Article Dans Une Revue Cardiovascular Diabetology Année : 2025

Beyond overweight, visceral adiposity is associated with estimation of cardiovascular risk in patients living with type 1 diabetes: findings from the SFDT1 cohort

1 EpiMaCT - Epidémiologie des Maladies Chroniques en zone tropicale
2 CHU Limoges - Centre Hospitalier Universitaire Dupuytren 1 et 2
3 INEM - UM 111 (UMR 8253 / U1151) - Institut Necker Enfants-Malades
4 Service de diabétologie et d'endocrinologie [CHU Lariboisière]
5 LIH - Luxembourg Institute of Health
6 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
7 UPS/Inserm U1297 - I2MC - Institut des Maladies Métaboliques et Casdiovasculaires
8 Folkhälsan Research Center
9 Helsingin yliopisto = Helsingfors universitet = University of Helsinki
10 HUS - Helsinki University Hospital [Finland]
11 Boehringer Ingelheim International GmbH
12 Comue de Toulouse - Communauté d'universités et établissements de Toulouse
13 Hôpital Avicenne [AP-HP]
14 Centre de Recherche en Nutrition Humaine - Ile de France (CRNH - IDF)
15 CINFO - Centre Intégré Nord Francilien de l'Obésité
16 CHLS - Centre Hospitalier Lyon Sud [CHU - HCL]
17 CarMeN - Cardiovasculaire, métabolisme, diabétologie et nutrition
18 Cardiovascular & Renal Clinical Trialists - INI-CRCT - French-Clinical Research Infrastructure Network / F-CRIN [Lyon]
19 LBEPS - Laboratoire de Biologie de l'Exercice pour la Performance et la Santé
20 CHSF - Centre Hospitalier Sud Francilien - Centre Hospitalier d'Evry
21 CERITD - Centre d'études et de recherches pour l'intensification du traitement du diabète
22 ITX-lab - ITX-lab unité de recherche de l'institut du thorax UMR1087 UMR6291
23 IC UM3 (UMR 8104 / U1016) - Institut Cochin
24 Hôpital Cochin [AP-HP]
25 Clinique Pasteur [Toulouse]
26 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
27 C2VN - Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research
28 EGID - Institut Européen de Génomique du Diabète - European Genomic Institute for Diabetes - FR 3508
29 Imperial College London
30 Hammersmith Hospital NHS Imperial College Healthcare
31 CRNH-IDF - Centre de Recherche en Nutrition Humaine d'Ile-de-France
32 EREN [CRESS - U1153 / UMR_A 1125] - Nutritional Epidemiology Research Team | Equipe de Recherche en Epidémiologie Nutritionnelle
33 UFR Médecine UPCité - UFR Médecine [Santé] - Université Paris Cité

Résumé

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/m 2 ) or overweight/obesity (≥ 25 kg/m 2 ), 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/m 2 . 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/m 2 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.

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Dates et versions

inserm-05214505 , version 1 (19-08-2025)

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Laurence Salle, Jean-Baptiste Julla, Guy Fagherazzi, Pierre Gourdy, Erika Bezerra Parente, et al.. Beyond overweight, visceral adiposity is associated with estimation of cardiovascular risk in patients living with type 1 diabetes: findings from the SFDT1 cohort. Cardiovascular Diabetology, 2025, 24 (1), pp.256. ⟨10.1186/s12933-025-02789-3⟩. ⟨inserm-05214505⟩
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