Overweight and obesity in adults with type 1 diabetes: associations with glycemic control and cardiometabolic risk.

IF 2.1 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes and Metabolic Disorders Pub Date : 2025-10-18 eCollection Date: 2025-12-01 DOI:10.1007/s40200-025-01718-1

Joana Lagoa, Ana Rita Leite, Patrícia Ferreira, Inês Meira, João Menino, Ana Margarida Lopes, Mariana Lourenço, Beatriz Viveiros, Maria João Barbosa, Sílvia Santos Monteiro, Celestino Neves, Joana Queirós, João Sérgio Neves

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引用次数: 0

Abstract

Purpose: An often-overlooked issue in type 1 diabetes' (T1D) management is the growing prevalence of overweight and obesity, as well as the control of accompanying cardiometabolic risk factors. This cross-sectional study investigates associations of body mass index (BMI) and waist circumference (WC) with glycemic control and other cardiometabolic risk factors in adults with T1D.

Methods: Patients followed in the Insulin Pump Clinic at a tertiary hospital were selected. Data from clinical records and continuous glucose monitoring-derived parameters were retrospectively documented, from 2022 to 2024. Associations of BMI and WC categories with cardiometabolic risk factors were assessed using linear regression models. Restricted cubic splines analyses were performed to assess for nonlinear associations.

Results: Of the 388 patients included, 32.3% were overweight and 13.7% had obesity. A U-shaped relationship was observed between BMI and glycated hemoglobin (HbA1c), with lower and higher BMI associated with increased HbA1c (p for non-linearity = 0.005). A higher time in range was found in the increased WC group (53.1 ± 18.4% vs. 59.8 ± 14.6%, p = 0.036). Patients with obesity had higher systolic (p = 0.013) and diastolic blood pressure (BP) (p = 0.001), non-high-density lipoprotein (HDL) cholesterol (p = 0.022) and triglycerides (p = 0.001) values, when compared to lower BMI categories. Patients with increased WC also presented higher systolic (p = 0.038) and diastolic BP (p = 0.015), non-HDL (p = 0.010) and triglycerides (p < 0.001) values, compared to those with normal WC.

Conclusion: In adults with T1D, BMI and WC showed stronger associations with BP and lipid profile than glycemic control, underscoring the importance of comprehensive cardiovascular risk assessment and targeted therapeutic strategies in this population.

Supplementary information: The online version contains supplementary material available at 10.1007/s40200-025-01718-1.

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1型糖尿病成人超重和肥胖：与血糖控制和心脏代谢风险的关系

目的：在1型糖尿病（T1D）的管理中，一个经常被忽视的问题是超重和肥胖的日益流行，以及伴随的心脏代谢危险因素的控制。本横断面研究调查了T1D成人体重指数（BMI）和腰围（WC）与血糖控制和其他心脏代谢危险因素的关系。方法：选取某三级医院胰岛素泵门诊随访的患者。从2022年到2024年，回顾性记录了临床记录和连续血糖监测参数的数据。使用线性回归模型评估BMI和WC类别与心脏代谢危险因素的关系。进行限制三次样条分析以评估非线性关联。结果：388例患者中，超重32.3%，肥胖13.7%。BMI与糖化血红蛋白（HbA1c）呈u型关系，BMI的高低与HbA1c的升高相关（非线性p = 0.005）。升高WC组的时间范围更大（53.1±18.4%比59.8±14.6%,p = 0.036）。与BMI指数较低的患者相比，肥胖患者的收缩压（p = 0.013）和舒张压（p = 0.001）、非高密度脂蛋白（HDL）胆固醇（p = 0.022）和甘油三酯（p = 0.001）值较高。体重增加的患者也有更高的收缩压（p = 0.038）和舒张压（p = 0.015）、非高密度脂蛋白（p = 0.010）和甘油三酯(p)。结论：在成年T1D患者中，体重指数和体重与血压和血脂的关系比血糖控制更强，强调了综合心血管风险评估和有针对性的治疗策略在这一人群中的重要性。补充资料：在线版本提供补充资料，网址为10.1007/s40200-025-01718-1。

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来源期刊

Journal of Diabetes and Metabolic Disorders Medicine-Internal Medicine

CiteScore

4.80

自引率

3.60%

发文量

210

期刊介绍： Journal of Diabetes & Metabolic Disorders is a peer reviewed journal which publishes original clinical and translational articles and reviews in the field of endocrinology and provides a forum of debate of the highest quality on these issues. Topics of interest include, but are not limited to, diabetes, lipid disorders, metabolic disorders, osteoporosis, interdisciplinary practices in endocrinology, cardiovascular and metabolic risk, aging research, obesity, traditional medicine, pychosomatic research, behavioral medicine, ethics and evidence-based practices.As of Jan 2018 the journal is published by Springer as a hybrid journal with no article processing charges. All articles published before 2018 are available free of charge on springerlink.Unofficial 2017 2-year Impact Factor: 1.816.