Work

Sex-specific thresholds of peak oxygen consumption for detecting cardiometabolic risk in children and adolescents with type 1 diabetes

Year: 2025

Type: article

Abstract: Aims To establish sex-specific peak oxygen consumption (VO 2peak ) thresholds that accurately discriminate cardiometabolic risk (CMR) in children and adolescents with type 1 diabetes and to validate these cut-off points using an independent cohort. Methods This longitudinal study included 83 participants (aged 8–18 years) with type 1 diabetes from the Diactive-1 cohort. VO 2peak was assessed via maximal exercise testing with direct gas analysis, and CMR was calculated using a composite z-score of waist circumference, lipid profile, HbA1c, and blood pressure. VO 2peak thresholds for CMR were identified by sex using logistic regression and receiver operating characteristic analysis, and externally validated in a Brazilian cohort (n = 36). A total of 62 individuals completed the 2-year follow-up assessment. Results Optimal VO 2peak thresholds were 40.8 ml/kg/min for boys and 33.7 ml/kg/min for girls, with areas under the curve of 0.71 and 0.78, respectively. Participants below these thresholds had significantly higher lipids and overall CMR. These associations persisted at the two-year follow-up and were confirmed in the Brazilian cohort, which also showed elevated HbA1c among high-risk individuals. Conclusions Our study supports the clinical utility of these thresholds as a non-invasive marker of metabolic health and reinforce the importance of cardiorespiratory fitness promotion in this population.

Source: Diabetes Research and Clinical Practice

DOI: 10.1016/j.diabres.2025.112410