期刊
JOURNAL OF PEDIATRICS
卷 201, 期 -, 页码 78-+出版社
MOSBY-ELSEVIER
DOI: 10.1016/j.jpeds.2018.05.014
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资金
- Federal Ministry of Education and Research within the German Center for Diabetes Research (DZD) [01GI1106]
- Innovative Medicines Initiative 2 Joint Undertaking (INNODIA) - European Union's Horizon 2020 research and innovation program [115797]
- EFPIA
- JDRF
- Leona M. and Harry B. Helmsley Charitable Trust
- German Diabetes Association (DDG)
- German Robert Koch Institute (RKI)
- European Foundation for the Study of Diabetes (EFSD)
Objective To identify distinct longitudinal patterns of body mass index (BMI) z score in type 1 diabetes from childhood to young adulthood and secondly to determine sex differences as well as associated clinical covariates. Study design A total of 5665 patients with type 1 diabetes (51% male) with follow-up from 8 to 20 years of age from the multicenter diabetes prospective registry DPV were studied (baseline diabetes duration >= 1 years, BMI z score aggregated per year of life). Latent class growth modeling (SAS: PROC TRAJ) was applied to analyze BMI z score over time. Results Six distinct BMI z score trajectories were identified (group 1: 7% of patients, group 2: 22%, group 3: 20%, group 4: 16%, group 5: 25%, and group 6: 10%). Group 1, 2, 5, and 6 had an almost stable BMI z score, either in the low, near-normal, high stable, or chronic overweight range. Group 3 (60% girls) increased their BMI during puberty, whereas group 4 (65% boys) had a BMI decrease. Similar patterns were observed for girls only, whereas boys followed nearly stable trajectories without fluctuation over time. Between the near-normal and the other groups, significant differences (P < .05) in sex ratio, migration background, mental health, height z score, glycated hemoglobin A1c, diabetes treatment, dyslipidemia, hypertension, and smoking were observed. Conclusions In youth with type 1 diabetes, a great heterogeneity of BMI z score trajectories exists that highlight the importance of personalized sexspecific intervention programs for subjects at risk for unfavorable BMI development.
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