A Correlation between Insulin Resistance and Body Composition in Type 1 Diabetes

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 807-838-Diabetes - Diagnosis, Complications & Outcomes
Clinical
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-828
Monica Maria Teixeira Teixeira1, Bruna Polonio Teixeira1, Danielle Marques Bicalho1, Isabella Cristina da Silva Arantes1, Janice Sepulveda Reis2, Maria Goretti Bravim Castro3, Teresa Cristina de Abreu Ferrari1, Maria de Fatima Haueisen Sander Diniz1 and Rodrigo Bastos Foscolo*1
1UFMG, Brazil, 2Santa Casa de Belo Horizonte, Brazil, 3Núcleo de Estudos em Densitometria, Belo Horizonte, Brazil
Objective: The aim of this study is to evaluate, in a group of Type 1 diabetes patients, the body composition and correlate to the presence of insulin resistance calculated by the estimated glucose disposal rate (eGDR) and the insulin sensitivity score (ISS).

Material and methods: An observational, descriptive cross-sectional study was conducted during the period January 2011 to June 2012. A total of 163 DM1 patients were submitted to clinical assessment, laboratory tests and evaluation of body composition by dual-energy x-ray absorptiometry (total and regional adiposity) and skinfold analyses. IR was estimated using Williams et al. and Dabelea et al.´s formulas. The association between obesity and insulin resistance were established correlating eGDR and ISS values with the adiposity markers.

Results:The 163 DM1 patients comprised 56.4% females with median age 27 years (range 12 – 58 years) and 43.6% males with median age 28 years (range 17 – 68 years). The median duration of the disease was 14 years (range 1 – 49 years). According to the Spearman test, there was a strong linear correlation (r = 0.796) between the eGDR and ISS methods. Additionally, there were strong correlations between the eGDR and ISS values and the variables gender, body mass index (BMI), total body fat, thoracoabdominal fat, subscapular skinfold thickness, lean mass percentage, and total insulin dosage per lean mass. Within all quartiles, eGDR and ISS values showed positive and statistically significant linear correlations with the variables BMI (P < 0.001) and thoracoabdominal fat (P < 0.001). ISS values were significantly associated with subscapular skinfold thickness (P < 0.001), total insulin dosage per lean mass (P = 0.003), total body fat (P < 0.001), lean mass percentage (P < 0.001), HDL (P < 0.001) and acanthosis nigricans (P < 0.001). eGDR values were significantly associated with age (P < 0.001 ) and duration of disease in years  (P < 0.001). There were no statistical associations between the eGDR and ISS values and the variables physical activity, history of DM2 and LDL. Based on the kappa coefficients, the concordance between the eGDR and ISS values was fair for the first quartile (k = 0.264; 72.8%) and moderate for the fourth quartile (k = 0.581; 84.3%).

Conclusion:The treatments available to DM1 patients and, consequently, their chances of survival have improved considerably in recent years. However, it is important not only to diagnose the disease as early as possible but also to identify those patients presenting IR. The results obtained herein demonstrate that clinical and laboratory parameters can be used to discriminate DM1 patients with IR. Early detection and appropriate treatment of IR could help to prevent diabetes-related complications. Additionally, further studies on the cohort described in this study may provide important information regarding the incidence of IR among these population.

Nothing to Disclose: MMTT, BPT, DMB, ICDSA, JSR, MGBC, TCDAF, MDFHSD, RBF

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm