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

Abstract 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...

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Main Authors: Laurence Salle, Jean-Baptiste Julla, Guy Fagherazzi, Pierre Gourdy, Erika Bezerra Parente, Hélène Hanaire, Sopio Tatulashvili, Emmanuel Disse, Sylvia Franc, Samy Hadjadj, Etienne Larger, Caroline Sanz, Patricia Vaduva, René Valero, Amélie Bonnefond, Emmanuel Cosson, Gloria A. Aguayo, Jean-Pierre Riveline, the SFDT1 group
Format: Article
Language:English
Published: BMC 2025-06-01
Series:Cardiovascular Diabetology
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Online Access:https://doi.org/10.1186/s12933-025-02789-3
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author Laurence Salle
Jean-Baptiste Julla
Guy Fagherazzi
Pierre Gourdy
Erika Bezerra Parente
Hélène Hanaire
Sopio Tatulashvili
Emmanuel Disse
Sylvia Franc
Samy Hadjadj
Etienne Larger
Caroline Sanz
Patricia Vaduva
René Valero
Amélie Bonnefond
Emmanuel Cosson
Gloria A. Aguayo
Jean-Pierre Riveline
the SFDT1 group
author_facet Laurence Salle
Jean-Baptiste Julla
Guy Fagherazzi
Pierre Gourdy
Erika Bezerra Parente
Hélène Hanaire
Sopio Tatulashvili
Emmanuel Disse
Sylvia Franc
Samy Hadjadj
Etienne Larger
Caroline Sanz
Patricia Vaduva
René Valero
Amélie Bonnefond
Emmanuel Cosson
Gloria A. Aguayo
Jean-Pierre Riveline
the SFDT1 group
author_sort Laurence Salle
collection DOAJ
description Abstract 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.
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series Cardiovascular Diabetology
spelling doaj-art-af23d7e023b948cebfb431713fb70d022025-08-20T03:20:59ZengBMCCardiovascular Diabetology1475-28402025-06-0124111210.1186/s12933-025-02789-3Beyond overweight, visceral adiposity is associated with estimation of cardiovascular risk in patients living with type 1 diabetes: findings from the SFDT1 cohortLaurence Salle0Jean-Baptiste Julla1Guy Fagherazzi2Pierre Gourdy3Erika Bezerra Parente4Hélène Hanaire5Sopio Tatulashvili6Emmanuel Disse7Sylvia Franc8Samy Hadjadj9Etienne Larger10Caroline Sanz11Patricia Vaduva12René Valero13Amélie Bonnefond14Emmanuel Cosson15Gloria A. Aguayo16Jean-Pierre Riveline17the SFDT1 groupInserm 1094 & IRD270, Limoges University HospitalUniversité Paris Cité, CNRS, INSERM, Institut Necker Enfants Malades-INEMDeep Digital Phenotyping Research Unit, Department of Precision Health (GAA, GF), Luxembourg Institute of HealthDepartment of Diabetology, Metabolic Diseases and Nutrition, Toulouse University HospitalFolkhälsan Research CenterDepartment of Diabetology, Metabolic Diseases and Nutrition, Toulouse University HospitalDepartment of Endocrinology-Diabetology-Nutrition, AP-HP, Avicenne Hospital, Université Paris 13, Sorbonne Paris Cité, CRNH-IdF, CINFODepartment of Endocrinology, Diabetes and Nutrition, Hospices Civils de Lyon, Hôpital Lyon SudDepartment of Endocrinology, Sud Francilien HospitalThorax Institute, CNRS, INSERM, Nantes University Hospital Center, Nantes UniversityDiabetology Department, Cochin Hospital, AP-HPDepartment of Diabetology, and Endocrinology Clinique PasteurDepartment of Endocrinology, Diabetes and Nutrition, Rennes University HospitalAix Marseille Univ, APHM, INSERM, INRAE, University Hospital La ConceptionInserm/CNRS UMR 1283/8199, Pasteur Institute of Lille, EGIDDepartment of Endocrinology-Diabetology-Nutrition, AP-HP, Avicenne Hospital, Université Paris 13, Sorbonne Paris Cité, CRNH-IdF, CINFODeep Digital Phenotyping Research Unit, Department of Precision Health (GAA, GF), Luxembourg Institute of HealthUniversité Paris Cité, CNRS, INSERM, Institut Necker Enfants Malades-INEMAbstract 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.https://doi.org/10.1186/s12933-025-02789-3Cardiovascular riskBody mass indexType 1 diabetesAdiposity distributionSexWaist circumference
spellingShingle Laurence Salle
Jean-Baptiste Julla
Guy Fagherazzi
Pierre Gourdy
Erika Bezerra Parente
Hélène Hanaire
Sopio Tatulashvili
Emmanuel Disse
Sylvia Franc
Samy Hadjadj
Etienne Larger
Caroline Sanz
Patricia Vaduva
René Valero
Amélie Bonnefond
Emmanuel Cosson
Gloria A. Aguayo
Jean-Pierre Riveline
the SFDT1 group
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
Cardiovascular risk
Body mass index
Type 1 diabetes
Adiposity distribution
Sex
Waist circumference
title Beyond overweight, visceral adiposity is associated with estimation of cardiovascular risk in patients living with type 1 diabetes: findings from the SFDT1 cohort
title_full Beyond overweight, visceral adiposity is associated with estimation of cardiovascular risk in patients living with type 1 diabetes: findings from the SFDT1 cohort
title_fullStr Beyond overweight, visceral adiposity is associated with estimation of cardiovascular risk in patients living with type 1 diabetes: findings from the SFDT1 cohort
title_full_unstemmed Beyond overweight, visceral adiposity is associated with estimation of cardiovascular risk in patients living with type 1 diabetes: findings from the SFDT1 cohort
title_short Beyond overweight, visceral adiposity is associated with estimation of cardiovascular risk in patients living with type 1 diabetes: findings from the SFDT1 cohort
title_sort beyond overweight visceral adiposity is associated with estimation of cardiovascular risk in patients living with type 1 diabetes findings from the sfdt1 cohort
topic Cardiovascular risk
Body mass index
Type 1 diabetes
Adiposity distribution
Sex
Waist circumference
url https://doi.org/10.1186/s12933-025-02789-3
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