Trajectories of Body Mass Index from Childhood to Young Adulthood among Patients with Type 1 Diabetes—A Longitudinal Group-Based Modeling Approach Based on the DPV Registry - 21/09/18
, Anke Schwandt, MS Statistics 1, 2, *, Marianne Becker, MD 3, Christian Denzer, MD 4, Monika Flury, MD 5, Maria Fritsch, MD 6, Angela Galler, MD, PhD 7, Andreas Lemmer, MD 8, Matthias Papsch, MD 9, Thomas Reinehr, MD, PhD 10, Joachim Rosenbauer, MD 2, 11, Reinhard W. Holl, MD, PhD 1, 2Abstract |
Objective |
To identify distinct longitudinal patterns of body mass index (BMI) z score in type 1 diabetes from childhood to young adulthood and secondly to determine sex differences as well as associated clinical covariates.
Study design |
A total of 5665 patients with type 1 diabetes (51% male) with follow-up from 8 to 20 years of age from the multicenter diabetes prospective registry DPV were studied (baseline diabetes duration ≥1 years, BMI z score aggregated per year of life). Latent class growth modeling (SAS: PROC TRAJ) was applied to analyze BMI z score over time.
Results |
Six distinct BMI z score trajectories were identified (group 1: 7% of patients, group 2: 22%, group 3: 20%, group 4: 16%, group 5: 25%, and group 6: 10%). Group 1, 2, 5, and 6 had an almost stable BMI z score, either in the low, near-normal, high stable, or chronic overweight range. Group 3 (60% girls) increased their BMI during puberty, whereas group 4 (65% boys) had a BMI decrease. Similar patterns were observed for girls only, whereas boys followed nearly stable trajectories without fluctuation over time. Between the near-normal and the other groups, significant differences (P < .05) in sex ratio, migration background, mental health, height z score, glycated hemoglobin A1c, diabetes treatment, dyslipidemia, hypertension, and smoking were observed.
Conclusions |
In youth with type 1 diabetes, a great heterogeneity of BMI z score trajectories exists that highlight the importance of personalized sex-specific intervention programs for subjects at risk for unfavorable BMI development.
Le texte complet de cet article est disponible en PDF.Keywords : BMI z score, developmental curves, diabetes, puberty, latent class growth modeling
Abbreviations : ADHD, BIC, BMI, BMIz, CSII, DPV Registry, KiGGS, LCGM
Plan
| Supported by the Federal Ministry of Education and Research within the German Center for Diabetes Research (DZD; 01GI1106); the Innovative Medicines Initiative 2 Joint Undertaking (INNODIA; 115797) supported by the European Union's Horizon 2020 research and innovation program and “EFPIA,” ‘JDRF,” and “The Leona M. and Harry B. Helmsley Charitable Trust”; the German Diabetes Association (DDG); the German Robert Koch Institute (RKI), and the European Foundation for the Study of Diabetes (EFSD). Sponsors were not involved in study design, collection, analysis and interpretation of data, writing of the report, and the decision to submit the manuscript for publication. The authors declare no conflicts of interest. |
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| Portions of this study were presented as an abstract at the 43rd International Society for Pediatric and Adolescent Diabetes Annual Meeting, October 18-21, 2017, Innsbruck, Austria. |
Vol 201
P. 78 - octobre 2018 Retour au numéro
Article précédent
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