Bojanin Dragana, Milenkovic Tatjana, Vekic Jelena, Vukovic Rade, Zeljkovic Aleksandra, Janac Jelena, Ivanisevic Jasmina, Todorovic Sladjana, Mazibrada Ilijana, Spasojevic-Kalimanovska Vesna
Biochemical Laboratory, Department for Clinical Chemistry and Hematology, Mother and Child Health Care Institute of Serbia "Dr Vukan Čupić", Belgrade, Serbia.
Department of Endocrinology, Mother and Child Health Care Institute of Serbia "Dr Vukan Čupić", Belgrade, Serbia.
Clin Biochem. 2018 Apr;54:11-17. doi: 10.1016/j.clinbiochem.2018.01.026. Epub 2018 Feb 2.
Paediatric patients with type 1 diabetes mellitus (T1DM) frequently develop other autoimmune disorders; most commonly autoimmune thyroiditis (ATD) and celiac disease (CD). In this study we evaluated whether co-existing autoimmune diseases had significant impact on lipid and lipoprotein subclasses, as known cardiovascular risk factors in T1DM.
Study included 201 subjects with T1DM (14.1 ± 2.9 years) and 141 age- and gender-matched controls. ATD was presented in 30 and CD in 15 T1DM patients. Serum lipid parameters were determined by routine laboratory methods and plasma low-density (LDL) and high-density lipoprotein (HDL) subclasses by gradient-gel electrophoresis method.
Both groups of T1DM patients with concomitant autoimmune disease had significantly lower HDL-C levels (P < 0.05) than the patients with T1DM only, but comparable to control group (P = 0.436). T1DM patients had significantly higher (P < 0.001) proportion of small HDL subclasses than controls. Mean value of atherosclerosis index in patients with T1DM + CD was the highest (1.75 ± 0.86) and it was significantly higher than the index in patients with T1DM only (1.33 ± 0.51; P < 0.05). LDL size did not differ between the groups of T1DM patients and control group (P = 0.619). The size of HDL particles was significantly reduced (P < 0.05) in the groups with associated autoimmune diseases. The patients with co-existing autoimmune diseases had higher risk of low HDL-C level (OR: 2.96; P < 0.05).
The results have shown significant impact of co-existing autoimmune diseases on lipid profile in patients with T1DM. The most prominent changes were found in HDL lipoprotein characteristics in T1DM + CD group.
1型糖尿病（T1DM）患儿常并发其他自身免疫性疾病；最常见的是自身免疫性甲状腺炎（ATD）和乳糜泻（CD）。在本研究中，我们评估了并存的自身免疫性疾病是否会对脂质和脂蛋白亚类产生显著影响，脂质和脂蛋白亚类是T1DM中已知的心血管危险因素。
研究纳入了201例T1DM患者（14.1±2.9岁）和141例年龄及性别匹配的对照者。30例T1DM患者患有ATD，15例患有CD。通过常规实验室方法测定血清脂质参数，采用梯度凝胶电泳法测定血浆低密度脂蛋白（LDL）和高密度脂蛋白（HDL）亚类。
两组并发自身免疫性疾病的T1DM患者的高密度脂蛋白胆固醇（HDL-C）水平均显著低于仅患T1DM的患者（P<0.05），但与对照组相当（P=0.436）。T1DM患者的小HDL亚类比例显著高于对照组（P<0.001）。T1DM+CD患者的动脉粥样硬化指数平均值最高（1.75±0.86），且显著高于仅患T1DM的患者（1.33±0.51；P<0.05）。T1DM患者组与对照组之间的LDL大小无差异（P=0.619）。在伴有自身免疫性疾病的组中，HDL颗粒大小显著减小（P<0.05）。并存自身免疫性疾病的患者发生低HDL-C水平的风险更高（比值比：2.96；P<0.05）。
结果表明并存的自身免疫性疾病对T1DM患者的血脂谱有显著影响。在T1DM+CD组中，HDL脂蛋白特征的变化最为显著。
