Longitudinal lipid screening and use of lipid-lowering medications in pediatric type 1 diabetes

J Pediatr. 2007 Feb;150(2):146-50, 150.e1-2. doi: 10.1016/j.jpeds.2006.10.054.

Abstract

Objective: Because cardiovascular disease (CVD) is the leading cause of death in patients with type 1 diabetes (T1D) and dyslipidemia is an important CVD risk factor, we investigated dyslipidemia and its treatment in children with T1D.

Study design: Subjects had T1D (n = 360), repeated lipid measurements (n = 1095; mean, 3.04 +/- 0.94; range, 2 to 11), and were seen between 1994 and 2004. Total cholesterol (TC), high-density lipoprotein cholesterol (HDL), and non-HDL cholesterol (non-HDL) were categorized on the basis of published guidelines. Age, diabetes duration, sex, body mass index, HbA1c, and lipid-lowering medication use were recorded. Predictors of TC, HDL, and non-HDL were determined.

Results: Sustained abnormalities existed for TC > or = 200 mg/dL (16.9%); HDL < 35 mg/dL (3.3%); and non-HDL > or = 130 mg/dL (27.8%), > or = 160 mg/dL (10.6%), and > or = 190 mg/dL (3.3%). Lipid-lowering medications were started on 23 patients. In mixed model longitudinal data analyses, HbA1c was significantly related to TC and non-HDL. Body mass index z-score was inversely related to HDL.

Conclusions: In this retrospective, longitudinal study of pediatric patients with T1D with repeated lipid measurements, sustained abnormal levels for TC, HDL, and non-HDL were present. Prospective longitudinal data for dyslipidemia in youth with T1D are needed.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Cardiovascular Diseases / prevention & control
  • Child
  • Child, Preschool
  • Cholesterol, HDL / analysis
  • Cholesterol, HDL / metabolism*
  • Cholesterol, LDL / analysis
  • Cholesterol, LDL / metabolism*
  • Diabetes Mellitus, Type 1 / diagnosis*
  • Diabetes Mellitus, Type 1 / drug therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Hyperlipidemias / diagnosis*
  • Hyperlipidemias / drug therapy*
  • Hypolipidemic Agents / therapeutic use*
  • Longitudinal Studies
  • Male
  • Retrospective Studies
  • Risk Assessment
  • Treatment Outcome

Substances

  • Cholesterol, HDL
  • Cholesterol, LDL
  • Hypolipidemic Agents