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.
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.
Authors: Michelle L Katz; Craig R Kollman; Carly E Dougher; Mohamed Mubasher; Lori M B Laffel Journal: Diabetes Care Date: 2016-10-20 Impact factor: 19.112
Authors: David M Maahs; Dana Dabelea; Ralph B D'Agostino; Jeannette S Andrews; Amy S Shah; Nancy Crimmins; Elizabeth J Mayer-Davis; Santica Marcovina; Giuseppina Imperatore; R Paul Wadwa; Steven R Daniels; Kristi Reynolds; Richard F Hamman; Lawrence M Dolan Journal: J Pediatr Date: 2012-07-11 Impact factor: 4.406
Authors: Amy S Shah; Dana Dabelea; Nora F Fino; Lawrence M Dolan; R Paul Wadwa; Ralph D'Agostino; Richard Hamman; Santica Marcovina; Stephen R Daniels; Elaine M Urbina Journal: Diabetes Care Date: 2015-12-30 Impact factor: 19.112
Authors: Amy S Shah; Lawrence M Dolan; Dana Dabelea; Jeanette M Stafford; Ralph B D'Agostino; Elizabeth J Mayer-Davis; Santica Marcovina; Giuseppina Imperatore; R Paul Wadwa; Stephen R Daniels; Kristi Reynolds; Richard F Hamman; Deborah A Bowlby; David M Maahs Journal: Pediatr Diabetes Date: 2014-08-07 Impact factor: 4.866