Gomes Marilia Brito, Santos Deborah Conte, Drummond Karla, Pinheiro André, Muniz Luiza Harcar, Leal Franz, Negrato Carlos Antonio
Department of Internal Medicine, State University of Rio de Janeiro, Blv. 28 de Setembro, 77, Rio de Janeiro, 20551-030, Brazil.
Department of Ophthalmology, Sao Paulo Federal University, Av. Dr. Arnaldo, 455, Cerqueira César, São Paulo, SP, Brasil.
Diabetol Metab Syndr. 2023 Feb 23;15(1):28. doi: 10.1186/s13098-023-00996-0.
To determine the prevalence of overweight/obesity and its relationship with metabolic syndrome (MS), fatty liver index (FLI), cardiovascular risk factors (CVRF), and diabetes-related chronic complications (DRCC) in adult patients with type 1 diabetes (T1D).
This study was conducted in 14 Brazilian public clinics in ten cities, with 1,390 patients: 802 females (57.7%), 779 (56.0%) Caucasians, aged 33.6 ± 10.8 years, age at diagnosis, 16.2 ± 9.2 years, diabetes duration, 17.4 ± 9.2 years, and HbA1c 8.8 ± 2.0%.
Overall, 825 patients (59.4%) had normal weight, and 565 had overweight/obesity; ( 429 (30.9%) presented overweight and 136 (9.8%) presented obesity). After adjustments, overweight/obesity was associated with age, family history of overweight/obesity, total daily insulin dose, hypertension, adherence to diet, type of health care insurance, use of metformin, levels of C-reactive protein, triglycerides, uric acid and HDL-cholesterol. These patients also presented a higher prevalence of MS, FLI ≥ 60, and CVRF than patients without overweight/obesity. Overweight/obesity was not associated with DRCC and with HbA1c levels.
Patients with T1D with overweight/obesity presented traditional risk factors for DRCC, cardiovascular diseases, MS, and non-alcoholic fatty liver disease; most of these risk factors are modifiable and can be avoided with interventions that prevent overweight/obesity.
确定1型糖尿病(T1D)成年患者中超重/肥胖的患病率及其与代谢综合征(MS)、脂肪肝指数(FLI)、心血管危险因素(CVRF)和糖尿病相关慢性并发症(DRCC)的关系。
本研究在巴西十个城市的14家公立诊所进行,共纳入1390例患者:802例女性(57.7%),779例(56.0%)为白种人,年龄33.6±10.8岁,诊断时年龄16.2±9.2岁,糖尿病病程17.4±9.2年,糖化血红蛋白(HbA1c)为8.8±2.0%。
总体而言,825例患者(59.4%)体重正常,565例患者超重/肥胖;(429例(30.9%)超重,136例(9.8%)肥胖)。调整后,超重/肥胖与年龄、超重/肥胖家族史、每日胰岛素总剂量、高血压、饮食依从性、医疗保险类型、二甲双胍使用情况、C反应蛋白水平、甘油三酯、尿酸和高密度脂蛋白胆固醇水平相关。与无超重/肥胖的患者相比,这些患者的MS、FLI≥60和CVRF患病率也更高。超重/肥胖与DRCC及HbA1c水平无关。
超重/肥胖的T1D患者存在DRCC、心血管疾病、MS和非酒精性脂肪性肝病的传统危险因素;这些危险因素大多是可改变的,通过预防超重/肥胖的干预措施可以避免。