Journal of Clinical Pediatrics >
Changes of body mass index and its related factors in children and adolescents with type 1 diabetes mellitus
Received date: 2022-05-16
Online published: 2023-07-05
Objective To compare the body mass index standard deviation scores (BMISDS) at diagnosis and last follow-up in children with type 1 diabetes mellitus (T1DM), and to reveal the related factors affecting the change of BMISDS. Methods The clinical data of children with T1DM initially diagnosed in the endocrinology department from June 2017 to January 2021 were retrospectively analyzed. The correlation between each factor and ΔBMISDS was analyzed. Results Fifty-three children with T1DM (26 boys and 27 girls) were included, and the median course of follow-up was 3.0 (1.5-4.0) years. The median age at diagnosis was 8.0 (5.5-11.0) years, the BMISDS were -1.1 (-1.8-0.6) and 12 patients (22.6%) were overweight and obese. Forty-two patients completed the last follow-up. The median age was 12.0 (8.8-13.3) years, the BMISDS were 0 (-0.6-0.7) and 5 patients (11.9%) were overweight and obese. The BMISDS at the last follow-up were higher than that at diagnosis, the difference was statistically significant (P<0.01). Of the 41 children who were not overweight and obese at the time of diagnosis, 30 completed the last follow-up. The ΔBMISDS of 14 boys and 16 girls were 0.3 (-0.3-1.8) and 1.9 (1.1-2.2), respectively. The ΔBMISDS of girls was higher than that of boys, and the difference was statistically significant (P<0.05). The ΔBMISDS of girls were higher than that of boys in 0~5 years old, 5~10 years old and ≥10 years old groups, and the difference was statistically significant (P<0.05). ΔBMISDS was significantly negatively correlated with BMISDS, fasting C-peptide (FCP), free triiodothyronine (FT3), free thyroxine (FT4) and thyrotropin (TSH) at diagnosis (P<0.05), and significantly positively correlated with glycosylated hemoglobin (HbA1c) at diagnosis (P<0.05). In multiple linear regression, ΔBMISDS was still significantly negatively correlated with BMISDS and TSH at diagnosis (P<0.05). Conclusions BMISDS in children with T1DM showed an increasing trend in the course of disease, which was related to gender, BMISDS and TSH at the time of diagnosis. Appropriate intervention measures should be developed to reduce the occurrence of overweight, obesity and its complications.
Ling ZHAO , Xiaojing LIU . Changes of body mass index and its related factors in children and adolescents with type 1 diabetes mellitus[J]. Journal of Clinical Pediatrics, 2023 , 41(7) : 519 -525 . DOI: 10.12372/jcp.2023.22e0686
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