Body Composition Assessment in Type 1 Diabetes Mellitus Patients Over 15 Years Old

Background: The aim of the present study was to assess the anthropometric characteristics and body composition in type 1 diabetic patients and compare the results with a randomly selected control population. Material and Methods: We studied 75 type 1 diabetic patients, 43 male and 32 female, recruited from consecutive diagnosed type 1 diabetic patients attending the Endocrine Unit and treated with a intensive insulin regimen, and 93 control subjects, 44 males and 49 females representative of the census of this city. We performed a dietary recall in patients and determined anthropometric characteristics, both in patients and controls, body weight, height, body-mass index, waist-hip ratio and body composition parameters: total body water, free-fat mass, body free-fat mass, fat mass and body fat by bioelectrical impedance analyser. Results: In diabetic male patients, we observed lower waist-hip ratio than in controls, 0.84 ± 0.06 vs. 0.88 ± 0.07, p = 0.021, higher free-fat mass in female diabetic patients, 48.5 ± 5.6 vs. 45.6 ± 5.9 kg, p = 0.03, lower fat mass in male diabetic patients, 9.5 ± 6.9 vs. 14.6 ± 8.5 kg, p = 0.003. We did not find any correlation among the parameters of body composition and dietary macronutrient intake in patients. Conclusions: The present study exposes the differences in anthropometric characteristics and body composition in type 1 diabetes mellitus, especially lower waist-hip ratio in male, higher free-fat mass in female and lower fat mass in male.

Body Composition - Body-Mass Index - Body Surface Area - Free-Fat Mass - Fat Mass - Type 1 Diabetes Mellitus - Waist-Hip Ratio

References

• 1 Heymsfield S B, Matthews D. Body composition: research and clinical advances - 1993. A.S.P.E.N. research workshop.  J Par Ent Nutr. 1994;  18 91-103
• 2 De Boer H, Block G -J, van der Veen E A. Clinical aspects of growth hormone deficiency in adults.  Endocr Rev. 1995;  16 63-86
• 3 Cuneo R C, Judd S, Wallace J D, Perry-Keene D, Burger H, Lim-Tio S. The Australian multicenter trial of growth hormone (GH) treatment in GH-deficient adults.  J Clin Endocrinol Metab. 1998;  83 197-216
• 4 Gómez Sáez J M, Gómez Arnaiz N, Soler Ramón J. Modificaciones de la composición corporal en pacientes adultos con hipopituitarismo después del tratamiento sustitutivo con hormona de crecimiento.  Med Clin (Bar). 1999;  113 246-249
• 5 Seppel T, Kosel A, Schlaghecke R. Bioelectrical impedance assessment of body composition in thyroid disease.  Eur J Endocrinol. 1997;  136 493-498
• 6 Tjellesen L, Staun M, Rannem T, Nielsen P K, Jarnum S. Body composition in patients on home parenteral nutrition.  Scand J Clin Lab Invest. 1996;  56 295-303
• 7 Egger N G, Carlson M S, Shaffer J L. Nutritional status and assessment of patients on home parenteral nutrition: anthropometry, bioelectrical impedance, or clinical judgment?.  Nutrition. 1999;  15 1-6
• 8 Molina A, Pita A M, Virgili N, Farriols N, Soler J, Gómez J M. Serum leptin levels in patients with short-bowel syndrome.  Clin Nutr. 2000;  19 333-338
• 9 Anonymus . NIH Consensus statement. Bioelectrical impedance analysis in body composition measurement. National Institute of Health technology assessment conference statement. December 12 - 14, 1994.  Nutrition. 1996;  12 749-762
• 10 Bartz J, Sulzbach U, Heinze E, Teller W M, Holl R W. Körperzusammensetzung bei Typ-I-Diabetes mellitus. Bioimpedanzmessungen bei 274 diabetischen Kindern, Jugendlichen und jungen Erwachsenen.  Deutsch Med Wochenschr. 1997;  122 815-819
• 11 Leiter L A. Use of bioelectrical impedance analysis measurements in patients with diabetes. The Diabetes Control and Complications Trial Research Group.  Am J Clin Nutr. 1996;  64 (3 Suppl) 515-518
• 12 World Health Organization .Diabetes Mellitus: Report of a WHO Study Group.  Geneva:; World Health Org (Tech. Rep. Ser., no. 727), 1985
• 13 Fernández-Castañer M, Molina A, López-Jiménez L, Gómez J M, Soler J. Clinical presentation and early course of type 1 diabetes mellitus in patients with and without thyroid autoimmunity.  Diabetes Care. 1999;  22 377-381
• 14 Backer J, Detsky A, Wesson D, et al. Nutritional assessment: a comparison of clinical judgement and objective measurements.  N Engl J Med. 1982;  306 967-972
• 15 DuBois D, DuBois E F. Clinical calorimetry. X. A formula to estimate the approximate surface area in height and weight to be known.  Arch Intern Med. 1916;  17 863
• 16 Lukaski H C, Johnson P E, Bolonchuk W W, Lykken G I. Assessment of fat-free mass using bioelectrical impedance measurements of the human body.  Am J Clin Nutr. 1985;  41 810-817
• 17 Rossner B. Fundamentals of Biostatistics. 3rd edition.  Boston:; PWS-Kent Publishing, 1990
• 18 The DCCT Research Group. Weight gain associated with intensive therapy in the diabetes control and complication trial.  Diabetes Care. 1988;  11 567-573
• 19 Ferrante E, Pitzalis G, Vania A, et al. Nutritional status, obesity and metabolic control in children with type 1 diabetes mellitus.  Min Ped. 1999;  51 39-46
• 20 Rigalleau V, Delafaye C, Baillet L, et al. Composition of insulin-induced body weight gain in diabetic patients: a bio-impedance study.  Diab Metab. 1999;  25 321-328
• 21 Svenson O L, Hassager C. Body composition and fat distribution measured by dual-energy x-ray absorptiometry in premenopausal and postmenopausal insulin-dependent and non-insulin-dependent diabetes mellitus patients.  Metabolism: Clin & Exp. 1998;  47 212-216
• 22 Sinha A, Formica C, Tsalamandris C, et al. Effects of insulin on body composition in patients with insulin-dependent and non-insulin-dependent diabetes.  Diab Med. 1996;  13 40-46
• 23 Björntorp P. Portal adipose tissue as generator or risk factors for cardiovascular disease and diabetes.  Arteriosclerosis. 1990;  10 493-496
• 24 Kiess W, Anil M, Blum W F, et al. Serum leptin levels in children and adolescents with insulin-dependent diabetes mellitus in relation to metabolic control and body mass index.  Eur J Endocrinol. 1998;  138 501-509
• 25 Gómez J M, Molina A, Fernández-Castañer, Casamitjana R, Martínez-Matos J A, Soler J. Insulin regulation of leptin synthesis and secretion in humans: the model of myotonic dystrophy.  Clin Endocrinol (Oxf). 1999;  50 569-575
• 26 Gómez J M, Molina A, Fernández-Castañer M, Soler J. Leptin in type 2 diabetic or myotonic dystrophy women.  Horm Metab Res. 2001;  33 246-249
• 27 Lukaski H C, Bolonchuk W W, Hall C B, Siders W A. Validaton of tetrapolar bioelectrical impedance method to assess human body composition.  J Appl Physiol. 1986;  69 1327-1332
• 28 Heymsfield S B, Wang Z, Visser M, Gallagher D, Pierson R N Jr. Techniques used in the measurement of body composition: an overview with emphasis on bioelectrical impedance analysis.  Am J Clin Nutr. 1996;  64 (Suppl 3) 478-484
• 29 Demura S, Kobayashi H, Tanaka K, Sato S, Nagasawa Y, Murase T. Comprehensive evaluation of selected methods for assessing human body composition.  App Hum Sci. 1999;  18 43-51
• 30 Lukaski H C. Requirements for clinical use of bioelectrical impedance analysis (BIA).  Ann N York Acad Sci. 1999;  873 72-76