Oza Chirantap, Khadilkar Anuradha, Mondkar Shruti, Amutha Anandakumar, Uppal Saurabh, De Hriday, Ghosh Apurba, Khadilkar Vaman, Mohan Viswanathan
Department of Growth and Pediatric Endocrinology, Hirabai Cowasji Jehangir Medical Research Institute, Pune, Maharashtra, India.
Department of Health Sciences, Savitribai Phule Pune University, Pune, Maharashtra, India.
Indian J Endocrinol Metab. 2023 Jul-Aug;27(4):301-306. doi: 10.4103/ijem.ijem_411_22. Epub 2023 Jun 30.
A previous study compared insulin sensitivity indices for the detection of double diabetes (DD) in Indian adolescents with type-1 diabetes (T1D) and derived a cut-off to predict future risk for the development of metabolic syndrome (MS) in adolescents with T1D. We conducted the current study with the aim to validate these cut-offs for detecting DD among Indian subjects with T1D from various geographical locations.
This multicentric cross-sectional study included 161 Indian adolescents with T1D. Demographic, anthropometric, clinical, and biochemical data were collected using standard protocols. Insulin sensitivity (IS) was calculated using various equations developed to determine insulin sensitivity in subjects with T1D. Metabolic syndrome was diagnosed using International Diabetes Federation (IDF) Consensus Definition 2017.
We report 4.3% prevalence of MS in Indian adolescents with T1D with an additional 29.8% of study participants at risk of development of MS. Low High density lipoprotein (HDL) (23.6%) was the commonest abnormal component of the MS definition. Insulin sensitivity calculated by an equation derived by the SEARCH group was the most appropriate index to identify MS and metabolic risk in Indian adolescents with T1D. The proposed cut-off of 5.48 had high specificity, positive predictive value, and negative predictive value in identifying the risk of the development of DD.
Insulin sensitivity calculated by the equation proposed by the SEARCH group together with cut-offs derived in earlier study may be used effectively to identify risk of development of MS/DD in Indian adolescents with T1D from various geographical locations.
先前的一项研究比较了胰岛素敏感性指标在检测印度 1 型糖尿病（T1D）青少年双重糖尿病（DD）中的作用，并得出了一个临界值，以预测 T1D 青少年未来发生代谢综合征（MS）的风险。我们开展了本研究，旨在验证这些临界值在检测来自不同地理位置的印度 T1D 患者中的 DD 情况。
这项多中心横断面研究纳入了 161 名印度 T1D 青少年。使用标准方案收集人口统计学、人体测量学、临床和生化数据。使用为确定 T1D 患者胰岛素敏感性而开发的各种公式计算胰岛素敏感性（IS）。采用国际糖尿病联盟（IDF）2017 年共识定义诊断代谢综合征。
我们报告印度 T1D 青少年中 MS 的患病率为 4.3%，另有 29.8%的研究参与者有发生 MS 的风险。高密度脂蛋白（HDL）低（23.6%）是 MS 定义中最常见的异常成分。SEARCH 组推导的公式计算出的胰岛素敏感性是识别印度 T1D 青少年中 MS 和代谢风险的最合适指标。提议的 5.48 的临界值在识别 DD 发生风险方面具有高特异性、阳性预测值和阴性预测值。
SEARCH 组提出的公式计算出的胰岛素敏感性以及早期研究得出的临界值可有效用于识别来自不同地理位置的印度 T1D 青少年发生 MS/DD 的风险。
