Muchacka-Bianga Małgorzata, Deja Grazyna, Jarosz-Chobot Przemysława, Małecka-Tendera Ewa, Kalina Maria, Grychtoł Maria
Katedra i Klinika Pediatrii, Endokrynologii i Diabetologii Dzieciecej Slaskiej AM w Katowicach, Katowice.
Endokrynol Diabetol Chor Przemiany Materii Wieku Rozw. 2006;12(1):25-30.
Increased risk of atherosclerosis in individuals with diabetes mellitus is not fully explained by the conventional risk factors. Therefore, new independent risk factors are taken under consideration. AIM OF THE STUDY was to evaluate selected risk factors of atherosclerosis in children with type 1 diabetes mellitus and hypercholesterolemia.
The study comprised 30 diabetic children, aged 5-18 years with plasma cholesterol concentration exceeding 170 mg/dl. In children, their parents and siblings plasma concentration of total cholesterol, HDL and LDL-cholesterol, triglicerides, homocysteine, apolipoprotein A-I, apolipoprotein B was measured and electrophoretic distribution of lipids was performed. Anthropometric measurements with BMI estimation were performed in diabetic children. Data were analyzed with respect to BMI, metabolic control and physical activity in children and with respect to family history of atherosclerosis.
No significant differences in measured parameters were found between diabetic children and their healthy siblings besides significantly lower homocysteine concentration (p=0.037). Concentration of triglicerides was significantly higher in children with low than with high physical activity (101.6+/-64.6 mg/dl vs. 60.2+/-27.4 mg/dl respectively, p<0.05), HDL cholesterol was significantly lower in children with poor than with a satisfactory metabolic control (58.3+/-10.0 mg/dl vs. 69.1+/-12 mg/dl, p<0.05) and lipoprotein apoB concentration was significantly higher in children with positive (0.77+/-0.15 g/l) compared to children with a negative family history of atherosclerosis (0.66+/-0.09 g/l, p<0.05). Overweight did not influence the measured parameters significantly. Statistically significant positive correlations were found for apoB between affected children and their mothers (r=0.62), for LDL-cholesterol between affected children and their fathers (r=0.35), and for total cholesterol (r=0.47) and homocysteine (r=0.44) between affected children and their siblings.
糖尿病患者动脉粥样硬化风险增加，传统危险因素并不能完全解释这一现象。因此，人们开始考虑新的独立危险因素。本研究的目的是评估1型糖尿病合并高胆固醇血症儿童的动脉粥样硬化相关危险因素。
本研究纳入了30名5至18岁的糖尿病儿童，其血浆胆固醇浓度超过170mg/dl。检测了这些儿童及其父母和兄弟姐妹的总胆固醇、高密度脂蛋白和低密度脂蛋白胆固醇、甘油三酯、同型半胱氨酸、载脂蛋白A-I、载脂蛋白B的血浆浓度，并进行了血脂的电泳分布检测。对糖尿病儿童进行了人体测量并估算了体重指数（BMI）。分析了儿童的BMI、代谢控制和身体活动情况以及动脉粥样硬化家族史相关的数据。
除了同型半胱氨酸浓度显著较低（p = 0.037）外，糖尿病儿童与其健康兄弟姐妹之间在检测参数上未发现显著差异。身体活动量低的儿童甘油三酯浓度显著高于身体活动量高的儿童（分别为101.6±64.6mg/dl和60.2±27.4mg/dl，p<0.05），代谢控制差的儿童高密度脂蛋白胆固醇显著低于代谢控制良好的儿童（58.3±10.0mg/dl和69.1±12mg/dl，p<0.05），有动脉粥样硬化家族史阳性的儿童载脂蛋白B浓度显著高于家族史阴性的儿童（0.77±0.15g/l和0.66±0.09g/l，p<0.05）。超重对检测参数没有显著影响。在患病儿童与其母亲之间，载脂蛋白B存在统计学显著的正相关（r = 0.62），在患病儿童与其父亲之间，低密度脂蛋白胆固醇存在正相关（r = 0.35），在患病儿童与其兄弟姐妹之间，总胆固醇（r = 0.47）和同型半胱氨酸（r = 0.44）存在正相关。
