ArticleEndocrine2025
Beyond conventional measures: body composition analyses and the role of Tri-Ponderal mass index in assessing adiposity in children with type 1 diabetes mellitus.
Article in Endocrine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundChildren with type 1 diabetes mellitus (T1DM) are at increased risk of excess adiposity due to sedentary lifestyle, dietary factors, and insulin therapy. Body mass index (BMI), the most commonly used measure of adiposity, cannot distinguish between fat and lean mass. To address this limitation, alternative indices such as the tri-ponderal mass index (TMI) have been proposed; however, its role in pediatric T1DM remains unclear.
objectiveTo compare body composition between children with T1DM and healthy peers, and to assess the utility of TMI in evaluating adiposity. SUBJECTS AND
methodsThis cross-sectional study included 65 children with T1DM and 65 age- and sex-matched healthy controls. Anthropometric data, waist-to-height ratio (WHR), disease duration, daily insulin dose, insulin regimen, and mean HbA1c values over the previous year were recorded. TMI was calculated as weight (kg)/height³ (m³). Body fat percentage (BFP), fat mass (FM), and fat-free mass (FFM) were assessed using bioelectrical impedance analysis (BIA).
resultsThe median age of children with T1DM was 14.4 (12.2–16.9) years, with a median disease duration of 4.3 (2.6–7.5) years. No significant differences were found between groups regarding SD scores of BMI, WHR, and TMI. Compared with controls, children with T1DM showed significantly higher BFP and BFP SD scores (p = 0.005 and p = 0.002), and elevated FM SD scores (p = 0.01). The FFM/FM ratio did not differ significantly (p = 0.09). Longer disease duration (≥ 5 years) was associated with higher BFP and FM (p < 0.05). TMI correlated positively with BFP (r = 0.66 ), BFP SD score (r = 0.78), FM SD score (r = 0.83), and WHR (r = 0.87), and negatively with the FFM/FM ratio (r = − 0.68) (all p < 0.001).
conclusionChildren with T1DM exhibit higher adiposity than healthy peers, particularly with longer disease duration. TMI showed strong correlations with body fat parameters and may serve as a simple, reliable, and clinically useful tool for assessing adiposity in pediatric T1DM.
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