血脂谱与 1 型糖尿病患儿和青少年的治疗方案有关：来自国际 SWEET 数据库的研究。

Lipid profile is associated with treatment regimen in a large cohort of children and adolescents with Type 1 diabetes mellitus: a study from the international SWEET database.

机构信息

Diabetes Centre, Division of Endocrinology, Diabetes and Metabolism, First Department of Paediatrics, National and Kapodistrian University of Athens, Medical School, Aghia Sophia Children's Hospital, Athens, Greece.

Institute of Epidemiology and Medical Biometry, ZIBMT, Ulm University, Ulm, Germany.

出版信息

Diabet Med. 2019 Oct;36(10):1294-1303. doi: 10.1111/dme.13963. Epub 2019 Jul 22.

DOI:10.1111/dme.13963

PMID:30972800

Abstract

AIMS

To examine the effect of pump vs injection therapy on the lipid profile of children with Type 1 diabetes mellitus.

METHODS

A cross-sectional analysis of the lipid profile of children aged ≤ 18 years with Type 1 diabetes mellitus from SWEET, an international diabetes registry, was conducted with a focus on the effect of treatment regimen. Dyslipidaemia was defined as LDL cholesterol ≥2.6 mmol/l or non-HDL cholesterol ≥3.1 mmol/l. LDL and non-HDL cholesterol values among 14 290 children (52% boys, 51% receiving pump therapy) from 60 SWEET centres were analysed by linear and logistic regression analysis adjusted for sex, age, diabetes duration, HbA and BMI-standard deviation score group, region, and common interactions between age, sex, HbA and BMI.

RESULTS

This study confirmed the established associations of increased lipids with female sex, age, diabetes duration, HbA and BMI. LDL and non-HDL cholesterol levels were lower in the pump therapy group compared to the injection therapy group [LDL cholesterol: injection therapy 2.44 mmol/l (95% CI 2.42 to 2.46) vs pump therapy 2.39 mmol/l (95% CI 2.37-2.41), P<0.001; non-HDL cholesterol: injection therapy 2.88 mmol/l (95% CI 2.86 to 2.90) vs pump therapy 2.80 mmol/l (95% CI 2.78-2.82), both P<0.0001]. Similarly, the odds ratios for LDL cholesterol ≥2.6 mmol/l [0.89 (95% CI 0.82-0.97)] and non-HDL cholesterol ≥3.1 mmol/l [0.85 (0.78 to 0.93)] were significantly lower in the pump therapy group, even after all adjustments.

CONCLUSIONS

Our results indicate that pump therapy is associated with a better lipid profile.

摘要

目的

研究胰岛素泵治疗与注射治疗对 1 型糖尿病患儿血脂谱的影响。

方法

采用国际糖尿病注册研究 SWEET 的横断面分析方法，对年龄≤18 岁的 1 型糖尿病患儿的血脂谱进行分析，重点关注治疗方案的影响。血脂异常定义为 LDL 胆固醇≥2.6mmol/L 或非 HDL 胆固醇≥3.1mmol/L。通过线性和逻辑回归分析，对来自 60 个 SWEET 中心的 14290 名儿童（52%为男孩，51%接受胰岛素泵治疗）的 LDL 和非 HDL 胆固醇值进行分析，并对性别、年龄、糖尿病病程、HbA1c 和 BMI 标准差评分组、地区以及年龄、性别、HbA1c 和 BMI 之间的常见交互作用进行调整。

结果

本研究证实了性别、年龄、糖尿病病程、HbA1c 和 BMI 与血脂升高的既定关联。与注射治疗组相比，胰岛素泵治疗组的 LDL 和非 HDL 胆固醇水平较低[LDL 胆固醇：注射治疗 2.44mmol/L（95%CI 2.42-2.46）与胰岛素泵治疗 2.39mmol/L（95%CI 2.37-2.41），P<0.001；非 HDL 胆固醇：注射治疗 2.88mmol/L（95%CI 2.86-2.90）与胰岛素泵治疗 2.80mmol/L（95%CI 2.78-2.82），均 P<0.0001]。同样，胰岛素泵治疗组 LDL 胆固醇≥2.6mmol/L 的比值比[0.89（95%CI 0.82-0.97）]和非 HDL 胆固醇≥3.1mmol/L 的比值比[0.85（0.78-0.93）]也显著降低，即使在所有调整后也是如此。