[Obesity and risk factors for metabolic syndrome in young people with type 1 diabetes].
Changes in the clinical presentation of diabetes mellitus in childhood and adolescence associated with obesity have resulted in an overlap of the two most common types of diabetes with a greater clinical heterogeneity. In order to characterize the type of diabetes at onset and assess the effect of obesity, 50 children with diabetes were studied. The patients were divided into two groups according to their nutritional status at diagnosis (over-weight/obese vs. normal weight). Insulin reserve was evaluated by measuring basal C-peptide and stimulated C-peptide in response to a mixed meal (MMTT) as well as HLA-DQB1 genotype, antibodies, and family history of risk factors for metabolic disease. Of all 50 patients, 38% was overweight/obese, 84% had a positive family history of metabolic syndrome, 82% had positive antibodies, and 100% were positive for the high-risk HLA-DQB1 genotype. No significant differences were found in fasting C-peptide or glycemic index/C-peptide levels between the two groups. In the overweight/obese group C-peptide response to MMTT showed higher levels at 60 and 120 minutes (p = 0.02 and 0.03) and the area under the curve for C-peptide was also higher (1.77 ng / ml vs. 5.5 ng/ ml, p = 0.0007) than in the normal-weight group. In conclusion, overweight/obese patients with type 1A diabetes had a greater pancreatic reserve, suggesting that nutritional status may accelerate disease onset.
Servicio de Nutrición, Hospital de Pediatría SAMIC J. P. Garrahan 1245 Buenos Aieres, Argentina. prietomar@gmail.com
Mariana
M
Prieto
Andrea G
AG
Krochik
Eduardo
E
Chaler
Mercedes
M
Maceiras
Anabel
A
Villalba
Silvina
S
Valdez
Gloria
G
Cerrone
Mariana
M
Tellechea
Mariana
M
Telechea
Carmen
C
Mazza
D000293:Adolescent; D015551:Autoimmunity; D015415:Biomarkers / Q000097:blood; D002096:C-Peptide / Q000097:blood*; D016009:Chi-Square Distribution; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis* / Q000235:genetics; D005260:Female; D005838:Genotype; D005968:Glutamate Decarboxylase / Q000097:blood; D059866:HLA-DQ beta-Chains / Q000097:blood; D006801:Humans; D007330:Insulin Antibodies / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications; D009765:Obesity / Q000150:complications; D011446:Prospective Studies; D054635:Receptor-Like Protein Tyrosine Phosphatases, Class 8 / Q000097:blood; D012307:Risk Factors
D015415:Biomarkers; D002096:C-Peptide; D059866:HLA-DQ beta-Chains; C069051:HLA-DQB1 antigen; D007330:Insulin Antibodies; D054635:Receptor-Like Protein Tyrosine Phosphatases, Class 8; D005968:Glutamate Decarboxylase