P-413: Frequency of overweight and obesity in pediatric GCK-MODY and type 1 diabetes: data from the Brazilian monogenic diabetes study (BRASMOD) and Brazilian type 1 diabetes study group (BrazDiab1SG)
A A Reis, M B S Giuffrida, L E Calliari, C M Genari, S A Dib, C Bulcão, B A Pititto, A F Reis, F M A GiuffridaAbstract
Introduction
Overweight (Ow) and obesity (Ob) are not commonly seen in pediatric GCK-MODY (GCK) and type 1 diabetes (T1D), since insulin resistance and related phenotypes are not part of their typical pathophysiology. Nevertheless, weight excess may occur in these subtypes and add to the challenge of differential diagnosis. Thus, it is important to quantify these traits and identify associated clinical factors.
Objectives
To assess the frequency of Ow/Ob in pediatric individuals with GCK and T1D, and to investigate clinical predictors in each subtype.
Methods
Individuals under 18 years of age from two Brazilian multicenter cohorts, BRASMOD for GCK and BrazDiab1SG for T1D, were evaluated. The analysis included 21 individuals with GCK and 1,218 with T1D. Ow was defined as a BMI z-score (BMIz) between the 85th and 95th percentiles, and Ob as BMIz ≥95th percentile. Associations between clinical predictors and BMIz were tested using linear regression models in each subtype. Interaction with diabetes type was also tested.
Results
Differences between GCK and T1D are shown on the table below. GCK and T1D showed similar frequencies of Ow and Ob. HbA1c was higher in T1D. In T1D, but not in GCK, BMIz was associated with age at diagnosis (β=-0.024, p=0.0003) and female sex (β=0.176, p=0.0009). Significant interaction with diabetes type was observed for both predictors, with p-values of 0.025 and 0.033, respectively. HbA1c was not associated with weight status in each group.
Conclusions
Data from two Brazilian multicenter cohorts suggest that Ow/Ob are present in a non-negligible proportion of pediatric individuals with GCK and T1D. In T1D, literature links weight excess to intensive insulin therapy and clinical overlap with type 2 diabetes; our findings suggest that sex and age at diagnosis may also be relevant and need further study. In GCK, weight excess is not typically part of the phenotype, but our data suggest it should not be used as an exclusion criterion for recruitment.