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DOI: 10.1101/2023.05.23.23290372

Surrogate markers of metabolic syndrome (MetS) and insulin resistance (IR) in children and young adults with type 1 diabetes: A systematic review & meta-analysis

S. B.Khandagale A. V. Khadilkar V. S. Kamble C. Oza S. Bhor S. P. Khare
Introduction: Metabolic syndrome (MetS), a collection of risk factors for cardiovascular disease, and Insulin resistance (IR) are associated with diabetes. The diagnosis of both these conditions are based on specific clinical parameters. However, the efficacy of these parameters has not been systematically studied in paediatric population with T1DM. Methodology: We performed a systematic review and meta-analysis in paediatric populations of type 1 diabetes. We assessed the strength of association of the parameters of MetS and IR. The meta-analysis was performed using a metaphor package in R. A random effect model was used to study the strength of association by estimating Hedges g. Results: The systematic review resulted in identification of 30 studies on MetS and IR in paediatric patients with T1DM. Insulin dosage and HbA1C, markers for glycaemic condition showed no association with MetS in patients with T1DM. In the lipid profile, increased triglyceride (TG) and low-density lipoprotein (LDL) showed better effect size than reduced high-density lipoprotein (HDL). In case of insulin resistance, heterogeneous nature of studies made it difficult to carry out a meta-analysis. A descriptive review of existing and novel markers is thus provided. Conclusion: Lack of association between markers of glycaemic condition suggested that MetS may develop independently of glycaemic control in children with T1DM. Other than TG and HDL, LDL may be used in the diagnosis of MetS. From the descriptive analysis it could be observed that a standard protocol for the diagnosis of IR is needed.