ESPE Abstracts

Background/Aim: Prediction of metabolic syndrome (Mets) plays important role in cardiovascular disease risk prevention. Although Mets is relatively common in children with T1DM, diagnosis and prediction are ignored. Visceral Adiposity Index VAI) has been defined as a new cardiometabolic risk marker reflecting abdominal fat distribution and dyslipidemia. The aim of the study is to reveal the relationship between Mets and components of VAI in patients with T1DM.

Materials and Methods: This is a single-center prospective study.168 patients aged 7-17 years with a diagnosis of T1DM were included. All patiens were performed following parameters: body mass index(BMI) z-score, waist-circumference, waist-to-height ratio(WHR), VAI, neck circumference, blood pressure, blood lipids, transaminase levels, heaptic ultrasound. The following criteria were used for obesity; high BMI(>95percentile) high neck and waist circumference(>90percentile), and high HHR(≥0.5) For VAI, the previously known formulation was used, and VAI cut-off:1.77 was accepted as a marker for Mets. Elevated ALT(≥45IU/l) unexplained for other reasons were considered to be risky for hepatosteatosis(HS). Patients who met WHO's child-adapted criteria were considered Mets positive.

Results: Eighty-four(50%) were female. The mean age of the patients was 12.54±2.85 years. According to BMI-SDS, 25 patients were overweight, while 2 were obese. The number of patients with high-waist and neck-circumferences as follows:22(13.09%), 68(42.5%). The mean values of these anthropometric measurements were as follows:69.59±8.33 cm, 30.75±3.17 cm. Of the patients,32(19%) had HS. Of the patients,33(19.6%) made diagnosed with Mets, while the VAI was found to be high in 109(64.8%) cases. A significant relationship was found between the presence of Mets and high VAI (P<0.001). The mean waist-neck circumferences and WHR were found to be higher in patients with high VAI(P=0.023, P=0.006 and P=0.004, respectively). Waist circumference was found to be associated with both the presence of Mets(P=0.03) and the high VAI(P=0.02). The high neck circumference was found to be associated only with the high VAI(P=0.006), not with the Mets(P=0.418). While the relationship in terms of HS or its risk was significant with the presence of Mets, it was not found with highVAI(P=0.02, P=0.356)

Conclusion: This study showed that high VAI is common in children with T1DM and is associated with Mets. It suggests that the use of VAI may be an appropriate approach in terms of its potential to predict the development of Mets early, which is overlooked in non-obese children with T1DM.