ESPE2015 Poster Category 3 Diabetes (94 abstracts)
HbA1c Rather Than BMI Lifestyle and Adherence to Mediterranean Diet is the Major Determinant of Triglyceride/HDL Cholesterol Ratio in Adolescents with Type 1 Diabetes
Silvia Poluzzi a , Stefano Zucchini a , Giulio Maltoni a , Maximiliano Zioutas a , Claudia Balsamo a , Antonio Maria Morselli-Labate b , Elena Nardi b & Laura Mazzanti a
aEndocrine Unit, Department of Pediatrics, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy; bDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
Background: Triglyceride (TG)/HDL ratio has recently been considered a index of cardio-metabolic risk in healthy and obese subjects. Diet, lifestyle indexes, anthropometric parameters, and metabolic control are the variables with possible influence on belonging to a certain cardio-metabolic risk group.
Objective and hypotheses: To identify whether HbA1c per se has an influence on TG/HDL and to study other possible variables influencing the ratio.
Method: We evaluated 85 adolescents with type 1 diabetes (T1D). Inclusion criteria were age range 12–19.9 years and T1D with at least 2-year duration. All patients underwent clinical examination and measurement of HbA1c and lipid profile, as well as filled-in the KIDMED questionnaire investigating Mediterranean diet quality index and a questionnaire on socio-economic and lifestyle indexes. The patients were subdivided according to Di Bonito et al. TG/HDL ratio tertiles (Diabetes Care 2012). The Kruskal–Wallis (a) and χ2 (b) tests were applied.
Results: The Table 1 shows mean±S.D. values of variables significantly different among TG/HDL ratio classes. Age, waist/height ratio, mediterranean diet adherence, socioeconomic, and lifestyle parameters were not significantly different among the three groups. A stepwise multinomial logit model identified HbA1c as the parameter with the highest independent influence on belonging to the highest cardio-metabolic risk group (P=0.002), followed by SBP (P=0.034), while BMI and waist/height ratio disappeared after SBP entered the model.
| TG/HDL ratio | <1.2 (n=53) | ≥1.2 and <2.0 (n=23) | ≥2.0 (n=9) | P value |
| BMI–SDS | 0.09±0.95 | 0.73±0.76 | 0.16±1.44 | 0.015a |
| SBP (mmHg) | 112±9 | 117±10 | 122±11 | 0.005a |
| DBP (mmHg) | 70±8 | 74±8 | 78±10 | 0.016a |
| Chol (mg/dl) | 168±29 | 183±35 | 200±42 | 0.030a |
| HbA1c (%) | 8.10±1.0 | 8.40±0.97 | 9.90±1.20 | 0.001a |
| Gender (M/F) | 22/31 | 11/12 | 8/1 | 0.022b |
Conclusion: In our group of adolescents with T1D, showing a fair level of adherence to Mediterranean diet and on average a correct lifestyle, HbA1c, and male sex were the major determinant of belonging to a low cardio-metabolic risk group.
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