A longitudinal assessment of lipids in youth with type 1 diabetes

Pediatr Diabetes. 2011 Jun;12(4 Pt 2):365-71. doi: 10.1111/j.1399-5448.2010.00733.x. Epub 2011 Mar 11.

Abstract

Background: Type 1 diabetes and dyslipidemia are known risk factors for cardiovascular disease (CVD), but the relationship between lipid levels in youth with type 1 diabetes and future CVD remains unknown.

Objective: To characterize lipid levels and CVD risk factors over time in youth with type 1 diabetes.

Subjects: The study included adolescents with type 1 diabetes (12-25 yr) with a minimum of 3-yr follow-up.

Methods: A longitudinal prospective, observational study of 46 youth with type 1 diabetes was performed. Fasting lipid profiles, A1C, and body mass index (BMI) were measured every 6 months for at least 3 yr (median 4.2 yr). Low-density lipoprotein (LDL)-cholesterol, total cholesterol (TC), and triglycerides (TG) were divided into categorical variables.

Results: At baseline, median age was 14.3 yr, mean diabetes duration was 6.4 ± 3.8 yr, mean A1C was 8.1 ± 1.0%, and median BMI z-score was 0.92. Fifty percent of subjects had LDL levels ≤ 100 mg/dL (≤ 2.6 mmol/L) at study onset. After adjusting for confounding factors, increasing BMI z-score [β = 0.2, 95% confidence interval (CI ) = 0.03-0.38, p = 0.03] and increasing A1C (β = 0.18, 95% CI = 0.08-0.29, p = 0.001) were associated with increasing LDL category over time. Non-Hispanic ethnicity (β = 0.45, 95% CI = 0.12-0.79, p = 0.008) and family history of stroke (β = 0.38, 95% CI = 0.04-0.72, p = 0.03) were also associated with increasing LDL category. Age, diabetes duration, and tobacco exposure were not related to change in LDL. Increasing A1C was associated with increases in TG (β = 18.1, 95% CI = 2.3-33.9, p = 0.03), TC (β = 20.3, 95% CI = 9.0-31.5, p < 0.0001), and LDL (β = 13.4, 95% CI = 3.17- 23.6, p = 0.01).

Conclusion: Glycemic control and BMI are modifiable risk factors for dyslipidemia in youth with type 1 diabetes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Blood Glucose / metabolism
  • Body Mass Index
  • Cardiovascular Diseases / etiology
  • Child
  • Cholesterol / blood
  • Cholesterol, LDL / blood
  • Diabetes Mellitus, Type 1 / metabolism*
  • Dyslipidemias / prevention & control
  • Female
  • Glycated Hemoglobin A / metabolism
  • Hispanic Americans
  • Humans
  • Lipid Metabolism*
  • Longitudinal Studies
  • Male
  • Prospective Studies
  • Risk Factors
  • Triglycerides / blood
  • Young Adult

Substances

  • Blood Glucose
  • Cholesterol, LDL
  • Glycated Hemoglobin A
  • Triglycerides
  • hemoglobin A1c protein, human
  • Cholesterol