Center For Endocrinology, Diabetes, and Metabolism, Childrens Hospital Los Angeles, Keck School of Medicine of USC, Los Angeles, CA 90027, USA
Pediatr Diabetes. 2011 Jun;12(4 Pt 2):365-71. doi: 10.1111/j.1399-5448.2010.00733.x. Epub 2011 Mar 11.
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.
To characterize lipid levels and CVD risk factors over time in youth with type 1 diabetes.
The study included adolescents with type 1 diabetes (12-25 yr) with a minimum of 3-yr follow-up.
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.
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).
Glycemic control and BMI are modifiable risk factors for dyslipidemia in youth with type 1 diabetes.
1 型糖尿病和血脂异常是心血管疾病（CVD）的已知危险因素，但青少年 1 型糖尿病患者的血脂水平与未来 CVD 的关系尚不清楚。
描述青少年 1 型糖尿病患者的血脂水平和 CVD 危险因素随时间的变化情况。
该研究纳入了至少有 3 年随访的 12-25 岁患有 1 型糖尿病的青少年。
对 46 名患有 1 型糖尿病的青少年进行了一项纵向前瞻性、观察性研究。空腹血脂谱、A1C 和体重指数（BMI）每 6 个月测量一次，至少持续 3 年（中位数为 4.2 年）。将低密度脂蛋白（LDL）-胆固醇、总胆固醇（TC）和甘油三酯（TG）分为分类变量。
基线时，中位年龄为 14.3 岁，平均糖尿病病程为 6.4±3.8 年，平均 A1C 为 8.1±1.0%，中位数 BMI z 评分为 0.92。50%的患者在研究开始时 LDL 水平≤100mg/dL（≤2.6mmol/L）。在调整混杂因素后，BMI z 评分增加[β=0.2，95%置信区间（CI）=0.03-0.38，p=0.03]和 A1C 增加[β=0.18，95%CI=0.08-0.29，p=0.001]与 LDL 分类随时间的增加相关。非西班牙裔（β=0.45，95%CI=0.12-0.79，p=0.008）和中风家族史（β=0.38，95%CI=0.04-0.72，p=0.03）也与 LDL 分类的增加相关。年龄、糖尿病病程和吸烟暴露与 LDL 变化无关。A1C 升高与 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）和 LDL（β=13.4，95%CI=3.17-23.6，p=0.01）升高相关。
血糖控制和 BMI 是青少年 1 型糖尿病患者血脂异常的可改变危险因素。
