Prevalence of cardiovascular disease risk factors in U.S. children and adolescents with diabetes: the SEARCH for diabetes in youth study.
OBJECTIVE
The purpose of this study was to determine the prevalence and correlates of selected cardiovascular disease (CVD) risk factors among youth aged <20 years with diabetes.


METHODS
The analysis included 1,083 girls and 1,013 boys examined as part of the SEARCH for Diabetes in Youth study, a multicenter, population-based study of youth 0-19 years of age with diabetes. Diabetes type was determined by a biochemical algorithm based on diabetes antibodies and fasting C-peptide level. CVD risk factors were defined as follows: HDL cholesterol <40 mg/dl; age- and sex-specific waist circumference >90th percentile; systolic or diastolic blood pressure >90th percentile for age, sex, and height or taking medication for high blood pressure; and triglycerides >110 mg/dl.


RESULTS
The prevalence of having at least two CVD risk factors was 21%. The prevalence was 7% among children aged 3-9 years and 25% in youth aged 10-19 years (P < 0.0001), 23% among girls and 19% in boys (P = 0.04), 68% in American Indians, 37% in Asian/Pacific Islanders, 32% in African Americans, 35% in Hispanics, and 16% in non-Hispanic whites (P < 0.0001). At least two CVD risk factors were present in 92% of youth with type 2 and 14% of those with type 1A diabetes (P < 0.0001). In multivariate analyses, age, race/ethnicity, and diabetes type were independently associated with the odds of having at least two CVD risk factors (P < 0.0001).


CONCLUSIONS
Many youth with diabetes have multiple CVD risk factors. Recommendations for weight, lipid, and blood pressure control in youth with diabetes need to be followed to prevent or delay the development of CVD as these youngsters mature.
Rodriguez
Beatriz L
BL
Department of Geriatric Medicine, Pacific Health Research Institute, University of Hawaii at Manoa, Honolulu, USA.
Fujimoto
Wilfred Y
WY
Mayer-Davis
Elizabeth J
EJ
Imperatore
Giuseppina
G
Williams
Desmond E
DE
Bell
Ronny A
RA
Wadwa
R Paul
RP
Palla
Shana L
SL
Liu
Lenna L
LL
Kershnar
Ann
A
Daniels
Stephen R
SR
Linder
Barbara
B
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012307:Risk Factors; D012727:Sex Characteristics; D014481:United States / Q000453:epidemiology