TY - JOUR
T1 - Beyond overweight, visceral adiposity is associated with estimation of cardiovascular risk in patients living with type 1 diabetes
T2 - findings from the SFDT1 cohort
AU - Salle, Laurence
AU - Julla, Jean Baptiste
AU - Fagherazzi, Guy
AU - Gourdy, Pierre
AU - Bezerra Parente, Erika
AU - Hanaire, Hélène
AU - Tatulashvili, Sopio
AU - Disse, Emmanuel
AU - Franc, Sylvia
AU - Hadjadj, Samy
AU - Larger, Etienne
AU - Sanz, Caroline
AU - Vaduva, Patricia
AU - Valero, René
AU - Bonnefond, Amélie
AU - Cosson, Emmanuel
AU - Aguayo, Gloria A.
AU - Riveline, Jean Pierre
AU - SFDT1 group
N1 - Funding:
SFDT1 has institutional support from Breakthrough T1D, iCare4CVD Consortium, Innovative Health Initiative, Fondation Francophone pour la Recherche sur le Diabète (FFRD), the Société Francophone du Diabète (SFD), Aide aux Jeunes Diabétiques (AJD) and Fédération Française des Diabétiques. SFDT1 is also supported by partners and donors: Lilly, Abbott, Air Liquide Healthcare, Novo Nordisk, Sanofi, Insulet, Medtronic, Dexcom, Ypsomed and Lifescan.
Publisher Copyright:
© 2025. The Author(s).
PY - 2025/6/14
Y1 - 2025/6/14
N2 - INTRODUCTION & OBJECTIVES: As in the general population, people living with type 1 diabetes (PWT1D) are faced with overweight and obesity, which contribute to cardiovascular (CV) risk. However, the role of visceral adiposity, due to its adverse metabolic profile, should also be addressed in PWT1D. We aimed to assess the 10-year CV risk of PWT1D according to body mass index (BMI) and waist-to-height ratio (WHtR), a parameter for estimating visceral adiposity. METHODS: In this cross-sectional study, PWT1D in primary CV prevention from the SFDT1 cohort were categorized by BMI status, either normal (18.5-24.9 kg/m2) or overweight/obesity (≥ 25 kg/m2), and by WHtR according to the validated threshold of 0.5. The 10-year CV risk was estimated using the Steno Type 1 Risk Engine and classified into three categories: low (< 10%), intermediate (10-20%) and high (> 20%). The distribution of CV risk was assessed using density plots. In multivariable analysis, the association between BMI, WHtR, and high estimated 10-year CV risk was studied using spline regression models with sex stratification. Thresholds were determined by the Receiver Operating Characteristic (ROC) curve. RESULTS: The study included 1,482 patients; 49.9% had a normal BMI, and 50.1% a BMI ≥ 25 kg/m2. The proportion of patients with high CV risk was higher in PWT1D with overweight/obesity (12% vs. 7%) and in those with WHtR ≥ 0.5 (13% vs. 4%). BMI was significantly associated with high CV risk in men (p = 0.001) but a non-significant trend was found in women (p = 0.053). WHtR was significantly associated with high CV risk in both men (p < 0.001) and women (p = 0.046). The BMI threshold associated with high CV risk was 24.9 kg/m2 for men, and the WHtR threshold was 0.5 for both men and women. CONCLUSION: In PWT1D in condition of primary CV prevention, visceral adiposity, assessed by WHtR, is a more robust marker of estimated 10-year CV risk than overweight/obesity status in both men and women.
AB - INTRODUCTION & OBJECTIVES: As in the general population, people living with type 1 diabetes (PWT1D) are faced with overweight and obesity, which contribute to cardiovascular (CV) risk. However, the role of visceral adiposity, due to its adverse metabolic profile, should also be addressed in PWT1D. We aimed to assess the 10-year CV risk of PWT1D according to body mass index (BMI) and waist-to-height ratio (WHtR), a parameter for estimating visceral adiposity. METHODS: In this cross-sectional study, PWT1D in primary CV prevention from the SFDT1 cohort were categorized by BMI status, either normal (18.5-24.9 kg/m2) or overweight/obesity (≥ 25 kg/m2), and by WHtR according to the validated threshold of 0.5. The 10-year CV risk was estimated using the Steno Type 1 Risk Engine and classified into three categories: low (< 10%), intermediate (10-20%) and high (> 20%). The distribution of CV risk was assessed using density plots. In multivariable analysis, the association between BMI, WHtR, and high estimated 10-year CV risk was studied using spline regression models with sex stratification. Thresholds were determined by the Receiver Operating Characteristic (ROC) curve. RESULTS: The study included 1,482 patients; 49.9% had a normal BMI, and 50.1% a BMI ≥ 25 kg/m2. The proportion of patients with high CV risk was higher in PWT1D with overweight/obesity (12% vs. 7%) and in those with WHtR ≥ 0.5 (13% vs. 4%). BMI was significantly associated with high CV risk in men (p = 0.001) but a non-significant trend was found in women (p = 0.053). WHtR was significantly associated with high CV risk in both men (p < 0.001) and women (p = 0.046). The BMI threshold associated with high CV risk was 24.9 kg/m2 for men, and the WHtR threshold was 0.5 for both men and women. CONCLUSION: In PWT1D in condition of primary CV prevention, visceral adiposity, assessed by WHtR, is a more robust marker of estimated 10-year CV risk than overweight/obesity status in both men and women.
KW - Adiposity distribution
KW - Body mass index
KW - Cardiovascular risk
KW - Registry
KW - Sex
KW - Type 1 diabetes
KW - Waist circumference
KW - Body Mass Index
KW - Prognosis
KW - Cross-Sectional Studies
KW - Risk Assessment
KW - Humans
KW - Middle Aged
KW - Male
KW - Intra-Abdominal Fat/physiopathology
KW - Obesity, Abdominal/physiopathology
KW - Waist-Height Ratio
KW - Adiposity
KW - Time Factors
KW - Diabetes Mellitus, Type 1/diagnosis
KW - Female
KW - Adult
KW - Heart Disease Risk Factors
KW - Cardiovascular Diseases/diagnosis
UR - http://www.scopus.com/inward/record.url?scp=105008836788&partnerID=8YFLogxK
UR - https://pubmed.ncbi.nlm.nih.gov/40517273/
U2 - 10.1186/s12933-025-02789-3
DO - 10.1186/s12933-025-02789-3
M3 - Article
C2 - 40517273
AN - SCOPUS:105008836788
SN - 1475-2840
VL - 24
JO - Cardiovascular Diabetology
JF - Cardiovascular Diabetology
IS - 1
M1 - 256
ER -