Diabetes Center, A' Department of Pediatrics, P&A Kyriakou Children's Hospitals, Athens, Greece.
Institute of Epidemiology and Medical Biometry, Central Institute for Biomedical Technology (ZIBMT), Ulm University, Ulm, Germany.
Diabetes Obes Metab. 2022 Dec;24(12):2420-2430. doi: 10.1111/dom.14834. Epub 2022 Sep 12.
To investigate the prevalence of modifiable cardiovascular risk factors (CVRFs), including dyslipidaemia, obesity and high glycated haemoglobin (HbA1c) concentration, in patients with type 1 diabetes (T1D), and to evaluate their association with blood pressure (BP) categories.
We analysed 21 634 children and adolescents with T1D from the SWEET international database with office BP values assessed at a three or more visits within a year from 2010 to 2021. Participants were classified into a normotensive group, a group with elevated BP (90 to 94th percentile) or a hypertensive group (≥95th percentile), based on the median BP for the visits within the last treatment year. The prevalences of dyslipidaemia [cholesterol ≥ 5.18 mmol/L (200 mg/dL) and/or HDL cholesterol ≤ 1.036 mmol/L (40 mg/dL) and/or LDL cholesterol ≥ 2.59 mmol/L (100 mg/dL)], obesity (body mass index ≥2 standard deviation score) and elevated HbA1c [≥ 75 mmol/mol (9%)] were evaluated in patients within each BP group.
Patients with hypertension/elevated BP had less favourable lipid profiles, and a higher prevalence of obesity and HbA1c ≥ 75 mmol/mol than normotensive patients. A total of 38.4% of hypertensive patients and 36.0% of those with elevated BP had one CVRF, 15.1% and 10.1%, respectively, had two CVRFs, and 2.3% and 0.8%, respectively, had three CVRFs. Patients with hypertension/elevated BP had a higher prevalence of one or more CVRFs versus normotensive patients (P < 0.001). Obesity was the CVRF most strongly related to hypertension. Girls had a higher prevalence of one or more CVRFs than boys. Similar results were found in patients aged ≥13 years with hypertension compared to those aged <13 years.
The prevalence of modifiable CVRFs is higher in children and adolescents with T1D who have elevated BP/hypertension than in those with normotension, suggesting that they are more vulnerable to future morbidity and mortality requiring early detection and intervention.
调查 1 型糖尿病（T1D）患者可改变的心血管风险因素（CVRFs）的流行情况，包括血脂异常、肥胖和糖化血红蛋白（HbA1c）浓度升高，并评估其与血压（BP）分类的关系。
我们分析了 2010 年至 2021 年期间，来自 SWEET 国际数据库的 21634 名患有 T1D 的儿童和青少年的数据，这些患者在过去的治疗年中至少有三次就诊时的办公室 BP 值进行了评估。根据过去一年就诊时的 BP 中位数，将参与者分为正常血压组、血压升高组（90 至 94 百分位）或高血压组（≥95 百分位）。评估了每个 BP 组中患者的血脂异常（胆固醇≥5.18mmol/L（200mg/dL）和/或高密度脂蛋白胆固醇≤1.036mmol/L（40mg/dL）和/或低密度脂蛋白胆固醇≥2.59mmol/L（100mg/dL））、肥胖（体重指数≥2 个标准差）和 HbA1c 升高[≥75mmol/mol（9%）]的患病率。
高血压/血压升高的患者血脂状况更差，肥胖和 HbA1c≥75mmol/mol 的患病率高于正常血压的患者。高血压患者中有 38.4%和血压升高的患者中有 36.0%有一个 CVRF，分别有 15.1%和 10.1%有两个 CVRF，分别有 2.3%和 0.8%有三个 CVRF。高血压/血压升高的患者有一个或多个 CVRF 的患病率高于正常血压的患者（P<0.001）。肥胖是与高血压关系最密切的 CVRF。女孩有一个或多个 CVRF 的患病率高于男孩。在年龄≥13 岁的高血压患者中也发现了类似的结果，与年龄<13 岁的患者相比。
与血压正常的 T1D 儿童和青少年相比，血压升高/高血压的 T1D 儿童和青少年中可改变的 CVRF 的患病率更高，这表明他们更容易受到未来发病率和死亡率的影响，需要早期发现和干预。
