Krepel Volsky Sari, Shalitin Shlomit, Fridman Elena, Yackobovitch-Gavan Michal, Lazar Liora, Bello Rachel, Oron Tal, Tenenbaum Ariel, de Vries Liat, Lebenthal Yael
National Center for Childhood Diabetes, The Jesse Z and Sara Lea Shafer Institute for Endocrinology and Diabetes, Schneider Children's Medical Center of Israel, Petach-Tikva 4920235, Israel.
World J Diabetes. 2021 Jan 15;12(1):56-68. doi: 10.4239/wjd.v12.i1.56.
Type 1 diabetes (T1D) contributes to altered lipid profiles and increases the risk of cardiovascular disease (CVD). Youth with T1D may have additional CVD risk factors within the first decade of diagnosis.
To examine risk factors for dyslipidemia in young subjects with T1D.
Longitudinal and cross-sectional retrospective study of 170 young subjects with T1D (86 males; baseline mean age 12.2 ± 5.6 years and hemoglobin A1c 8.4% ± 1.4%) were followed in a single tertiary diabetes center for a median duration of 15 years. Predictors for outcomes of lipid profiles at last visit (total cholesterol [TC], triglycerides [TGs], low-density lipoprotein-cholesterol [LDL-c], and high-density lipoprotein-cholesterol [HDL-c]) were analyzed by stepwise linear regression models.
At baseline, 79.5% of the patients had at least one additional CVD risk factor (borderline dyslipidemia/dyslipidemia [37.5%], pre-hypertension/hypertension [27.6%], and overweight/obesity [16.5%]) and 41.6% had multiple (≥ 2) CVD risk factors. A positive family history of at least one CVD risk factor in a first-degree relative was reported in 54.1% of the cohort. Predictors of elevated TC: family history of CVD (β[SE] = 23.1[8.3], = 0.006); of elevated LDL-c: baseline diastolic blood pressure (DBP) (β[SE] = 11.4[4.7], = 0.003) and family history of CVD (β[SE] = 20.7[6.8], = 0.017); of elevated TGs: baseline DBP (β[SE] = 23.8[9.1], = 0.010) and family history of CVD (β[SE] = 31.0[13.1], = 0.020); and of low HDL-c levels: baseline DBP (β[SE] = 4.8[2.1], = 0.022]).
Our findings suggest that elevated lipid profiles are associated with DBP and a positive family history of CVD. It is of utmost importance to prevent and control modifiable risk factors such as these, as early as childhood, given that inadequate glycemic control and elevation in blood pressure intensify the risk of dyslipidemia.
1型糖尿病（T1D）会导致血脂谱改变，并增加心血管疾病（CVD）风险。T1D青年患者在确诊后的第一个十年内可能还存在其他CVD风险因素。
研究T1D青年患者血脂异常的风险因素。
对170例T1D青年患者（86例男性；基线平均年龄12.2±5.6岁，糖化血红蛋白8.4%±1.4%）进行纵向和横断面回顾性研究，在单一的三级糖尿病中心随访，中位随访时间为15年。通过逐步线性回归模型分析末次随访时血脂谱结果（总胆固醇[TC]、甘油三酯[TGs]、低密度脂蛋白胆固醇[LDL-c]和高密度脂蛋白胆固醇[HDL-c]）的预测因素。
基线时，79.5%的患者至少有一项其他CVD风险因素（临界血脂异常/血脂异常[37.5%]、高血压前期/高血压[27.6%]和超重/肥胖[16.5%]），41.6%的患者有多种（≥2种）CVD风险因素。54.1%的队列患者报告一级亲属中至少有一项CVD风险因素的阳性家族史。TC升高的预测因素：CVD家族史（β[标准误]=23.1[8.3]，P=0.006）；LDL-c升高的预测因素：基线舒张压（DBP）（β[标准误]=11.4[4.7]，P=0.003）和CVD家族史（β[标准误]=20.7[6.8]，P=0.017）；TGs升高的预测因素：基线DBP（β[标准误]=23.8[9.1]，P=0.010）和CVD家族史（β[标准误]=31.0[13.1]，P=0.020）；HDL-c水平降低的预测因素：基线DBP（β[标准误]=4.8[2.1]，P=0.022）。
我们的研究结果表明，血脂谱升高与DBP及CVD阳性家族史有关。鉴于血糖控制不佳和血压升高会增加血脂异常风险，尽早预防和控制这些可改变的风险因素至关重要。
