A collaborative study from CIBERDEM-ISCIII shows that abdominal fat speeds up vascular ageing and increases the risk of long-term vascular complications, even before obesity appears.
A research team from the Parc Taulí Research and Innovation Institute (I3PT), together with the Pere Virgili Health Research Institute (IISPV) and the Hospital del Mar Research Institute (IMIM), has identified a clear link between abdominal fat accumulation and early vascular ageing in people with type 1 diabetes who have no previous cardiovascular disease.
The study was carried out with a group of 179 people with this condition, all evaluated at Parc Taulí University Hospital under the coordination of José Miguel González-Clemente, endocrinologist and head of the diabetes–cardiovascular risk group at I3PT, and Joan Vendrell, IISPV researcher, co-leader of the DIAMET research group and member of CIBERDEM-ISCIII.
Even though the participants had good control of blood glucose, blood pressure and lipid levels, around 10% showed signs of early vascular ageing. This is an important factor in the development of cardiovascular and microvascular complications that directly affect quality of life and life expectancy.
“In type 1 diabetes, insulin treatment is essential to control blood glucose, but over the years it can lead to gradual weight gain and a higher risk of complications,” González-Clemente explains. He adds that abdominal fat can accumulate before general obesity appears, especially visceral fat, which is metabolically active and strongly linked to artery damage. “This type of fat reduces arterial elasticity, a process related to the degradation of elastin, a key protein in the vascular wall. It may contribute to complications such as heart attack, stroke, circulation problems in the legs, or damage to the retina, kidneys and peripheral nerves.”
The waist-to-height ratio, a tool to detect early vascular ageing
To easily identify people at higher risk, the study highlights the waist-to-height ratio, calculated by dividing waist circumference by height, both in centimetres. The results show that a value of 0.56 or higher is linked to accelerated vascular ageing, measured through pulse wave velocity, a non-invasive technique that assesses arterial stiffness. “Almost all people with high pulse wave velocity had a waist-to-height ratio of 0.56 or more,” González-Clemente notes, adding that other common indicators, such as body mass index or waist-to-hip ratio, are less effective at detecting this risk.
The findings, published in Diabetes Research and Clinical Practice, underline the importance of preventing weight gain and monitoring abdominal fat as a preventive strategy. “Early control of this index would allow intervention before obesity develops, improve metabolic control and reduce the risk of long-term vascular complications,” he concludes.
The researchers point out that the next step is to confirm these results in larger cohorts with longer follow-up. The study also suggests that some drugs used in people with type 2 diabetes to reduce weight might also be useful in type 1 diabetes, although more clinical evidence is still needed.
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