Lipid and Lipoprotein Profiles in Youth With and Without Type 1 Diabetes The SEARCH for Diabetes in Youth Case-Control Study
The purpose of this study was to compare the lipid profile and the prevalence of lipid abnormalities in youth with and without type 1 diabetes and explore the role of glycemic control on the hypothesized altered lipid profile in youth with type 1 diabetes. We conducted a cross-sectional analysis of 512 youth with type 1 diabetes (mean duration 4.22 years) and 188 healthy control subjects aged 10-22 years in Colorado and South Carolina. SEARCH for Diabetes in Youth (SEARCH) participants with type 1 diabetes and healthy control subjects recruited from primary care offices in the same geographic regions were invited to attend a research visit. Fasting lipid profiles were compared between youth with type 1 diabetes (stratified according to categories of optimal [A1C <7.5%] and suboptimal [A1C >or=7.5%] glycemic control) and healthy nondiabetic youth, using multiple linear and logistic regression. Youth with type 1 diabetes and optimal A1C had lipid concentrations that were similar (total cholesterol, LDL cholesterol, and LDL particle size) or even less atherogenic (HDL cholesterol, non-HDL cholesterol, triglyceride, and triglyceride-to-HDL cholesterol ratio) than those observed in nondiabetic youth, whereas youth with suboptimal glycemic control had elevated standard lipid levels (total cholesterol, LDL cholesterol, and non-HDL cholesterol). Youth with type 1 diabetes also had significantly elevated apolipoprotein B levels and more small, dense LDL particles than nondiabetic youth, regardless of glycemic control. Youth with type 1 diabetes have abnormal lipid levels and atherogenic changes in lipoprotein composition, even after a relatively short disease duration. As in adults, glycemic control is an important mediator of these abnormalities.
[Show abstract] [Hide abstract] ABSTRACT: Objectives To compare lipid parameters between diabetics and controls and to study association between metabolic control and lipid profile. Methods Lipid profile and HbA1c were measured (n=80, 39 boys) in diabetic children [age 10.7(3.4) y] and 54 controls, tests repeated after 1 year (in 45 diabetics). Results Diabetic children had higher mean (SD) LDL-C [95.3(27.7) vs 84.5(26.4) mg/dL], lower HDL-C [48.2 (13.1) vs 53.1(11.9) mg/dl]. Moderate physical activity (P=0.014) protected against high LDL-C levels. HbA1c (P=0.00) predicted total and LDL-C levels. At 1year, 63% showed reduced LDL-C with improving HbA1c; 72% showed increased LDL-C with deteriorated HbA1c. Conclusion Improving metabolic control is cardinal to reduce cardiometabolic risk; physical activity is beneficial.
- "Deranged lipids have been reported amongst adolescents and youth in the SEARCH for Diabetes in Youth study. Although data on the influence of blood glucose control on development of atherosclerosis is conflicting, there is increasing evidence of an association between the two2345. This study was conducted to i) compare lipid parameters between diabetic children and controls; ii) determine factors influencing lipid parameters in diabetic children; and iii) examine effect of lowering of glycosylated hemoglobin on lipids in diabetic children at one year. "
[Show abstract] [Hide abstract] ABSTRACT: Patients with type 1 diabetes (T1D) present increased risk of cardiovascular disease (CVD). The aim of this study is to improve the assessment of lipoprotein profile in patients with T1D by using a robust developed method 1H nuclear magnetic resonance spectroscopy (1H NMR), for further correlation with clinical factors associated to CVD. Thirty patients with T1D and 30 non-diabetes control (CT) subjects, matched for gender, age, body composition (DXA, BMI, waist/hip ratio), regular physical activity levels and cardiorespiratory capacity (VO2peak), were analyzed. Dietary records and routine lipids were assessed. Serum lipoprotein particle subfractions, particle sizes, and cholesterol and triglycerides subfractions were analyzed by 1H NMR. It was evidenced that subjects with T1D presented lower concentrations of small LDL cholesterol, medium VLDL particles, large VLDL triglycerides, and total triglycerides as compared to CT subjects. Women with T1D presented a positive association with HDL size (p<0.005; R = 0.601) and large HDL triglycerides (p<0.005; R = 0.534) and negative (p<0.005; R = -0.586) to small HDL triglycerides. Body fat composition represented an important factor independently of normal BMI, with large LDL particles presenting a positive correlation to total body fat (p<0.005; R = 0.505), and total LDL cholesterol and small LDL cholesterol a positive correlation (p<0.005; R = 0.502 and R = 0.552, respectively) to abdominal fat in T1D subjects; meanwhile, in CT subjects, body fat composition was mainly associated to HDL subclasses. VO2peak was negatively associated (p<0.005; R = -0.520) to large LDL-particles only in the group of patients with T1D. In conclusion, patients with T1D with adequate glycemic control and BMI and without chronic complications presented a more favourable lipoprotein profile as compared to control counterparts. In addition, slight alterations in BMI and/or body fat composition showed to be relevant to provoking alterations in lipoproteins profiles. Finally, body fat composition appears to be a determinant for cardioprotector lipoprotein profile.
- "However, this finding is controversial, as it may depend on the method used and the clinical characteristics of the population under study. As noticed, Guy and colleagues  identified that young T1D patients presented higher levels of small LDL particles than subjects without diabetes, independent of their glycemic control. Different findings were described by Alberts and cols., in which poor glycemic control was related to more dense LDL particles . "
[Show abstract] [Hide abstract] ABSTRACT: Diabetes is associated with a high risk of cardiovascular disease (CVD). The classic “diabetic dyslipidemia” is mostly described as hypertriglyceridemia and low levels of HDL-C. Elevated LDL-C is an established risk factor for CVD.
- "11,15 In the present work, mean duration of diabetes showed no significant difference between the dyslipidemic group and the normolipidemic group (4.1 ± 2.7 and 4.6 ± 2.6 years respectively ); there were patients with less than 2 years diabetes duration and having dyslipidemia. This finding is in agreement with Kanagalakshmi and Sultana (2012) and Guy et al. (2009) who found that the dyslipidemia in children and adolescents with T1DM is present despite short duration of diabetes. 18,19 This is in contrast to the results reported by Moayeri and Oloomi (2006) who found that lipid concentrations correlate positively with the duration of diabetes. "