Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Jan 15, 2024; 15(1): 81-91
Published online Jan 15, 2024. doi: 10.4239/wjd.v15.i1.81
Body composition and metabolic syndrome in patients with type 1 diabetes
Qiong Zeng, Xiao-Jing Chen, Yi-Ting He, Ze-Ming Ma, Yi-Xi Wu, Kun Lin
Qiong Zeng, Department of Neurology, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong Province, China
Xiao-Jing Chen, Yi-Ting He, Ze-Ming Ma, Medical College, Shantou University Medical College, Shantou 515041, Guangdong Province, China
Yi-Xi Wu, Kun Lin, Department of Endocrinology, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong Province, China
Author contributions: Lin K and Zeng Q designed the research study; Chen XJ, He YT, Ma ZM and Wu YX performed the research; Zeng Q and Chen XJ contributed new reagents and analytic tools; Lin K and Zeng Q analyzed the data and wrote the manuscript; All authors have read and approve the final manuscript.
Supported by the “SDF-sweet doctor cultivation” Project of Sinocare Diabetes Foundation, No. 2022SD11 and No. 2021SD09.
Institutional review board statement: The study was reviewed and approved by the First Affiliated Hospital of Shantou University Medical College (approval No. B-2022-236).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kun Lin, Doctor, Department of Endocrinology, The First Affiliated Hospital of Shantou University Medical College, No. 57 Changping Road, Shantou 515041, Guangdong Province, China. jornbar@126.com
Received: September 18, 2023
Peer-review started: September 18, 2023
First decision: November 9, 2023
Revised: November 19, 2023
Accepted: December 5, 2023
Article in press: December 5, 2023
Published online: January 15, 2024
ARTICLE HIGHLIGHTS
Research background

At present, the mechanism of insulin resistance in patients with type 1 diabetes (T1DM) is not completely clear; The reasons for the increase in obesity and metabolic syndrome in T1DM patients are also unclear. Clarifying the relationship between body composition, metabolic syndrome and insulin resistance is of great significance for the implementation of strategies targeting insulin resistance-related characteristics in T1DM management.

Research motivation

In this study, we employed bioelectrical impedance analysis (BIA) to assess body composition (BC) in patients with T1DM and investigate the relationship between BC, metabolic syndrome (MS), and insulin resistance.

Our study contribute to our understanding of the relationship between BC, insulin resistance, and MS in individuals with T1DM, particularly in the Chinese population.

Another important significance of the study is to verify that BC studies, specifically detecting visceral fat (trunk fat), may be useful in recognizing the elevated risk of MS in non-obeseT1DM patients.

Research objectives

The objective of the research was to assess BC in T1DM patients and evaluate the relationship between BC, MS, and insulin resistance in these individuals. This study would contribute to identify the independent risk factors for MS in Chinese T1DM and verify that BC studies, specifically detecting visceral fat (trunk fat), may be useful in recognizing the elevated risk of MS in non-obese T1DM patients.

Research methods

A total of 101 subjects with T1DM, aged 10 years or older, and with a disease duration of over 1 year were included. BIA using the Tsinghua-Tongfang BC Analyzer BCA-1B was employed to measure various BC parameters. Clinical and laboratory data were collected, and insulin resistance was calculated using the estimated glucose disposal rate (eGDR).

The BIA measurement provided valuable analysis data such as muscle mass, fat mass, and visceral fat index (VFI). In this study, VFI represents visceral fat volumeas and was calculated as follows: VFI = visceral fat area (cm2) divided by 10 cm2.

Research results

Several important research achievements are as follows: Visceral fat was found to be a superior predictor of metabolic syndrome compared to conventional measures such as BMI and waist-to-hip ratio in Chinese individuals with T1DM; VFI, eGDR, and a family history of diabetes were identified as independent risk factors for metabolic syndrome in Chinese individuals with T1DM; skeletal muscle mass showed a significant positive correlation with blood pressure and emerged as an independent risk factor for hypertension in Chinese individuals with T1DM.

Research conclusions

Visceral fat, eGDR, and a family history of diabetes are important independent risk factors for metabolic syndrome while skeletal muscle mass acts as an independent risk factor for hypertension. Body composition analysis, specifically identifying visceral fat, has unique value in identifying metabolic syndrome in Chinese patients with T1DM.

Research perspectives

The future research direction is to evaluate the relationship between BC and MS, mortality through expanding sample size and cohort studies.