Spectrum and prevalence of atherogenic risk factors in 27,358 children, adolescents, and young adults with type 1 diabetes: cross-sectional data from the German diabetes documentation and quality management system (DPV).
OBJECTIVE
The aim of this data analysis was to ascertain the type and prevalence rate as well as age and sex distribution of cardiovascular risk factors in type 1 diabetic patients up to 26 years of age.


METHODS
Cardiovascular risk factors such as obesity, hypertension, dyslipidemia, poor glycemic control, and smoking were analyzed in 27,358 patients who were divided into three groups (prepubertal, pubertal, and adult) using specifically designed diabetes software for prospective disease documentation.


RESULTS
More than half of the patients per age-group had at least one cardiovascular risk factor. Two risk factors were age dependently found in 6.2-21.7% and three or four risk factors in 0.5-4.7%. Elevated values of HbA(1c), total cholesterol, and BMI were found most frequently. Hypertension, smoking, and HDL cholesterol were observed more frequently in males, and elevated BMI, total cholesterol, and LDL cholesterol more often in females. Although 28.6% of the patients had dyslipidemia, merely 0.4% of them received medical treatment, and of the 8.1% of the patients with hypertension, only 2.1% of them were given antihypertensive medication.


CONCLUSIONS
With increasing age, a greater number of patients with cardiovascular risk factors were observed. Significant sex differences were seen in the majority of risk factors. Despite the high prevalence of risk factors, only a small minority of patients received antihypertensive or lipid-lowering treatment. Early identification, prevention, and treatment of additional risk factors seem to be necessary, particularly in light of the high incidence of future cardiovascular disease.
Schwab
K Otfried
KO
Department of Pediatrics and Adolescence Medicine, Freiburg University Hospital, Mathilden Str. 1, D-79106 Freiburg, Germany. schwab@kikli.ukl.uni-freiburg.de
Doerfer
Jürgen
J
Hecker
Wolfgang
W
Grulich-Henn
Jürgen
J
Wiemann
Dagobert
D
Kordonouri
Olga
O
Beyer
Peter
P
Holl
Reinhard W
RW
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001317:Austria / Q000453:epidemiology; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D002784:Cholesterol / Q000097:blood; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology*; D050171:Dyslipidemias / Q000150:complications* / Q000453:epidemiology; D005260:Female; D005858:Germany / Q000453:epidemiology; D006442:Glycated Hemoglobin; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000453:epidemiology; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications* / Q000453:epidemiology; D011159:Population Surveillance; D015995:Prevalence; D012042:Registries; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*
D002784:Cholesterol; D006442:Glycated Hemoglobin