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J Clin Lipidol. 2014 Mar-Apr;8(2):194-8. doi: 10.1016/j.jacl.2013.12.006. Epub 2013 Dec 17.

Non-HDL-cholesterol in an adolescent diabetes population.

Author information

1
Cohen Children's Medical Center of NY, 1991 Marcus Avenue, Suite M100, Lake Success, NY, 11042.
2
Prohealth, Lake Success, NY.
3
Cohen Children's Medical Center of NY, 1991 Marcus Avenue, Suite M100, Lake Success, NY, 11042. Electronic address: gfrank@lij.edu.

Abstract

BACKGROUND:

Screening for dyslipidemia poses some challenges. Nonfasting lipid profiles frequently have elevated triglycerides. In addition, in the standard lipid profile, low-density lipoprotein (LDL) cholesterol is a calculated value rather than a direct measurement and is triglyceride dependent. Non-high-density lipoprotein cholesterol (non-HDL-C) is an alternative method to assess for dyslipidemia and provides a single estimate of all atherogenic apolipoprotein B-containing lipoproteins.

OBJECTIVE:

To calculate the non-HDL-C in adolescents with diabetes and to evaluate risk factors associated with an elevated non-HDL-C and to compare the prevalence of dyslipidemia, defined by non-HDL-C, with the prevalence of dyslipidemia defined by LDL cholesterol in the SEARCH study.

METHODS:

Data were collected from 502 adolescent patients with diabetes and analyzed. Non-HDL-C was calculated and levels were categorized into normal, borderline, and high based on the National Cholesterol Education Program.

RESULTS:

Lipid profile was performed in 370 patients, 92% of whom had type 1 diabetes. In the 339 subjects with type 1 diabetes, mean hemoglobin A1c (HbA1c) of those with normal non-HDL-C (8.6%) was significantly lower than the HbA1c of those with high non-HDL-C (9.6%) (P = .005). Subjects with normal non-HDL-C had a lower body mass index (BMI) z-score (0.4 ± 0.8) than the group with borderline and high non-HDL-C (0.75 ± 0.9%), P = .002. In the 31 subjects with type 2 diabetes, the mean HbA1c of those with normal non-HDL-C (8.1%) and those with borderline non-HDL-C (7.0%) was significantly lower than the mean HbA1c of those with high non-HDL-C (11.8%) (P = .04, and P = .009, respectively). In addition, the subjects with normal non-HDL-C had a lower BMI z-score (1.3 ± 1.3) than the group with borderline and high non-HDL-C (2.2 ± 0.6%), P = .03. The prevalence of dyslipidemia using non-HDL-C was similar to prevalence rates using LDL-C in the SEARCH study.

CONCLUSIONS:

In adolescents with diabetes, non-HDL-C is increased with poorer diabetes control and higher BMI. It appears to be a superior nonfasting lipid screening test for adolescents with diabetes that can be readily calculated on a randomly obtained rather than fasting sample.

KEYWORDS:

Adolescents; Diabetes; Dyslipidemia; Non-HDL-cholesterol

PMID:
24636179
DOI:
10.1016/j.jacl.2013.12.006
[Indexed for MEDLINE]

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