Ann Pediatr Endocrinol Metab.  2014 Dec;19(4):191-196. 10.6065/apem.2014.19.4.191.

Serum lipid profiles and glycemic control in adolescents and young adults with type 1 diabetes mellitus

• Kim SH
• Jung IA
• Jeon YJ
• Cho WK
• Cho KS
• Park SH
• Jung MH
• Suh BK

• KMID: 1769351
• DOI: http://doi.org/10.6065/apem.2014.19.4.191

Abstract

PURPOSE
We aimed to investigate serum lipid profiles and glycemic control in adolescents and young adults with type 1diabetes mellitus (T1DM).
METHODS
This cross-sectional study included 29 Korean young adults and adolescents with T1DM. The median age was 17 years (range, 10-25 years) and 18 (62.1%) were female. We compared the lipid profiles of patients with dyslipidemia and those without dyslipidemia. Correlations between glycosylated hemoglobin (HbA1c) and lipid profiles (total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], and triglyceride [TG]) were determined by linear regression analysis.
RESULTS
Of the 29 patients with T1DM, 11 (37.9%) were classified as having dyslipidemia due to the following lipid abnormality: TC> or =200 mg/dL in 8 patients, LDL-C> or =130 mg/dL in 4 patients, TG> or =150 mg/dL in 2 patients, and HDL-C< or =35 mg/dL in 2 patients. Compared to patients without dyslipidemia, patients with dyslipidemia were more likely to have higher values of HbA1c (median, 10.6%; range, 7.5%-12.3% vs. median, 8.0%; range, 6.6%-10.0%; P=0.002) and a higher body mass index z score (median, 0.7; range, -0.57 to 2.6 vs. median, -0.4; range, -2.5 to 2.2; P=0.02). HbA1c levels were positively correlated with TC (P=0.03, R2=0.156) and TG (P=0.005, R2=0.261).
CONCLUSION
A substantial proportion of adolescents and young adults with T1DM had dyslipidemia. We found a correlation between poor glycemic control and poor lipid profiles in those patients.

Keyword

Diabetes mellitus; Dyslipidemia; Glycemic index; Prevalence; Young adult

MeSH Terms

Adolescent*
Body Mass Index
Cholesterol
Cross-Sectional Studies
Diabetes Mellitus
Diabetes Mellitus, Type 1*
Dyslipidemias
Female
Glycemic Index
Hemoglobin A, Glycosylated
Humans
Linear Models
Lipoproteins
Prevalence
Triglycerides
Young Adult*
Cholesterol
Lipoproteins

Figure

• 

  Fig. 1 Prevalence of dyslipidemia for patients with type 1 diabetes mellitus is shown. TC, total cholesterol; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; TG, triglyceride.

• 

  Fig. 2 Correlation between glycemic control parameters and plasma lipid variables is shown. HbA1c, hemoglobin A1c; TC, total cholesterol; TG, triglyceride; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol.

Reference

1. Maahs DM, Wadwa RP, Bishop F, Daniels SR, Rewers M, Klingensmith GJ. Dyslipidemia in youth with diabetes: to treat or not to treat. J Pediatr. 2008; 153:458–465. PMID: 18847618.

2. Jarvisalo MJ, Putto-Laurila A, Jartti L, Lehtimaki T, Solakivi T, Ronnemaa T, et al. Carotid artery intima-media thickness in children with type 1 diabetes. Diabetes. 2002; 51:493–498. PMID: 11812760.

3. Krantz JS, Mack WJ, Hodis HN, Liu CR, Liu CH, Kaufman FR. Early onset of subclinical atherosclerosis in young persons with type 1 diabetes. J Pediatr. 2004; 145:452–457. PMID: 15480366.

4. Newman WP 3rd, Freedman DS, Voors AW, Gard PD, Srinivasan SR, Cresanta JL, et al. Relation of serum lipoprotein levels and systolic blood pressure to early atherosclerosis. The Bogalusa Heart Study. N Engl J Med. 1986; 314:138–144. PMID: 3455748.

5. Berenson GS, Srinivasan SR, Bao W, Newman WP 3rd, Tracy RE, Wattigney WA. Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. The Bogalusa Heart Study. N Engl J Med. 1998; 338:1650–1656. PMID: 9614255.

6. Raitakari OT, Juonala M, Kahonen M, Taittonen L, Laitinen T, Maki-Torkko N, et al. Cardiovascular risk factors in childhood and carotid artery intima-media thickness in adulthood: the Cardiovascular Risk in Young Finns Study. JAMA. 2003; 290:2277–2283. PMID: 14600186.

7. Juonala M, Jarvisalo MJ, Maki-Torkko N, Kahonen M, Viikari JS, Raitakari OT. Risk factors identified in childhood and decreased carotid artery elasticity in adulthood: the Cardiovascular Risk in Young Finns Study. Circulation. 2005; 112:1486–1493. PMID: 16129802.

8. Shamir R, Kassis H, Kaplan M, Naveh T, Shehadeh N. Glycemic control in adolescents with type 1 diabetes mellitus improves lipid serum levels and oxidative stress. Pediatr Diabetes. 2008; 9:104–109. PMID: 18221422.

9. Bustos P, Radojkovic C, Ulloa N, Munoz M, Martinez A, Calvo C, et al. Lipoprotein composition in children and adolescents with type 1 diabetes mellitus. J Pediatr Endocrinol Metab. 2005; 18:257–264. PMID: 15813604.

10. Azad K, Parkin JM, Court S, Laker MF, Alberti KG. Circulating lipids and glycaemic control in insulin dependent diabetic children. Arch Dis Child. 1994; 71:108–113. PMID: 7944528.

11. Ladeia AM, Adan L, Couto-Silva AC, Hiltner A, Guimaraes AC. Lipid profile correlates with glycemic control in young patients with type 1 diabetes mellitus. Prev Cardiol. 2006; 9:82–88. PMID: 16603826.

12. Gunczler P, Lanes R, Soros A, Verdu L, Ramon Y, Guevara B, et al. Coronary artery calcification, serum lipids, lipoproteins, and peripheral inflammatory markers in adolescents and young adults with type 1 diabetes. J Pediatr. 2006; 149:320–323. PMID: 16939740.

13. Guy J, Ogden L, Wadwa RP, Hamman RF, Mayer-Davis EJ, Liese AD, et al. Lipid and lipoprotein profiles in youth with and without type 1 diabetes: the SEARCH for Diabetes in Youth case-control study. Diabetes Care. 2009; 32:416–420. PMID: 19092167.

14. Rodriguez BL, Fujimoto WY, Mayer-Davis EJ, Imperatore G, Williams DE, Bell RA, et al. Prevalence of cardiovascular disease risk factors in U.S. children and adolescents with diabetes: the SEARCH for diabetes in youth study. Diabetes Care. 2006; 29:1891–1896. PMID: 16873798.

15. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2008; 31(Suppl 1):S55–S60. PMID: 18165338.

16. Moon JS, Lee SY, Nam CM, Choi JM, Choe BK, Seo JW, et al. 2007 Korean National Growth Charts: review of developmental process and an outlook. Korean J Pediatr. 2008; 51:1–25.

17. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA. 2001; 285:2486–2497. PMID: 11368702.

18. American Diabetes Association. Management of dyslipidemia in children and adolescents with diabetes. Diabetes Care. 2003; 26:2194–2197. PMID: 12832334.

19. Yang S, Hwang JS, Park HK, Lee HS, Kim HS, Kim EY, et al. Serum lipid concentrations, prevalence of dyslipidemia, and percentage eligible for pharmacological treatment of Korean children and adolescents; data from the Korea National Health and Nutrition Examination Survey IV (2007-2009). PLoS One. 2012; 7:e49253. PMID: 23251338.

20. Lee MH, Kim HC, Ahn SV, Hur NW, Choi DP, Park CG, et al. Prevalence of dyslipidemia among Korean Adults: Korea National Health and Nutrition Survey 1998-2005. Diabetes Metab J. 2012; 36:43–55. PMID: 22363921.

21. Schwab KO, Doerfer J, Hecker W, Grulich-Henn J, Wiemann D, Kordonouri O, et al. Spectrum and prevalence of atherogenic risk factors in 27,358 children, adolescents, and young adults with type 1 diabetes: cross-sectional data from the German diabetes documentation and quality management system (DPV). Diabetes Care. 2006; 29:218–225. PMID: 16443863.

22. Libby P, Nathan DM, Abraham K, Brunzell JD, Fradkin JE, Haffner SM, et al. Report of the National Heart, Lung, and Blood Institute-National Institute of Diabetes and Digestive and Kidney Diseases Working Group on Cardiovascular Complications of Type 1 Diabetes Mellitus. Circulation. 2005; 111:3489–3493. PMID: 15983263.

23. Maahs DM, Wadwa RP, McFann K, Nadeau K, Williams MR, Eckel RH, et al. Longitudinal lipid screening and use of lipid-lowering medications in pediatric type 1 diabetes. J Pediatr. 2007; 150:146–150. 150.e1–150.e2. PMID: 17236891.

24. al Muhtaseb N, al Yousuf A, Bajaj JS. Apolipoprotein A-I, A-II, B, C-II, and C-III in children with insulin-dependent diabetes mellitus. Pediatrics. 1992; 89(5 Pt 1):936–941. PMID: 1579407.

25. Maahs DM, Dabelea D, D'Agostino RB Jr, Andrews JS, Shah AS, Crimmins N, et al. Glucose control predicts 2-year change in lipid profile in youth with type 1 diabetes. J Pediatr. 2013; 162:101–107.e1. PMID: 22795314.

26. Maahs DM, Maniatis AK, Nadeau K, Wadwa RP, McFann K, Klingensmith GJ. Total cholesterol and high-density lipoprotein levels in pediatric subjects with type 1 diabetes mellitus. J Pediatr. 2005; 147:544–546. PMID: 16227045.

27. Purnell JQ, Hokanson JE, Marcovina SM, Steffes MW, Cleary PA, Brunzell JD. Effect of excessive weight gain with intensive therapy of type 1 diabetes on lipid levels and blood pressure: results from the DCCT. Diabetes Control and Complications Trial. JAMA. 1998; 280:140–146. PMID: 9669786.

28. Jenkins AJ, Lyons TJ, Zheng D, Otvos JD, Lackland DT, McGee D, et al. Lipoproteins in the DCCT/EDIC cohort: associations with diabetic nephropathy. Kidney Int. 2003; 64:817–828. PMID: 12911531.

29. Marcovecchio ML, Dalton RN, Prevost AT, Acerini CL, Barrett TG, Cooper JD, et al. Prevalence of abnormal lipid profiles and the relationship with the development of microalbuminuria in adolescents with type 1 diabetes. Diabetes Care. 2009; 32:658–663. PMID: 19171721.

30. Garces C, Oya Id, Lasuncion MA, Lopez-Simon L, Cano B, de Oya M. Sex hormone-binding globulin and lipid profile in pubertal children. Metabolism. 2010; 59:166–171. PMID: 19765778.

31. Laskarzewski PM, Morrison JA, Gutai J, Khoury PR, Glueck CJ. Longitudinal relationships among endogenous testosterone, estradiol, and Quetelet index with high and low density lipoprotein cholesterols in adolescent boys. Pediatr Res. 1983; 17:689–698. PMID: 6889012.