ESPE Abstracts (2015) 84 P-3-701

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 Poluzzia, Stefano Zucchinia, Giulio Maltonia, Maximiliano Zioutasa, Claudia Balsamoa, Antonio Maria Morselli-Labateb, Elena Nardib & Laura Mazzantia

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.

Table 1
TG/HDL ratio<1.2 (n=53)≥1.2 and <2.0 (n=23)≥2.0 (n=9)P value
SBP (mmHg)112±9117±10122±110.005a
DBP (mmHg)70±874±878±100.016a
Chol (mg/dl)168±29183±35200±420.030a
HbA1c (%)8.10±1.08.40±0.979.90±1.200.001a
Gender (M/F)22/3111/128/10.022b

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.