Manyanga Taru, Sellers Elizabeth Ac, Wicklow Brandy A, Doupe Malcolm, Fransoo Randall
School of Human Kinetics, University of Ottawa, Faculty of Health Sciences, Ottawa, ON, Canada.
Children's Hospital of Eastern Ontario Research Institute, Healthy Active Living and Obesity Research Group, Ottawa, ON, Canada.
Pediatr Diabetes. 2016 Dec;17(8):599-607. doi: 10.1111/pedi.12344. Epub 2016 Jan 8.
Insulin therapy is lifesaving treatment for individuals with type 1 diabetes (T1D). Its initiation maybe associated with significant weight gain because of change from a catabolic to an anabolic state. Excessive weight-gain increases the risk of obesity and is associated with chronic disease.
To examine if change in body mass index (BMI) among children in the 6 months after diagnosis with type 1 diabetes mellitus is associated with long-term obesity.
This was a population-based retrospective study of 377 children (aged 2-18 yr) with type 1 diabetes. Measured heights and weights were used to calculate BMI z-scores based on Centers for Disease Control and Prevention (CDC) cut-points. Generalized Linear Models using BMI group, and age group at diagnosis; postdiagnosis weight change; and sex were applied to assess associations between postdiagnosis weight change and BMI z-score at transition to adult care.
Mean BMI z-score increased from 0.28 at diagnosis, to 0.53 at 6 months and 0.66 at transition to adult care. Change in BMI z-scores differed by initial BMI group and magnitude of postdiagnosis weight change. Younger children (<11 yr) had higher (p = 0.004) BMI z-scores at diagnosis but not at last visit (p = 0.1) than older (≥11 yr) children at diagnosis. BMI z-score at diagnosis, postdiagnosis weight change, female sex, and longer duration with TID were associated with higher BMI z-score at time of transition.
BMI z-score at diagnosis was the strongest predictor of BMI z-score at time of transition to adult care, however; its effect was mediated by magnitude of weight change 6 months after diagnosis, sex, and age group at diagnosis.
胰岛素治疗是1型糖尿病（T1D）患者的救命疗法。由于从分解代谢状态转变为合成代谢状态，开始胰岛素治疗可能会导致显著的体重增加。体重过度增加会增加肥胖风险，并与慢性疾病相关。
研究1型糖尿病确诊后6个月内儿童体重指数（BMI）的变化是否与长期肥胖有关。
这是一项基于人群的回顾性研究，纳入了377名2至18岁的1型糖尿病儿童。根据疾病控制与预防中心（CDC）的切点，使用测量的身高和体重计算BMI z评分。采用广义线性模型，以BMI分组、确诊时的年龄组、确诊后的体重变化和性别为变量，评估确诊后体重变化与转为成人护理时BMI z评分之间的关联。
平均BMI z评分从确诊时的0.28增加到6个月时的0.53，转为成人护理时为0.66。BMI z评分的变化因初始BMI分组和确诊后体重变化的幅度而异。确诊时年龄较小（<11岁）的儿童BMI z评分高于年龄较大（≥11岁）的儿童（p = 0.004），但在最后一次随访时差异无统计学意义（p = 0.1）。确诊时的BMI z评分、确诊后的体重变化、女性性别以及T1D病程较长与转为成人护理时较高的BMI z评分相关。
确诊时的BMI z评分是转为成人护理时BMI z评分的最强预测因素，然而，其影响由确诊后6个月的体重变化幅度、性别和确诊时的年龄组介导。
