Body Composition and Regional Adiposity in Adolescents With Type 1 Diabetes: Relation to Insulin Resistance, Glycaemic Control and Vascular Complications

Abstract

Aim: Obesity is increasingly recognized among people with type 1 diabetes mellitus (T1DM). Little is known about the body composition of adolescents with T1DM and its metabolic outcomes. Hence, this study assessed the body composition of adolescents with T1DM and its relationship with glycaemic control, insulin resistance and vascular complications. Materials and Methods: One hundred twenty adolescents with T1DM were assessed for anthropometric measures, insulin therapy, bioelectrical impedance analysis (BIA), fasting lipids, glycated haemoglobin, with estimated glucose disposal rate (eGDR) calculation. Regional body fat quantification was performed via Magnetic resonance imaging (MRI) 3-T. Results: Thirty-three adolescents with T1DM were overweight (27.5%), and 8 were obese (6.6%). Adolescents with T1DM having insulin resistance were found to have significantly higher BMI z score, total body fat %, and visceral/subcutaneous fat % than those without insulin resistance (p < 0.05). Moreover, adolescents with T1DM having microvascular complications showed significantly higher total fat % and visceral/subcutaneous fat % than those without microvascular complications (p < 0.05). Visceral fat % and visceral/subcutaneous fat ratio were positively correlated with waist/hip ratio, eGDR and LDL level (p < 0.05). Waist/hip ratio and eGDR were the most significant independent variables associated with visceral fat % and visceral/subcutaneous fat ratio among adolescents with T1DM using multivariate regression analysis. Conclusions: Overweight and visceral adiposity are frequently encountered among the studied adolescents with T1DM. Visceral adiposity is associated with insulin resistance, hyperlipidaemia and microvascular complications among adolescents with T1DM independent of glycaemic control and insulin dosage.