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身体脂肪和去脂体重对1型糖尿病儿童及青少年糖化血红蛋白和血脂谱的影响

The Influence of Body Fat and Lean Mass on HbA1c and Lipid Profile in Children and Adolescents with Type 1 Diabetes Mellitus.

作者信息

Menegucci Thais, Chagas Eduardo Federighi Baisi, de Oliveira Zanuso Barbara, Quesada Karina, Dos Santos Haber Jesselina Francisco, Menegucci Zutin Tereza Laís, Felipe Pimenta Luis, Cressoni Araújo Adriano, Landgraf Guiguer Elen, Rucco P Detregiachi Claudia, Gabaldi Rocha Marcia, Cincotto Dos Santos Bueno Patrícia, Fornari Laurindo Lucas, Barbalho Sandra M

机构信息

Postgraduate Program in Structural and Functional Interactions in Rehabilitation, School of Medicine, Universidade de Marília (UNIMAR), Marília 17525-902, São Paulo, Brazil.

Postgraduate Program of Health and Aging, School of Medicine, Faculdade de Medicina de Marília (FAMEMA), Marília 17519-030, São Paulo, Brazil.

出版信息

Diseases. 2023 Sep 23;11(4):125. doi: 10.3390/diseases11040125.

Abstract

Glycated hemoglobin (HbA1c) is used to assess glycemic control in Type 1 diabetes (DM1) patients. Apolipoproteins play an essential role in DM1 pathophysiology and may be associated with complications and HbA1c. This cross-sectional observational study of 81 children and adolescents of both sexes diagnosed with DM1 investigated the relationship between body fat distribution and lean mass with HbA1C and apolipoprotein values, analyzing biochemical and body composition measurements. A Shapiro-Wilk test with Lilliefors correction, a non-parametric Mann-Whitney test, and others were used with a significance level of 5%. The sample had a diagnosis time of 4.32 years and high blood glucose levels (mean 178.19 mg/dL) and HbA1c (mean 8.57%). Subjects also had a moderate level of adiposity, as indicated by arm and thigh fat areas. The study also found significant differences in the distribution of patients concerning levels of apolipoproteins A and B, with a smaller proportion of patients having undesirable levels. Finally, the study found a significant difference in the distribution of patients with estimated cardiovascular risk based on the ApoB/ApoA-I ratio. Conclusively, visceral fat in children and adolescents with DM1 may increase the risk of DM1 long-term complications owing to its association with elevated HbA1C and apolipoprotein values.

摘要

糖化血红蛋白(HbA1c)用于评估1型糖尿病(DM1)患者的血糖控制情况。载脂蛋白在DM1病理生理学中起着至关重要的作用,可能与并发症及HbA1c相关。这项横断面观察性研究对81名确诊为DM1的儿童和青少年(男女均有)进行了调查,分析生化指标和身体成分测量结果,以研究体脂分布和瘦体重与HbA1C及载脂蛋白值之间的关系。使用了经Lilliefors校正的Shapiro-Wilk检验、非参数Mann-Whitney检验等,显著性水平为5%。样本的诊断时间为4.32年,血糖水平较高(平均178.19mg/dL),HbA1c水平也较高(平均8.57%)。如手臂和大腿脂肪面积所示,受试者的肥胖程度为中度。该研究还发现,患者在载脂蛋白A和B水平的分布上存在显著差异,具有不良水平的患者比例较小。最后,该研究发现,根据载脂蛋白B/载脂蛋白A-I比值估计的心血管疾病风险在患者分布上存在显著差异。总之,DM1儿童和青少年的内脏脂肪可能会增加DM1长期并发症的风险,因为它与升高的HbA1C和载脂蛋白值有关。

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