Department of Pediatrics, Women's and Children's Health, Azienda Ospedaliero-Universitaria Ospedali Riuniti Ancona, Marche Polytechnic University, 60121 Ancona, Italy.
Institut für Epidemiologie und Medizinische Biometrie, Universität Ulm, ZIBMT, Albert-Einstein-Allee 41, 89081 Ulm, Germany.
Nutrients. 2021 Dec 15;13(12):4473. doi: 10.3390/nu13124473.
A higher frequency of dyslipidemia is reported in children with type 1 diabetes (T1D) and celiac disease (CD). Recently, continuous subcutaneous insulin infusion (CSII) has been associated with better lipid profiles in patients with T1D. The aim of this study was to investigate the association between treatment modality and lipid profile, metabolic control, and body mass index (BMI)-SDS in children with both T1D and CD.
Cross-sectional study in children registered in the international SWEET database in November 2020. Inclusion criteria were children (2-18 years) with T1D and CD with available data on treatment modality (CSII and injections therapy, IT), triglyceride, total cholesterol, HDL, LDL, dyslipidemia, HbA1c, and BMI-SDS. Overweight/obesity was defined as > +1 BMI-SDS for age. Data were analyzed by linear and logistical regression models with adjustment for age, gender, and diabetes duration.
In total 1009 children with T1D and CD (female 54%, CSII 54%, age 13.9 years ±3.6, diabetes duration 7.2 years ±4.1, HbA1c 7.9% ±1.4) were included. Significant differences between children treated with CSII vs. IT were respectively found; HDL 60.0 mg/dL vs. 57.8 mg/dL, LDL 89.4 mg/dL vs. 94.2 mg/dL, HbA1c 7.7 vs. 8.1%, BMI-SDS 0.4 vs. 0.6, overweight and obesity 17% vs. 26% (all < 0.05).
CSII is associated with higher HDL and lower LDL, HbA1c, BMI-SDS, and percentage of overweight and obesity compared with IT in this study. Further prospective studies are required to determine whether CSII improves lipid profile, metabolic control and normalize body weight in children with both T1D and CD.
有研究报道，1 型糖尿病（T1D）和乳糜泻（CD）患儿中血脂异常的频率较高。最近，连续皮下胰岛素输注（CSII）与 T1D 患者更好的血脂谱相关。本研究旨在探讨 T1D 和 CD 患儿的治疗方式与血脂谱、代谢控制和体质指数（BMI）-SDS 之间的关系。
2020 年 11 月在国际 SWEET 数据库中进行的横断面研究。纳入标准为患有 T1D 和 CD 的儿童（2-18 岁），并具有治疗方式（CSII 和注射治疗，IT）、甘油三酯、总胆固醇、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、血脂异常、糖化血红蛋白（HbA1c）和 BMI-SDS 的可用数据。超重/肥胖定义为年龄的+1 BMI-SDS。数据通过线性和逻辑回归模型进行分析，并针对年龄、性别和糖尿病病程进行调整。
共纳入 1009 名患有 T1D 和 CD 的儿童（女性 54%，CSII 54%，年龄 13.9 岁±3.6，糖尿病病程 7.2 年±4.1，HbA1c 7.9%±1.4）。与 IT 相比，CSII 治疗的儿童分别存在显著差异；HDL 60.0mg/dL 与 57.8mg/dL，LDL 89.4mg/dL 与 94.2mg/dL，HbA1c 7.7%与 8.1%，BMI-SDS 0.4 与 0.6，超重和肥胖 17%与 26%（均<0.05）。
与 IT 相比，本研究中 CSII 与更高的 HDL 和更低的 LDL、HbA1c、BMI-SDS、超重和肥胖的比例相关。需要进一步的前瞻性研究来确定 CSII 是否可以改善 T1D 和 CD 患儿的血脂谱、代谢控制和体重正常化。
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