Sex differences in body composition in youth with type 1 diabetes and its predictive value in cardiovascular disease risk assessment.


Journal

Diabetes/metabolism research and reviews
ISSN: 1520-7560
Titre abrégé: Diabetes Metab Res Rev
Pays: England
ID NLM: 100883450

Informations de publication

Date de publication:
01 2023
Historique:
revised: 06 09 2022
received: 21 07 2022
accepted: 10 10 2022
pubmed: 22 10 2022
medline: 10 1 2023
entrez: 21 10 2022
Statut: ppublish

Résumé

Women with type 1 diabetes (T1D) are more susceptible than men to cardiovascular disease (CVD). Signs of increased risk may already appear among adolescent girls. We explored the contribution of body composition to the development of CVD risk factors among youth with T1D. One hundred and eighty nine subjects with T1D (mean age 15.3 ± 5.1 years, 55% boys) followed between January 2018-January 2022 were included in this observational study. Sociodemographic and clinical data were extracted from medical files. Body composition was measured by bioelectrical impedance analysis, and muscle-to-fat ratio (MFR) z-scores were calculated. Logistic regression model assessed the association between body composition (MFR z-scores) and evidence of CVD risk factors. Females were characterised by higher median BMI z-scores (0.47 vs. 0.04, p = 0.012), higher fat and truncal fat percentage levels (p ≤ 0.001) and lower median MFR z-scores (-0.64 vs. -0.25, p ≤ 0.001), higher median triglyceride (TG) levels (71 vs. 61 mg/dl, p = 0.05), longer disease duration to initiation of insulin pump therapy (p = 0.041), and more time spent in marked hypoglycemia (1 vs. 0.2%, p = 0.007) than males. Males' MFR z-scores were associated with several diabetes-related parameters (age at diagnosis, CGM metrics, HbA1c and insulin dose), while the females'' MFR z-scores were linked to the atherogenic dyslipidemia index (TG:HDL ratio). The odds for CVD risk factors were doubled for every 1 SD decrease in MFR z-score (OR = 0.50, CI [0.30-0.84], p = 0.009) and also increased with age (OR = 1.07, CI [1.004-1.148], p = 0.038). Body composition measurement has a predictive value in CVD risk assessment in youth with T1D, with unique characteristics and influences in each sex.

Sections du résumé

BACKGROUND
Women with type 1 diabetes (T1D) are more susceptible than men to cardiovascular disease (CVD). Signs of increased risk may already appear among adolescent girls.
OBJECTIVES
We explored the contribution of body composition to the development of CVD risk factors among youth with T1D.
METHODS
One hundred and eighty nine subjects with T1D (mean age 15.3 ± 5.1 years, 55% boys) followed between January 2018-January 2022 were included in this observational study. Sociodemographic and clinical data were extracted from medical files. Body composition was measured by bioelectrical impedance analysis, and muscle-to-fat ratio (MFR) z-scores were calculated. Logistic regression model assessed the association between body composition (MFR z-scores) and evidence of CVD risk factors.
RESULTS
Females were characterised by higher median BMI z-scores (0.47 vs. 0.04, p = 0.012), higher fat and truncal fat percentage levels (p ≤ 0.001) and lower median MFR z-scores (-0.64 vs. -0.25, p ≤ 0.001), higher median triglyceride (TG) levels (71 vs. 61 mg/dl, p = 0.05), longer disease duration to initiation of insulin pump therapy (p = 0.041), and more time spent in marked hypoglycemia (1 vs. 0.2%, p = 0.007) than males. Males' MFR z-scores were associated with several diabetes-related parameters (age at diagnosis, CGM metrics, HbA1c and insulin dose), while the females'' MFR z-scores were linked to the atherogenic dyslipidemia index (TG:HDL ratio). The odds for CVD risk factors were doubled for every 1 SD decrease in MFR z-score (OR = 0.50, CI [0.30-0.84], p = 0.009) and also increased with age (OR = 1.07, CI [1.004-1.148], p = 0.038).
CONCLUSIONS
Body composition measurement has a predictive value in CVD risk assessment in youth with T1D, with unique characteristics and influences in each sex.

Identifiants

pubmed: 36269559
doi: 10.1002/dmrr.3584
pmc: PMC10078230
doi:

Substances chimiques

Insulin 0

Types de publication

Observational Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e3584

Informations de copyright

© 2022 The Authors. Diabetes/Metabolism Research and Reviews published by John Wiley & Sons Ltd.

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Auteurs

Avivit Brener (A)

Pediatric Endocrinology and Diabetes Unit, "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

Sandy Hamama (S)

Pediatric Endocrinology and Diabetes Unit, "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

Hagar Interator (H)

Pediatric Endocrinology and Diabetes Unit, "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
The Nutrition & Dietetics Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Asaf Ben Simon (A)

Pediatric Endocrinology and Diabetes Unit, "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

Irina Laurian (I)

Pediatric Endocrinology and Diabetes Unit, "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Nursing Services, "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Anna Dorfman (A)

Pediatric Endocrinology and Diabetes Unit, "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Nursing Services, "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Efrat Chorna (E)

Pediatric Endocrinology and Diabetes Unit, "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Social Services, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Michal Yackobovitch-Gavan (M)

Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Asaf Oren (A)

Pediatric Endocrinology and Diabetes Unit, "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

Ori Eyal (O)

Pediatric Endocrinology and Diabetes Unit, "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

Yael Lebenthal (Y)

Pediatric Endocrinology and Diabetes Unit, "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

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