Universidade Federal do Rio Grande do Sul, Programa de Pós-graduação em Endocrinologia, Porto Alegre, RS, Brasil,
Universidade Federal do Rio Grande do Sul, Programa de Pós-graduação em Endocrinologia, Porto Alegre, RS, Brasil.
Arch Endocrinol Metab. 2023 Mar 30;67(3):401-407. doi: 10.20945/2359-3997000000599. Epub 2023 Feb 7.
Body composition changes are associated with adverse effects such as increased insulin resistance (IR) in individuals with diabetes mellitus. This study aims to evaluate the association between different body adiposity markers and IR in adults with type 1 diabetes (T1D).
The cross-sectional study included outpatient adults with T1D from a university public hospital in southern Brazil. The body adiposity markers studied were waist circumference (WC), waist-height ratio (WHtR), body mass index (BMI), conicity index (CI), lipid accumulation product (LAP) and body adiposity index (BAI). IR was calculated using an Estimated Glucose Disposal Rate (EGDR) equation (analyzed in tertiles), considering an inverse relation between EGDR and IR. Poisson regression models were used to estimate the odds ratio (OR) and 95% CIs of association of adiposity markers with IR.
A total of 128 patients were enrolled (51% women), with a median EGDR of 7.2 (4.4-8.7) mg.kg.min. EGDR was negatively correlated with WC ( = -0.36, p < 0.01), WHtR ( = -0.39, p < 0.01), CI ( = -0.44, p < 0.01), LAP ( = -0.41, p < 0.01) and BMI ( = -0.24, p < 0.01). After regression analyses, WC (OR = 2.07; CIs: 1.12-3.337; p = 0.003), WHtR (OR = 2.77; CIs: 1.59-4.79; p < 0.001), CI (OR = 2.59; CIs: 1.43-4.66; p = 0.002), LAP (OR = 2.27; CIs: 1.25-4.11; p = 0.007) and BMI (OR = 1.78; CIs: 1.09-2.91; p = 0.019) remained associated with IR.
The authors suggest using the studied adiposity markers as a routine since they were shown to be suitable parameters in association with IR.
身体成分的变化与 2 型糖尿病患者的胰岛素抵抗（IR）等不良后果相关。本研究旨在评估不同的体脂标志物与 1 型糖尿病（T1D）成人患者的 IR 之间的关系。
这是一项横断面研究，纳入了来自巴西南部一所大学附属医院的门诊 T1D 成年患者。研究中所涉及的体脂标志物包括腰围（WC）、腰高比（WHtR）、体重指数（BMI）、凸性指数（CI）、脂质蓄积产物（LAP）和体脂指数（BAI）。IR 采用估计葡萄糖处置率（EGDR）方程（分析为三分位数）计算，EGDR 与 IR 呈负相关。采用泊松回归模型来估计体脂标志物与 IR 之间关联的比值比（OR）和 95%置信区间（CI）。
共纳入了 128 名患者（51%为女性），中位 EGDR 为 7.2（4.4-8.7）mg.kg.min。EGDR 与 WC（ = -0.36，p < 0.01）、WHtR（ = -0.39，p < 0.01）、CI（ = -0.44，p < 0.01）、LAP（ = -0.41，p < 0.01）和 BMI（ = -0.24，p < 0.01）呈负相关。经回归分析，WC（OR = 2.07；95%CI：1.12-3.337；p = 0.003）、WHtR（OR = 2.77；95%CI：1.59-4.79；p < 0.001）、CI（OR = 2.59；95%CI：1.43-4.66；p = 0.002）、LAP（OR = 2.27；95%CI：1.25-4.11；p = 0.007）和 BMI（OR = 1.78；95%CI：1.09-2.91；p = 0.019）与 IR 仍相关。
作者建议将研究中所涉及的体脂标志物作为常规指标，因为它们与 IR 有相关性，是合适的参数。
