Muscle-to-fat ratio in children and adolescents with type 1 diabetes in predicting glycaemic control and partial clinical remission.

Abstract

Advances in treatment could mitigate the expected adverse changes in the body composition of children and adolescents with type 1 diabetes (T1D). To examine the evolution of weight status and body composition and their association with glycaemic control and partial clinical remission in youth with T1D. Ninety-nine participants with T1D (median age 9.5 years [interquartile range 7.3, 12.9], 59.6% boys) were longitudinally followed for 3years since diagnosis. Data at seven pre-determined time points were extracted from medical files. Outcome measures included body mass index (BMI) z-scores, muscle-to-fat ratio (MFR) z-scores, haemoglobin A1c (HbA1c) levels, continuous glucose monitoring metrics, and insulin dose-adjusted HbA1c (IDAA1c) levels. The BMI z-scores increased significantly (p<0.001) for both sexes, with no significant change in MFR z-scores over time. The girls had higher BMI z-scores (p<0.001) and lower MFR z-scores than the boys (p=0.016). The mean HbA1c levels decreased during the first month and at 3months since diagnosis (p<0.001), then plateaued and achieved a median overall HbA1c of 7.1% for the entire cohort. At 12months, 37 participants (37.6%) were in partial clinical remission, as evidenced by IDAA1c≤9. The odds of partial clinical remission at 2years increased by 2.1-fold for each standard deviation increase in the MFR z-score (p<0.001). Higher MFR z-scores were associated with better metabolic control. Integration of body composition assessments could mitigate adverse body changes in paediatric patients with T1D.