Edge J A, James T, Shine B
Department of Paediatric Endocrinology and Diabetes, Oxford Children's Hospital, Headington, Oxford, UK.
Diabet Med. 2008 Aug;25(8):942-8. doi: 10.1111/j.1464-5491.2008.02518.x.
To determine the prevalence of abnormal lipid levels in a large group of children and adolescents with Type 1 diabetes and to examine the changes longitudinally. In addition, to study the relationships of any lipid abnormalities to glycaemic control, age and duration of diabetes.
Non-fasting blood samples were taken annually from all the patients in the Oxford Children's diabetes clinic and total cholesterol (TC), high-density lipoprotein (HDL) cholesterol, triglycerides (TG) and glycated haemoglobin (HbA(1c)) measured over a period of 8 years. Low-density lipoprotein (LDL) cholesterol and non-HDL were calculated from these values and compared. Tests performed less than 4 months after diagnosis were excluded.
A total of 229 children had complete data from more than 1 year and 798 sets of data were examined. TC was lower in males and increased with duration of diabetes and with increasing HbA(1c). HDL cholesterol fell with increasing age, but independently increased with duration, and was not related to HbA(1c). LDL cholesterol and non-HDL cholesterol were highly correlated (r = 0.9). Both were lower in males and increased with duration of diabetes. Non-HDL cholesterol increased with HbA(1c). A total of 23.7% had HDL cholesterol < 1.1 mmol/l and 22.5% had TC > 5.2 mmol/l. Thirty-eight per cent had LDL cholesterol > 2.6 mmol/l and 10.8% > 3.4 mmol/l, the thresholds for lifestyle and drug intervention respectively.
Abnormalities in plasma lipid levels are common in this age group and the prevalence increases with poor glycaemic control and with duration of diabetes. Around 10% of adolescents would fit criteria for lipid-lowering medication in adults, but further study is needed to examine the risks and benefits in this age group.
确定一大群1型糖尿病儿童和青少年中血脂异常的患病率，并纵向观察其变化。此外，研究任何血脂异常与血糖控制、年龄和糖尿病病程之间的关系。
每年从牛津儿童糖尿病诊所的所有患者中采集非空腹血样，在8年时间里检测总胆固醇（TC）、高密度脂蛋白（HDL）胆固醇、甘油三酯（TG）和糖化血红蛋白（HbA1c）。根据这些值计算低密度脂蛋白（LDL）胆固醇和非HDL胆固醇并进行比较。排除诊断后不到4个月进行的检测。
共有229名儿童有超过1年的完整数据，共检查了798组数据。男性的TC较低，且随糖尿病病程和HbA1c的升高而增加。HDL胆固醇随年龄增长而下降，但随病程独立增加，且与HbA1c无关。LDL胆固醇和非HDL胆固醇高度相关（r = 0.9）。两者在男性中均较低，并随糖尿病病程增加。非HDL胆固醇随HbA1c升高。共有23.7%的患者HDL胆固醇<1.1 mmol/l，22.5%的患者TC>5.2 mmol/l。38%的患者LDL胆固醇>2.6 mmol/l，10.8%的患者>3.4 mmol/l，这分别是生活方式和药物干预的阈值。
该年龄组血浆脂质水平异常很常见，患病率随血糖控制不佳和糖尿病病程增加而升高。约10%的青少年符合成人降脂药物治疗标准，但需要进一步研究以探讨该年龄组的风险和益处。
