Longitudinal lipid screening and use of lipid-lowering medications in pediatric type 1 diabetes.
OBJECTIVE
Because cardiovascular disease (CVD) is the leading cause of death in patients with type 1 diabetes (T1D) and dyslipidemia is an important CVD risk factor, we investigated dyslipidemia and its treatment in children with T1D.


METHODS
Subjects had T1D (n = 360), repeated lipid measurements (n = 1095; mean, 3.04 +/- 0.94; range, 2 to 11), and were seen between 1994 and 2004. Total cholesterol (TC), high-density lipoprotein cholesterol (HDL), and non-HDL cholesterol (non-HDL) were categorized on the basis of published guidelines. Age, diabetes duration, sex, body mass index, HbA1c, and lipid-lowering medication use were recorded. Predictors of TC, HDL, and non-HDL were determined.


RESULTS
Sustained abnormalities existed for TC > or = 200 mg/dL (16.9%); HDL < 35 mg/dL (3.3%); and non-HDL > or = 130 mg/dL (27.8%), > or = 160 mg/dL (10.6%), and > or = 190 mg/dL (3.3%). Lipid-lowering medications were started on 23 patients. In mixed model longitudinal data analyses, HbA1c was significantly related to TC and non-HDL. Body mass index z-score was inversely related to HDL.


CONCLUSIONS
In this retrospective, longitudinal study of pediatric patients with T1D with repeated lipid measurements, sustained abnormal levels for TC, HDL, and non-HDL were present. Prospective longitudinal data for dyslipidemia in youth with T1D are needed.
Maahs
David M
DM
Barbara Davis Center for Childhood Diabetes and the Department of Medicine, University of Colorado Health Sciences Center, Aurora, Colorado 80045, USA. David.Maahs@uchsc.edu
Wadwa
R Paul
RP
McFann
Kim
K
Nadeau
Kristen
K
Williams
Matthew R
MR
Eckel
Robert H
RH
Klingensmith
Georgeanna J
GJ
D000293:Adolescent; D002318:Cardiovascular Diseases / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D008076:Cholesterol, HDL / Q000032:analysis / Q000378:metabolism*; D008078:Cholesterol, LDL / Q000032:analysis / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006949:Hyperlipidemias / Q000175:diagnosis* / Q000188:drug therapy*; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008137:Longitudinal Studies; D008297:Male; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D000960:Hypolipidemic Agents