Selvaraj Meghana, Prasad Hemchand Krishna, White Sherline, Prasanna Bala, Sangaralingam Thangavelu
Department of Pediatrics, Mehta Multispeciality Hospitals India Pvt. Ltd, Chennai, Tamil Nadu, India.
Department of Pediatric Endocrinology, Mehta Multispeciality Hospitals India Pvt. Ltd, Chennai, Tamil Nadu, 600031, India.
Indian J Pediatr. 2023 Feb;90(2):118-123. doi: 10.1007/s12098-022-04130-2. Epub 2022 Apr 2.
To describe the prevalence and determinants of occurrence of dyslipidemia in children and adolescents with type 1 diabetes mellitus (T1DM).
A cross-sectional study was conducted in the diabetic clinic of a tertiary care referral hospital over two years. Subjects with T1DM aged 2-18 y had assessment of Lipid profile after 12 h of fasting. Glycemic control was assessed by glycosylated hemoglobin (HbA1C). Modifiable and nonmodifiable determining factors were assessed during clinic visit as per standard criteria. Body mass index (BMI) more than 23 adult equivalent and 27 adult equivalent were considered as overweight and obesity, respectively. Lipid parameters were considered as abnormal if: Low density lipoprotein (LDL) > 100 mg/dL, high density lipoprotein (HDL) < 40 mg/dL, triglycerides > 100 mg/dL (< 10 y) and > 130 mg/dL (> 10 y).
A total of 171 subjects (mean age: 11.8 ± 3.5 y, M:F = 75:96) were recruited during the study period. The mean fasting LDL level, HDL level, and triglyceride level observed in the study sample were 106.6 ± 26.9 mg/dL (62% abnormal), 52.6 ± 14.3 mg/dL (9.4% abnormal), and 85.3 ± 39.4 mg/dL (10.5% abnormal), respectively; 115 (67.3%) of the subjects had at least one abnormality in the serum lipid profile. On multivariate analysis, HbA1C was the most significant factor in determining the occurrence of dyslipidemia (p < 0.05). HbA1C was 9.9 ± 1.6 in subjects with abnormal LDL versus 9.1 ± 1.5 in those with normal LDL (p < 0.05).
Prevalence of dyslipidemia in the study children and adolescents with T1DM was 67.3%. HbA1C remains the most important modifiable determinant of the occurrence of dyslipidemia.
描述1型糖尿病(T1DM)儿童及青少年血脂异常的患病率及其影响因素。
在一家三级转诊医院的糖尿病门诊进行了一项为期两年的横断面研究。年龄在2至18岁的T1DM患者在禁食12小时后接受血脂水平评估。通过糖化血红蛋白(HbA1C)评估血糖控制情况。根据标准标准在门诊就诊期间评估可改变和不可改变的决定因素。成人等效体重指数(BMI)大于23和大于27分别被视为超重和肥胖。如果低密度脂蛋白(LDL)>100mg/dL、高密度脂蛋白(HDL)<40mg/dL、甘油三酯>100mg/dL(<10岁)和>130mg/dL(>10岁),则血脂参数被视为异常。
在研究期间共招募了171名受试者(平均年龄:11.8±3.5岁,男:女 = 75:96)。研究样本中观察到的平均空腹LDL水平、HDL水平和甘油三酯水平分别为106.6±26.9mg/dL(62%异常)、52.6±14.3mg/dL(9.4%异常)和85.±39.4mg/dL(10.5%异常);115名(67.3%)受试者的血脂谱至少有一项异常。多因素分析显示,HbA1C是决定血脂异常发生的最显著因素(p<0.05)。LDL异常的受试者HbA1C为9.9±1.6,而LDL正常的受试者为HbA1C 9.1±1.5(p<0.05)。
本研究中T1DM儿童及青少年血脂异常的患病率为67.3%。HbA1C仍然是血脂异常发生的最重要的可改变决定因素。