Body composition and metabolic syndrome in patients with type 1 diabetes

Qiong Zeng; Xiao-Jing Chen; Yi-Ting He; Ze-Ming Ma; Yi-Xi Wu; Kun Lin

doi:10.4239/wjd.v15.i1.81

Body composition and metabolic syndrome in patients with type 1 diabetes

World J Diabetes. 2024 Jan 15;15(1):81-91. doi: 10.4239/wjd.v15.i1.81.

Authors

Qiong Zeng¹, Xiao-Jing Chen², Yi-Ting He², Ze-Ming Ma², Yi-Xi Wu³, Kun Lin⁴

Affiliations

¹ Department of Neurology, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong Province, China.
² Medical College, Shantou University Medical College, Shantou 515041, Guangdong Province, China.
³ Department of Endocrinology, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong Province, China.
⁴ Department of Endocrinology, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong Province, China. jornbar@126.com.

Abstract

Background: In recent years, the prevalence of obesity and metabolic syndrome in type 1 diabetes (T1DM) patients has gradually increased. Insulin resistance in T1DM deserves attention. It is necessary to clarify the relationship between body composition, metabolic syndrome and insulin resistance in T1DM to guide clinical treatment and intervention.

Aim: To assess body composition (BC) in T1DM patients and evaluate the relationship between BC, metabolic syndrome (MS), and insulin resistance in these indi-viduals.

Methods: A total of 101 subjects with T1DM, aged 10 years or older, and with a disease duration of over 1 year were included. Bioelectrical impedance analysis using the Tsinghua-Tongfang BC Analyzer BCA-1B was employed to measure various BC parameters. Clinical and laboratory data were collected, and insulin resistance was calculated using the estimated glucose disposal rate (eGDR).

Results: MS was diagnosed in 16/101 patients (15.84%), overweight in 16/101 patients (15.84%), obesity in 4/101 (3.96%), hypertension in 34/101 (33.66%%) and dyslipidemia in 16/101 patients (15.84%). Visceral fat index (VFI) and trunk fat mass were significantly and negatively correlated with eGDR (both P < 0.001). Female patients exhibited higher body fat percentage and visceral fat ratio compared to male patients. Binary logistic regression analysis revealed that significant factors for MS included eGDR [P = 0.017, odds ratio (OR) = 0.109], VFI (P = 0.030, OR = 3.529), and a family history of diabetes (P = 0.004, OR = 0.228). Significant factors for hypertension included eGDR (P < 0.001, OR = 0.488) and skeletal muscle mass (P = 0.003, OR = 1.111). Significant factors for dyslipidemia included trunk fat mass (P = 0.033, OR = 1.202) and eGDR (P = 0.037, OR = 0.708).

Conclusion: Visceral fat was found to be a superior predictor of MS compared to conventional measures such as body mass index and waist-to-hip ratio in Chinese individuals with T1DM. BC analysis, specifically identifying visceral fat (trunk fat), may play an important role in identifying the increased risk of MS in non-obese patients with T1DM.

Keywords: Body composition; Estimated glucose disposal rate; Insulin resistance; Metabolic syndrome; Visceral fat.