Lipid and lipoprotein profiles in youth with and without type 1 diabetes: the SEARCH for Diabetes in Youth case-control study.
OBJECTIVE
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Guy
John
J
Department of Epidemiology, Colorado School of Public Health, University of Colorado, Denver, Colorado, USA.
Ogden
Lorraine
L
Wadwa
R Paul
RP
Hamman
Richard F
RF
Mayer-Davis
Elizabeth J
EJ
Liese
Angela D
AD
D'Agostino
Ralph
R
Marcovina
Santica
S
Dabelea
Dana
D
D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D003120:Colorado; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000378:metabolism; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood*; D008074:Lipoproteins / Q000097:blood*; D008075:Lipoproteins, HDL / Q000097:blood; D008297:Male; D013022:South Carolina; D014280:Triglycerides / Q000097:blood; D055815:Young Adult
C034396:HDL-triglyceride; D008055:Lipids; D008074:Lipoproteins; D008075:Lipoproteins, HDL; D014280:Triglycerides