BODY COMPOSITION AND THE METABOLIC IMPACT OF WEIGHT EXCESS IN PATIENTS WITH TYPE 1 AND TYPE 2 DIABETES MELLITUS

Background and aims. Increased fat accumulation associated to increased cardiometabolic risk factors is a prominent feature of type 2 diabetes. In type 1 diabetes, increased fat accumulation is not prevalent and its metabolic impact has not been fully evaluated. We aimed to evaluate differences in body composition, clinical and metabolic profile in type 1 and type 2 diabetes patients with varying degrees of adiposity. Materials and methods. Clinical, biochemical and body composition data (using a bioelectric impedance analyzer) from 96 type 1 and 253 type 2 adult diabetes patients have been collected. Results. In type 1 patients estimated visceral fat area (eVFA) increased significantly (84.3±27.9 vs. 103.0±27.9 vs. 128.1±29.1 cm 2 , p=0.006, 0.003, and 25 kg/m 2 ) type 1 patients there were no significant differences either in triglycerides (128.7±135.6 vs. 92.8±50.6 mg/dl, p=0.1), HDL-cholesterol (53.6±15.9 vs. 52.3±13.7 mg/dl, p=0.6) and uric acid levels (3.4±2.0 vs. 2.9±1.2 mg/dl, p=0.2), or in hypertension (39.5% vs. 40.0%, p=0.7) and nonalcoholic hepatosteatosis (NASH) (10.0% vs. 10.5%, p=0.6) prevalences. In type 2 patients, BMI (32.3±5.9 vs. 29.5±5.1 vs. 27.9±5.0 kg/m 2 , p=0.001, p=0.04, p<0.001) and BFM (34.5±12.7 vs. 29.6±10.2 vs. 27.1±10.8 kg, p=0.007, p=0.11, p <0.001) decreased, while eVFA did not differ across age tertiles, suggesting that older age increases central fat distribution. Compared to normal weight, overweight type 2 diabetes patients had greater triglycerides (218.8±303.4 vs. 110.9±44.9 mg/dl, p=0.01), uric acid (4.5±2.4 vs. 3.3±1.4 mg/dl, p=0.01), and lower HDL-cholesterol (43.9±12.9 vs. 54.1±15.4 mg/dl, p<0.001) serum levels, and higher prevalences of hypertension (71.8% vs. 39.4%, p=0.005) and NASH (59.1% vs. 25.0%, p=0.005). Conclusion. Visceral fat accumulation is associated with older age in both types of diabetes, but only in type 2 diabetes is associated with cardiometabolic anomalies.