Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Jan 15, 2024; 15(1): 81-91
Published online Jan 15, 2024. doi: 10.4239/wjd.v15.i1.81
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
Qiong Zeng, Department of Neurology, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong Province, China
Xiao-Jing Chen, Yi-Ting He, Ze-Ming Ma, Medical College, Shantou University Medical College, Shantou 515041, Guangdong Province, China
Yi-Xi Wu, Kun Lin, Department of Endocrinology, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong Province, China
Author contributions: Lin K and Zeng Q designed the research study; Chen XJ, He YT, Ma ZM and Wu YX performed the research; Zeng Q and Chen XJ contributed new reagents and analytic tools; Lin K and Zeng Q analyzed the data and wrote the manuscript; All authors have read and approve the final manuscript.
Supported by the “SDF-sweet doctor cultivation” Project of Sinocare Diabetes Foundation, No. 2022SD11 and No. 2021SD09.
Institutional review board statement: The study was reviewed and approved by the First Affiliated Hospital of Shantou University Medical College (approval No. B-2022-236).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kun Lin, Doctor, Department of Endocrinology, The First Affiliated Hospital of Shantou University Medical College, No. 57 Changping Road, Shantou 515041, Guangdong Province, China. jornbar@126.com
Received: September 18, 2023
Peer-review started: September 18, 2023
First decision: November 9, 2023
Revised: November 19, 2023
Accepted: December 5, 2023
Article in press: December 5, 2023
Published online: January 15, 2024
Processing time: 115 Days and 22.2 Hours
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; Metabolic syndrome; Insulin resistance; Visceral fat; Estimated glucose disposal rate

Core Tip: Visceral fat was found to be a superior predictor of metabolic syndrome (MS) compared to conventional measures such as body mass index and waist-to-hip ratio in Chinese individuals with type 1 diabetes (T1DM). Visceral fat index, estimated glucose disposal rate, and a family history of diabetes were identified as independent risk factors for MS in Chinese individuals with T1DM. Skeletal muscle mass showed a significant positive correlation with blood pressure and emerged as an independent risk factor for hypertension in Chinese individuals with T1DM. Body composition analysis, specifically identifying visceral fat, may be important in identifying the increased risk of MS in patients T1DM, particularly those who are non-obese.