Canha Marta, Ferreira Sofia, Santos Silva Rita, Azevedo Aida, Rodrigues Ana S, Castro-Correia Cintia
Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário São joão, Porto, PRT.
Pediatric Endocrinology and Diabetology Unit, Centro Hospitalar Universitário São joão, Porto, PRT.
Cureus. 2023 Aug 13;15(8):e43416. doi: 10.7759/cureus.43416. eCollection 2023 Aug.
The association between glycemic control and metabolic status is poorly defined in children and adolescents with T1D, besides being biologically plausible. We aimed to evaluate the association between glycemic control and body mass index (BMI), blood pressure (BP), and lipid profile in children and adolescents with T1D.
Observational cross-sectional study including children and adolescents (5-18 years old) followed in our outpatient clinic with the diagnosis of T1D for at least a year. We used linear regression models (unadjusted and adjusted to sex and age) to evaluate the association between glycated hemoglobin (A1c) and time in range (TIR), several prespecified metabolic parameters, and prespecified demographic and clinical characteristics. We considered a p-value of <0.05 to be statistically significant.
A total of 144 patients were included, 51% of whom were female. The population had a mean age of 12.7±3.4 years old. We report a positive association between A1c and BMI, systolic and diastolic BP, total- and LDL-cholesterol and triglycerides. Females and patients diagnosed at a younger age presented with higher A1c values. There is a tendency for a negative association between TIR and the former parameters. Higher A1c levels and lower TIR were associated with higher glycemic variability and were treated with a higher basal insulin per Kg dose.
Our results support an important association between worse glycemic control and an unhealthier metabolic profile in children and adolescents with T1D. We can hypothesize that a good glycemic profile is needed to achieve good metabolic control at a young age.
除了具有生物学合理性外，1型糖尿病（T1D）儿童和青少年的血糖控制与代谢状况之间的关联尚不明确。我们旨在评估T1D儿童和青少年的血糖控制与体重指数（BMI）、血压（BP）和血脂谱之间的关联。
观察性横断面研究，纳入在我们门诊随访至少一年且诊断为T1D的儿童和青少年（5 - 18岁）。我们使用线性回归模型（未调整以及按性别和年龄调整）来评估糖化血红蛋白（A1c）与血糖达标时间（TIR）、几个预先指定的代谢参数以及预先指定的人口统计学和临床特征之间的关联。我们认为p值<0.05具有统计学意义。
共纳入144例患者，其中51%为女性。人群平均年龄为12.7±3.4岁。我们报告A1c与BMI、收缩压和舒张压、总胆固醇和低密度脂蛋白胆固醇以及甘油三酯之间呈正相关。女性和诊断时年龄较小的患者A1c值较高。TIR与上述参数之间存在负相关趋势。较高的A1c水平和较低的TIR与较高的血糖变异性相关，并且每千克剂量的基础胰岛素治疗量更高。
我们的结果支持T1D儿童和青少年中较差的血糖控制与更不健康的代谢谱之间存在重要关联。我们可以推测，在年轻时需要良好的血糖状况来实现良好的代谢控制。
