Muscle‐to‐fat ratio in children and adolescents with type 1 diabetes in predicting glycaemic control and partial clinical remission

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Abstract

Abstract Background Advances in treatment could mitigate the expected adverse changes in the body composition of children and adolescents with type 1 diabetes (T1D). Objectives To examine the evolution of weight status and body composition and their association with glycaemic control and partial clinical remission in youth with T1D. Methods Ninety‐nine participants with T1D (median age 9.5 years [interquartile range 7.3, 12.9], 59.6% boys) were longitudinally followed for 3 years since diagnosis. Data at seven pre‐determined time points were extracted from medical files. Outcome measures included body mass index (BMI) z ‐scores, muscle‐to‐fat ratio (MFR) z ‐scores, haemoglobin A1c (HbA1c) levels, continuous glucose monitoring metrics, and insulin dose‐adjusted HbA1c (IDAA1c) levels. Results The BMI z ‐scores increased significantly ( p < 0.001) for both sexes, with no significant change in MFR z ‐scores over time. The girls had higher BMI z ‐scores ( p < 0.001) and lower MFR z ‐scores than the boys ( p = 0.016). The mean HbA1c levels decreased during the first month and at 3 months since diagnosis ( p < 0.001), then plateaued and achieved a median overall HbA1c of 7.1% for the entire cohort. At 12 months, 37 participants (37.6%) were in partial clinical remission, as evidenced by IDAA1c ≤ 9. The odds of partial clinical remission at 2 years increased by 2.1‐fold for each standard deviation increase in the MFR z ‐score ( p < 0.001). Higher MFR z ‐scores were associated with better metabolic control. Conclusions Integration of body composition assessments could mitigate adverse body changes in paediatric patients with T1D.

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