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

A longitudinal assessment of lipids in youth with type 1 diabetes.

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1
Center For Endocrinology, Diabetes, and Metabolism, Childrens Hospital Los Angeles, Keck School of Medicine of USC, Los Angeles, CA 90027, USA

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.

[Indexed for MEDLINE]

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