The Change Of Body Mass Index And Its Correlation Analysis In Children And Adolescents With Type 1 Diabetes Mellitus

Objective:Type 1 diabetes mellitus(T1DM)is one of the common chronic diseases in children and adolescents.In the past,it was thought that most of the children with T1 DM were thin.But in recent years,with the increase of the incidence of T1 DM in children and adolescents,the rate of overweight and obesity also shows an increasing trend.Overweight and obesity will make some new problems and seriously affect the growth and development of children and the prognosis of the disease.The purpose of this study is to compare the body mass index standard deviation score(BMISDS)of children with T1 DM at diagnosis and at the last follow-up,know about the change of body mass index in children with T1 DM and reveal the relevant factors affecting their changes,in order to pay more attention to overweight and obesity in children with T1 DM,monitor high-risk children and give necessary intervention measures in time.Methods:The clinical data and laboratory indexes of the first diagnosed children with T1 DM,admitted to the Department of Pediatric Endocrinology from June 2017 to January 2021,were analyzed retrospectively.The basic characteristics were summarized and grouped according to age,sex,diabetic acidosis,insulin administration and blood glucose monitoring methods.And the correlation between various factors and BMISDS was analyzed.The data were analyzed by SPSS26.0 statistical software.The correlation between the two variables was analyzed by Spearman rank correlation or Pearson correlation and multiple linear regression.Results:(1)53 children(26 males and 27 females)with T1 DM were included and the median follow-up period was 3.0(1.5-4.0)year.Upon diagnosis,the median age was8.0(5.5-11.0)years,BMISDS was-1.1(-1.8-0.6)and 12(22.6%)cases were overweight and obesity.To the last follow-up,42 cases completed the follow-up,the median age was 12.0(8.8-13.3)years,the BMISDS was 0(-0.6-0.7)and 5(11.9%)cases were overweight and obesity.The BMISDS at the last follow-up was significantly higher than that at the time of diagnosis.(2)Among 41 children who were not overweight and obesity on diagnosis,30 cases completed the follow-up.There were 14 males with△BMISDS was 0.3(-0.3-1.8)and 16 females with △BMISDS was 1.9(1.1-2.2).The△BMISDS of females was significantly higher than that of males.(3)In the groups of< 5 years old,5-10 years old and ≥ 10 years old,the BMISDS of girls was significantly higher than that of boys.(4)△BMISDS was negatively correlated with BMISDS,FCP,FT3,FT4,TSH and positively correlated with Hb A1 c at diagnosis(P<0.05).In the multiple linear regression of,△BMISDS was still negatively associated with BMISDS and TSH at the time of diagnosis.Conclusions:BMISDS in children with T1 DM shows an increasing trend in the course of the disease,which is related to gender,BMISDS,FCP,Hb A1 c,FT3,FT4,and TSH at diagnosis.Appropriate intervention measures should be formulated to prevent and reduce the occurrence of overweight and obesity and its complications.