Sociodemographic associations of longitudinal adiposity in youth with type 1 diabetes

Abstract

Excess adiposity is common in youth with type 1 diabetes, yet little is known about the sociodemographic factors that predict longitudinal trajectories of body fat. We analyzed data from 363 females and 379 males with type 1 diabetes over ~9 years of follow-up (mean baseline age 12.8 ± 2.3 years in females, 13.2 ± 2.4 years in males). Estimated body fat percentage (eBFP) was calculated with validated sex- and race/ethnicity-specific equations. Group-based modeling identified three eBFP trajectories for each sex. All female trajectories showed gradual increases, while male trajectories showed gradual decreases (<5% in eBFP) that plateaued around 7 years of diabetes duration. Female trajectories showed differences in baseline eBFP: Group F1 (38.0%), mean eBFP 27.8 ± 3.0%: Group F2 (47.9%), mean eBFP 33.9 ± 3.0%: and Group F3 (14.1%), mean eBFP 41.7 ± 4.1%. Male trajectories also showed differences in baseline eBFP: Group M1 (57.2%), mean eBFP 22.0 ± 3.0%: Group M2 (30.9%), mean eBFP 33.9 ± 3.0%: and Group M3 (12.9%), mean eBFP 36.1 ± 3.7%. In multinomial models, adjusted for clinical factors (eg, insulin regimen, insulin dose, and hemoglobin A1c), females who reported a single-parent household (adjusted odds ratio [aOR] = 3.34, 95% confidence interval [CI]: 1.49, 7.47), parental education of less than a college degree (aOR = 3.79, 95% CI: 1.60, 9.60), and a lack of private health insurance (aOR = 3.74, 95% CI: 1.45, 9.60), and a household income of less than $75 000 per year (aOR = 3.13, 95% CI: 1.27, 7.70) were approximately three to four times more likely to be in the highest eBFP trajectory group relative to the lowest eBFP trajectory group. Males who reported a household income of <$75 000/year were almost twice as likely to be in the Group M3 than the Group M1 in the unadjusted model only (aOR = 1.79, 95% CI: 0.91, 4.01 vs unadjusted OR: 2.48, 95% CI: 1.22, 5.06). Lower socioeconomic status may be associated with excess body fat throughout adolescence in type 1 diabetes, particularly among females.

Assessment of serum vitamin D level in children with type 1 diabetes mellitus: A cross-sectional study

“…21 Another potential explanation is that vitamin D has direct effects on B-cells, such as improving insulin secretion, increasing VDR expression, and improving islet morphology. 22 The current study found a strong positive correlation between serum vitamin D and disease duration, while there was a strong negative correlation between serum vitamin D and hospital admission, FBG and HbA1c.…”

Association of Insulin Regimen and Estimated Body Fat Over Time among Youths and Young Adults with Type 1 Diabetes: The SEARCH for Diabetes in Youth Study

“…Estimated body fat percentage has been operationalized previously to examine longitudinal patterns of adiposity over time among youths with type 1 diabetes and associations of trajectory group membership with sociodemographic factors [24]. The present analysis used a longitudinal, mixed modeling approach better suited to incorporate time-varying variables that may drive change in body composition over time.…”

“…Equations are sex-and race/ethnicity-specific (white, black, Mexican-American, and "other"), and participants who identified as Hispanic/Mexican American were modeled with the Mexican American equation; all others who did not fall into one of the three specific race/ ethnicity categories were modeled with the "other" equation [23]. SEARCH previously operationalized these equations for the prediction of eBFP to examine longitudinal patterns of adiposity over time among youths with T1D [24].…”