Dietary fats do not contribute to hyperlipidemia in children and adolescents with type 1 diabetes.
OBJECTIVE
To determine the relative influence of diet, metabolic control, and familial factors on lipids in children with type 1 diabetes and control subjects.


METHODS
We assessed fasting serum cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, lipoprotein(a), apolipoprotein (apo)-A1, and apoB in 79 children and adolescents with type 1 diabetes and 61 age- and sex-matched control subjects, together with dietary intakes using a quantitative food frequency questionnaire.


RESULTS
Total cholesterol, LDL cholesterol, apoB, HDL cholesterol, and apoA1 were significantly higher in children with diabetes. Children with diabetes had higher percentage energy intake from complex carbohydrates (P = 0.001) and fiber intake (P = 0.02), and they had lower intake of refined sugar (P < 0.001) and percentage energy from saturated fat (P = 0.045) than control subjects. Total cholesterol (beta = 0.43, P < 0.001), LDL cholesterol (beta = 0.4, P < 0.001), and apoB (beta = 0.32, P = 0.006) correlated independently with HbA(1c) but not dietary intake. HDL cholesterol (beta = 0.24, P = 0.05) and apoA1 (beta = 0.32, P = 0.004) correlated independently with HbA(1c), and HDL cholesterol (beta = -0.34, P = 0.009) correlated with percentage energy intake from complex carbohydrates. Triglycerides correlated independently with percentage energy intake from complex carbohydrates (beta = 0.33, P = 0.01) and insulin dose (beta = 0.26, P = 0.04). Subjects with diabetes and elevated LDL (>3.35 mmol/l, >130 mg/dl), for whom dietary therapy would be recommended, had significantly higher HbA(1c) (P = 0.007), but they had higher intake of complex carbohydrates than subjects with LDL cholesterol <3.35 mmol/l.


CONCLUSIONS
Lipid abnormalities remain common in children and adolescents with type 1 diabetes who adhere to current dietary recommendations, and they relate to metabolic control but not dietary intake.
Wiltshire
Esko J
EJ
Department of Diabetes and Endocrinology, Women's and Children's Hospital, North Adelaide, Australia. esko@wnmeds.ac.nz
Hirte
Craig
C
Couper
Jennifer J
JJ
D000293:Adolescent; D002648:Child; D002784:Cholesterol / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000235:genetics; D004041:Dietary Fats / Q000494:pharmacology*; D005247:Feeding Behavior; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology*; D007328:Insulin / Q000627:therapeutic use; D017270:Lipoprotein(a) / Q000097:blood; D008074:Lipoproteins / Q000097:blood; D008297:Male; D011795:Surveys and Questionnaires; D014280:Triglycerides / Q000097:blood
D002784:Cholesterol; D004041:Dietary Fats; D006442:Glycated Hemoglobin; D007328:Insulin; D017270:Lipoprotein(a); D008074:Lipoproteins; D014280:Triglycerides