Effects of Age, Gender, BMI, and Anatomical Site on Skin Thickness in Children and Adults with Diabetes

<div><p>Objective</p><p>We aimed to assess the effects of age, sex, body mass index (BMI), and anatomical site on skin thickness in children and adults with diabetes.</p><p>Methods</p><p>We studied 103 otherwise healthy children and adolescents with type 1 diabetes aged 5–19 years, and 140 adults with type 1 and type 2 diabetes aged 20–85 years. The thicknesses of both the dermis and subcutis were assessed using ultrasound with a linear array transducer, on abdominal and thigh skin.</p><p>Results</p><p>There was an age-related thickening of both dermis (p&lt;0.0001) and subcutis (p = 0.013) in children and adolescents. Girls displayed a substantial pubertal increase in subcutis of the thigh (+54%; p = 0.048) and abdomen (+68%; p = 0.009). Adults showed an age-related decrease in dermal (p = 0.021) and subcutis (p = 0.009) thicknesses. Pubertal girls had a thicker subcutis than pubertal boys in both thigh (16.7 vs 7.5 mm; p&lt;0.0001) and abdomen (16.7 vs 8.8 mm; p&lt;0.0001). Men had greater thigh dermal thickness than women (1.89 vs 1.65 mm; p = 0.003), while the subcutis was thicker in women in thigh (21.3 vs 17.9 mm; p = 0.012) and abdomen (17.7 vs 9.8 mm; p&lt;0.0001). In boys, men, and women, both dermis and subcutis were thicker on the abdomen compared to thigh; in girls this was only so for dermal thickness. In both children and adults, the skin (dermis and subcutis) became steadily thicker with increasing BMI (p&lt;0.0001).</p><p>Conclusions</p><p>Skin thickness is affected by age, pubertal status, gender, BMI, and anatomical site. Such differences may be important when considering appropriate sites for dermal/subcutaneous injections and other transdermal delivery systems.</p></div

The association of BMI SDS and BMI with thickness of skin layers in children (n = 103) and adults (n = 140), respectively.

<p>Data for females are in red and for males in blue.</p

Thickness of skin layers in abdomen (full bars) and thigh (striped bars) in males (blue) and females (red).

<p>*p&lt;0.05, **p&lt;0.01, ***p&lt;0.001, and ****p&lt;0.0001 for comparisons between abdominal and thigh measurements.</p

Skin thickness in boys (blue bars) and girls (red bars), according to pubertal status.

<p>****p&lt;0.0001.</p