风险分布。在多变量分析中，使用带有性别分层的样条回归模型研究了BMI、WHtR和高估计10年CV风险之间的关系。阈值由受试者工作特征（ROC）曲线确定。结果：纳入1482例患者；49.9% BMI正常，50.1% BMI≥25kg /m2。超重/肥胖的PWT1D患者中CV高危的比例更高（12%比7%），WHtR≥0.5的PWT1D患者中CV高危的比例更高（13%比4%）。BMI与男性的高CV风险显著相关（p = 0.001），但在女性中没有发现显著趋势（p = 0.053）。WHtR与两名男性的高CV风险显著相关（男性为p 2），男性和女性的WHtR阈值均为0.5。结论：在原发性CV预防的PWT1D患者中，WHtR评估的内脏脂肪是一个比超重/肥胖状态更可靠的10年CV风险评估指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cardiovascular Diabetology 医学-内分泌学与代谢

CiteScore

12.30

自引率

15.10%

发文量

240

审稿时长

1 months

期刊介绍： Cardiovascular Diabetology is a journal that welcomes manuscripts exploring various aspects of the relationship between diabetes, cardiovascular health, and the metabolic syndrome. We invite submissions related to clinical studies, genetic investigations, experimental research, pharmacological studies, epidemiological analyses, and molecular biology research in this field.