Phase Angle and Body Composition in Long-term Type 1 Diabetes in Adults: A comparative study in a Brazilian Public Reference Outpatient Clinic

Abstract

Introduction: Type 1 Diabetes Mellitus (DM1) is a disease that affects a small percentage of the population. Nevertheless prevalence is currently growing, with alarming data on lack of control. The importance of body composition and Phase Angle (PA) as assessed by Bioelectrical Impedance (BIA) in long term DM1 patients lies in the fact that alterations in cellular integrity and body compartments may affect risk profiles and metabolic control. The objective of this study was to compare different PA and body composition parameters in a sample of adults with DM1, with healthy controls. Methods: A comparative study was carried out in a state public university outpatient clinic, including a cohort of adult patients of both sexes, diagnosed with DM1, and a control group matched by age and sex, in a 2:1 ratio. Anthropometric measurements included weight, height and BMI. From the raw bioelectrical impedance data of Resistance and Reactance, Fat-Free Mass (FFM), Fat Mass (FM), Fat-Free Mass Index (FFMI), Fat Mass Index (FMI), PA and standardized PA (SPA) were calculated. Means or medians were compared. Regression models were used to show distinguishing characteristics of both groups or to disclose associations within the diabetic group (HbA1c, disease duration, presence of microvascular complications, capillary blood glucose, BMI and FMI). Results: 88 patients with Type 1 Diabetes and 46 healthy controls were evaluated. PA was lower in diabetics (6.05 vs 6.85, p = 0.000), as well as SPA (-1.47 vs -1.36, p = 0.000). Diabetics displayed higher adiposity (%FM = 29.6 vs 27.6, p = 0.016; FMI = 7.00 vs 6.33, p= 0.016) and lower %FFM. Most of the differences were maintained after sex stratification and diabetic man disclose a lower FFMI than male controls (18.2 vs20.16, p = 0.029). Conclusion:Patients with DM1 present greater nutritional risk and worse cell membrane integrity when assessed by PA. Significant body composition differences among groups and between sexes were highlighted, with data showing greater adiposity in diabetic women and diabetic men displaying lower muscle mass. These findings suggest the importance including PA and body composition evaluation in the multidisciplinary clinical outpatient follow-up of patients with Type 1 Diabetes, in an attempt to obtain better metabolic control and consequently, a better prognosis.