Department of Pediatrics, McMaster University, 1280 Main Street West, HSC-3A57, Hamilton, ON, L8S 4K1, Canada.
Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada.
Sci Rep. 2021 Apr 27;11(1):9111. doi: 10.1038/s41598-021-88705-7.
Pediatric type 2 diabetes mellitus (T2DM) patients are often overweight or obese, yet there are no validated clinical measures of adiposity to stratify cardiometabolic risk in this population. The tri-ponderal mass index (TMI, kg/m) has recently been reported as a measure of adiposity in children, but there has been no validation of the association of TMI with adiposity in pediatric T2DM. We hypothesized that in children with T2DM, the TMI can serve as a more accurate measure of adiposity when compared to BMI z-score, and that it is associated with components of the metabolic syndrome. This is a cross-sectional secondary data analysis from the Improving Renal Complications in Adolescents with Type 2 Diabetes Through REsearch (iCARE) study (n = 116, age 10.20-17.90 years). Spearman's correlations and multivariable regression were used in the analyses. When compared to DXA, TMI demonstrated significant correlation with total adiposity versus BMI z-score (TMI r = 0.74, p-value < 0.0001; BMI z-score r = - 0.08, p-value 0.403). In regression analyses, TMI was associated with WHtR (B = 35.54, 95% CI 28.81, 42.27, p-value < 0.0001), MAP dipping (B = 1.73, 95% CI 0.12, 3.33, p-value = 0.035), and HDL (B = - 5.83, 95% CI - 10.13, - 1.54, p-value = 0.008). In conclusion, TMI is associated with adiposity and components of the metabolic syndrome in pediatric T2DM patients.
儿科 2 型糖尿病（T2DM）患者通常超重或肥胖，但目前尚无经过验证的临床肥胖指标来对该人群的心血管代谢风险进行分层。三部位质量指数（TMI，kg/m）最近被报道为儿童肥胖的一种衡量指标，但尚未对 TMI 与儿科 T2DM 患者肥胖的相关性进行验证。我们假设，在患有 T2DM 的儿童中，与 BMI z 分数相比，TMI 可以作为衡量肥胖的更准确指标，并且与代谢综合征的组成部分相关。这是通过研究（n = 116，年龄 10.20-17.90 岁）对改善青少年 2 型糖尿病肾脏并发症的研究（iCARE）的横断面二次数据分析。在分析中使用了 Spearman 相关和多变量回归。与 DXA 相比，TMI 与总脂肪量相比 BMI z 分数具有显著相关性（TMI r = 0.74，p 值<0.0001；BMI z 分数 r = -0.08，p 值 0.403）。在回归分析中，TMI 与 WHtR（B = 35.54，95%CI 28.81，42.27，p 值<0.0001）、MAP 下潜（B = 1.73，95%CI 0.12，3.33，p 值 = 0.035）和 HDL（B = -5.83，95%CI -10.13，-1.54，p 值 = 0.008）相关。总之，TMI 与儿科 T2DM 患者的肥胖和代谢综合征的组成部分相关。
