Hypertriglyceridemic waist in type 1 diabetes patients: prevalence and related factors.

Background: The hypertriglyceridemic waist has been linked to a higher number of cardiovascular risk factors and a greater probability of developing diabetes and cardiovascular disease. Around 50% of individuals with type 1 diabetes (T1D) are overweight or obese and triglyceridemia is associated with the onset of micro- and macrovascular complications.
Methods: A cross-sectional study was conducted in men with T1D to assess the association between the prevalence of hypertriglyceridemic waist and cardiovascular risk factors and hypogonadism. Triglyceride levels + abdominal circumference taken together were stratified into quartiles to identify the hypertriglyceridemic waist phenotype.
Results: One hundred and eighty-one male patients were included. An increased prevalence of hypogonadism and hypertension in parallel to increased triglyceride + waist circumference quartile was observed. Patients in the highest quartile had higher insulin resistance measured by estimated glucose disposal rate (eGDR 7.8±2.1 mg/kg-1.min-1 in 1st quartile vs. 5.8±1.8 mg/kg-1.min-1 in 4th quartile, P=0.000), insulin requirements, hip circumference, percentage of fat mass, glycosilated hemoglobin and total and LDL cholesterol as well as lower levels of total testosterone (27.24±9.3 nmol/L in 1st quartile vs. 17.4±8 nmol/L in 4th quartile, P=0.000) and HDL cholesterol. An inverse relationship was found between triglycerides + waist circumference and total testosterone levels (R=-0.367, P<0.0001).
Conclusions: The hypertriglyceridemic waist in men with T1D is associated with an atherogenic lipid profile, hypertension, worse metabolic diabetes control, increased insulin resistance and a higher prevalence of hypogonadism.