Baylor College of Medicine, Pediatric Diabetes and Endocrinology, Houston, Texas.
Jaeb Center for Health Research, Tampa, Florida.
Diabetes Obes Metab. 2019 Jan;21(1):170-172. doi: 10.1111/dom.13475. Epub 2018 Aug 16.
For individuals aged 10 to <40 years with type 1 diabetes and dyslipidaemia, US national guidelines recommend consideration of statin therapy based on age, low-density lipoprotein cholesterol (LDL-C) level and other cardiovascular risk factors. We evaluated dyslipidaemia prevalence, statin therapy use, and associations between not meeting target LDL-C [<100 mg/dL (<5.55 mmol/L)] and other cardiovascular disease (CVD) risk factors in individuals aged 10 to <40 years in the T1D Exchange clinic registry. In 7223 participants, statin use was 2% in 10 to <18 year olds, 4% in 18 to <25 year olds, and 21% in 25 to <40 year olds. Individuals not on statin therapy with LDL-C above target were more likely to have ≥1 additional CVD risk factor(s) than those with LDL-C in the target range for all age groups (all P < 0.01). While most individuals not on statin therapy had LDL-C in the target range, those who did not were more likely to have ≥1 additional CVD risk factor(s), and therefore longitudinal study of lipid levels and statin use is needed to see if treatment of dyslipidaemia to target LDL-C levels may lower the risk of future CVD in individuals aged 10 to <40 years with type 1 diabetes.
对于年龄在 10 岁至<40 岁、患有 1 型糖尿病和血脂异常的个体,美国国家指南建议根据年龄、低密度脂蛋白胆固醇(LDL-C)水平和其他心血管危险因素考虑使用他汀类药物治疗。我们评估了年龄在 10 岁至<40 岁的 T1D Exchange 诊所登记处的个体中血脂异常的患病率、他汀类药物的使用情况以及未达到 LDL-C 目标(<100mg/dL(<5.55mmol/L))与其他心血管疾病(CVD)危险因素之间的关系。在 7223 名参与者中,10 至<18 岁者他汀类药物使用率为 2%,18 至<25 岁者为 4%,25 至<40 岁者为 21%。与 LDL-C 处于目标范围内的个体相比,未接受他汀类药物治疗且 LDL-C 高于目标值的个体更有可能具有≥1 个额外的 CVD 危险因素(所有 P<0.01)。尽管大多数未接受他汀类药物治疗的个体的 LDL-C 处于目标范围内,但这些个体更有可能具有≥1 个额外的 CVD 危险因素,因此需要对血脂水平和他汀类药物使用进行纵向研究,以观察针对 LDL-C 水平治疗血脂异常是否可能降低 10 岁至<40 岁患有 1 型糖尿病的个体未来发生 CVD 的风险。