Texas Children's Hospital, Diabetes and Endocrinology Section, Baylor College of Medicine, Houston, Texas, USA
Texas Children's Hospital, Diabetes and Endocrinology Section, Baylor College of Medicine, Houston, Texas, USA.
BMJ Open Diabetes Res Care. 2020 Oct;8(1). doi: 10.1136/bmjdrc-2020-001683.
We aimed to test whether the serum adipokines leptin and adiponectin are more strongly associated with body fat percentage (BF%) than body mass index (BMI) in adolescents with type 1 diabetes (T1D) and overweight/obesity.
We studied all participants in the T1D Exchange Metformin Study (n=122, median age 12.9 years, range 12-19.5; 32% males; 77% non-Hispanic whites, 100% overweight or obesity; median diabetes duration 6.7 years, range 1.4-15) with a baseline serum sample where we measured leptin and adiponectin concentrations. Anthropometric, clinical, laboratory and dual-energy X-ray absorptiometry (DEXA) scan measurements were analyzed. We compared correlation coefficients between variables of interest.
BF% by DEXA was significantly correlated with BMI Z-score (r=0.38, p<0.0001), BMI per cent of the 95th percentile (BMI%95) (r=0.45, p<0.0001), waist circumference (r=0.46, p<0.0001), leptin (r=0.58, p<0.00001) and leptin/adiponectin ratio (r=0.36, p<0.0001), while it was not significantly correlated with absolute body weight, adiponectin or insulin dose (total or basal). BF% was significantly more strongly correlated with leptin than with BMI Z-score in the overall group (p=0.022). However, there were sex-based differences. Among the significant correlations in the overall group, BF% was most strongly associated with leptin (r=0.75) in boys (n=39) but with waist circumference (r=0.58) in girls (n=83) (all p<0.0001).
Serum leptin could be used as a surrogate convenient marker of adiposity in overweight/obese adolescent boys with T1D, equivalent to BMI Z-score or BMI%95. In girls, waist circumference was the best performing marker overall, and was also strongly correlated with %BF in boys.
我们旨在测试在超重/肥胖的 1 型糖尿病（T1D）青少年中，与体重指数（BMI）相比，血清脂肪因子瘦素和脂联素是否与体脂肪百分比（BF%）的相关性更强。
我们研究了 T1D Exchange 二甲双胍研究（n=122，中位年龄 12.9 岁，范围 12-19.5；32%为男性；77%为非西班牙裔白人，100%为超重或肥胖；中位糖尿病病程 6.7 年，范围 1.4-15 年）中所有参与者的基线血清样本，测量了瘦素和脂联素浓度。分析了人体测量、临床、实验室和双能 X 射线吸收法（DEXA）扫描测量值。我们比较了感兴趣变量之间的相关系数。
DEXA 测量的 BF%与 BMI Z 评分（r=0.38，p<0.0001）、BMI 第 95 百分位数的百分比（BMI%95）（r=0.45，p<0.0001）、腰围（r=0.46，p<0.0001）、瘦素（r=0.58，p<0.00001）和瘦素/脂联素比值（r=0.36，p<0.0001）显著相关，而与绝对体重、脂联素或胰岛素剂量（总剂量或基础剂量）不相关。在总体人群中，BF%与瘦素的相关性显著强于与 BMI Z 评分的相关性（p=0.022）。然而，存在性别差异。在总体人群中具有统计学意义的相关性中，BF%与瘦素的相关性最强（r=0.75），男孩（n=39），而与女孩（n=83）的腰围相关性最强（r=0.58）（均 p<0.0001）。
在超重/肥胖的 T1D 青少年中，血清瘦素可以作为一种方便的肥胖替代标志物，与 BMI Z 评分或 BMI%95 相当。在女孩中，腰围是整体表现最佳的标志物，与男孩的 BF%也有很强的相关性。
