Body composition, metabolic syndrome and insulin resistance in type 1 diabetes mellitus

Abstract

Objective: Our aim was to determine the relationship between body fat composition, metabolic syndrome (MS), and insulin resistance in type 1 diabetes (DM1). Subjects and methods: Forty-five DM1 women (36 ± 9 years; body mass index 24.6 ± 4.4 kg/m 2 ) had body composition and insulin resistance determined by dual-energy X-ray absorptiometry and estimated glucose disposal ratio (eGDR), respectively. Twenty patients (45%) had MS according to World Health Organization (WHO) criteria. Results: Women with DM1 and MS had increased central fat and lower eGDR than women without MS (41.9 ± 2.0 vs. 33.7 ± 1.8%; p = 0.004 and 4.99 ± 0.40 vs. 8.37 ± 0.39; p < 0.0001, respectively). Total body fat and peripheric fat were similar between the groups. Central fat negatively correlated with eGDR (r = -0.33; p = 0.03). Conclusion: Central fat deposition in young non-obese DM1 women was related to MS and insulin resistance. Thus, body fat composition analysis might be important to identify DM1 patients with increased metabolic risk. Arq Bras Endocrinol Metab. 2011;55(3):189-93 Keywords Type 1 diabetes; body composition; metabolic syndrome; insulin resistance RESUMO Objetivo: Avaliar a relação entre composição corporal, síndrome metabólica (SM) e resistência insulínica (RI) no diabetes tipo 1 (DM1). Sujeitos e métodos: Quarenta e cinco mulheres com DM1 (36 ± 9 anos; índice de massa corporal 24,6 ± 4,4 kg/m 2 ) foram submetidas à análise de composição corporal e RI por meio de densitometria por dupla emissão de raios-X e taxa de disponibilização de glicose estimada (eGDR), respectivamente. Vinte mulheres (45%) apresentavam SM, conforme critérios da Organização Mundial da Saúde (OMS). Resultados: Mulheres com SM apresentaram maior gordura central e menor eGDR do que as sem SM (41,9 ± 2,0 vs. 33,7±1,8%; p = 0,004 e 4,99 ± 0,40 vs. 8,37 ± 0,39; p < 0,0001). A gordura corporal total e a gordura periférica não diferiram entre os grupos. A gordura central foi inversamente correlacionada com eGDR (r = -0,33; p = 0,03). Conclusão: Deposição de gordura central em mulheres jovens não obesas com DM1 esteve associada com SM e RI. Avaliação da composição corporal pode ser importante na identificação de pacientes com risco metabólico elevado. Arq Bras Endocrinol Metab. 2011;55(3):189-93 Descritores Diabetes tipo 1; composição corporal; síndrome metabólica; resistência insulínica

Insulin Pump Therapy – Influence on Body Fat Redistribution, Skeletal Muscle Mass and Ghrelin, Leptin Changes in T1D Patients

“…However, there is growing evidence about the association of the parameters of metabolic syndrome (MS) and T1D, known as ‘double diabetes’ – where abdominal obesity plays the main role. The reported prevalence of MS in T1D is rather high – 30–45% [1] in adults and about 3.2% in children with T1D, with one-third of the children being overweight or obese [2]. …”

“…In non-obese women with T1D, the higher central depots of fats are the main determinant of MS, while peripheral fat distribution and total fat percentage show no correlation with MS [1]. Men without diabetes have higher visceral adiposity compared to women without diabetes, while men with diabetes have lower visceral adiposity compared to women with diabetes [4].…”

“…There are not many proofs comparing changes of body composition in patients with T1D after switching from MDI to CSII. DCCT and other studies are, among other factors, focused on changes of BW, body composition on intensified regimen or compared the prevalence of metabolic syndrome on CSII [1, 7, 10, 11]. …”

Predictors of subclinical atherosclerosis evaluated by carotid intima-media thickness in asymptomatic young women with type 1 diabetes mellitus

“…Chronic hyperglycemia may predispose to inflammation, endothelial dysfunction, and changes in coagulation, which in turn are associated with cardiovascular diseases (CVD). In addition, more youths today have overweight and central obesity, both predisposing to insulin resistance and hypertension and further increasing the risk of CVD in individuals with type 1 DM (5)(6)(7)(8). Based on that, the identification of clinical predictors of subclinical atherosclerosis is essential to prevent the morbidity and mortality associated with CVD in these patients.…”

Pharmacokinetics of Insulin Aspart and Glucagon in Type 1 Diabetes during Closed-Loop Operation

“…4,5 We aimed to assess the pharmacokinetics of insulin aspart and glucagon during closed-loop operation and to assess their relationship with body composition variables, as these are known to potentially affect insulin absorption and action. 6,7 …”