Leptin is associated with cardiopulmonary fitness independent of body-mass index and insulin sensitivity in adolescents with type 1 diabetes: a brief report from the EMERALD study

Abstract

Brief summary Cardiopulmonary fitness is decreased in type 1 diabetes for reasons that are incompletely understood. In this study, leptin was associated with exercise capacity independent of insulin sensitivity (IS) and body mass index (BMI), suggesting that leptin may relate to cardiopulmonary fitness by mechanisms beyond IS and/or obesity.

Impact of Obesity on Measures of Cardiovascular and Kidney Health in Youth With Type 1 Diabetes as Compared With Youth With Type 2 Diabetes

“…We found a significant increase in both hs-CRP and leptin concentrations with obesity in our T1D group, with elevations similar to the T2D group. These changes parallel lower cardiopulmonary fitness with increasing BMI in T1D, similar to our previous finding of an independent inverse association between leptin levels and both VO 2 peak and insulin sensitivity in T1D (40). We and others have reported reduced cardiopulmonary fitness in normal-weight youth and adults with T1D (41,42), and we now demonstrate further decline in cardiopulmonary fitness in adolescents with T1D with elevated BMI.…”

Predictors of the maximal oxygen consumption in adult patients with type 1 diabetes treated with personal insulin pumps

“…Other factors previously shown to be associated with higher CF were higher insulin sensitivity, better lipid profile, elevated leptin, serum 2‐hydroxyvitamin D ≥75 nmol/L, lower levels of general anxiety and higher health‐related quality of life, among other factors 4,29,32–34 . American Diabetes Association/International Society for Pediatric and Adolescent Diabetes goal achievement (target: HbA1c <7.5%, blood pressure <90th percentile, low‐density lipoprotein cholesterol <100 mg/dL, high‐density lipoprotein cholesterol >35 mg/dL, triglycerides <150 mg/dL and BMI <85th percentile) has also been shown to be associated with CF 35 .…”

Bone mineral content and bone density is lower in adolescents with type 1 diabetes: A brief report from the RESISTANT and EMERALD studies

“…Adolescents (12–19 years) with T1D (n = 125) and pubertal stage frequency-matched controls (n = 80) with whole-body BMC and BMD dual x-ray absorptiometry (DXA) available were included from two ongoing studies: RESistance to InSulin in Type 1 And Type 2 diabetes (RESISTANT) and Effects of MEtformin on CardiovasculaR Function in AdoLescents with Type 1 Diabetes (EMERALD). 11,12 T1D was defined per the American Diabetes Association criteria plus ≥1 diabetes-associated antibodies. 11,12 Controls were healthy adolescents without diabetes or a family history of diabetes; absence of diabetes was confirmed by a 2-h, 75-g oral glucose tolerance test.…”

“…11,12 T1D was defined per the American Diabetes Association criteria plus ≥1 diabetes-associated antibodies. 11,12 Controls were healthy adolescents without diabetes or a family history of diabetes; absence of diabetes was confirmed by a 2-h, 75-g oral glucose tolerance test. Height, weight and body mass index (BMI) were measured as described previously.…”

“…Height, weight and body mass index (BMI) were measured as described previously. 11,12 Pubertal development was assessed by a pediatric endocrinologist using Tanner and Marshall criteria. Exclusion criteria were Tanner stage <2, hypertension (blood pressure 003E 140/90 mmHg), hemoglobin <9%, serum creatinine >1.5 mg/dl, HbA1c ≥12%, smoking and receiving steroid or oral hypoglycemic agents.…”