Characterization of 33 488 children and adolescents with type 1 diabetes based on the gender-specific increase of cardiovascular risk factors.
OBJECTIVE
Characterization of children with type 1 diabetes (T1DM) regarding number and gender distribution of cardiovascular risk factors (cvRF) and of total cholesterol/high-density lipoprotein cholesterol ratio (TC/HDL-C ratio) for risk assessment.


METHODS
33488 patients <or=18 years were included in this cross-sectional analysis and placed into 5 categories by their number of cvRF. Dyslipidemia (TC >200 mg/dL, >5.17 mmol/L; and/or HDL-C <35 mg/dL, <0.91 mmol/L; and/or LDL-C >130 mg/dL, >3.36 mmol/L), elevated systolic and/or diastolic blood pressure (BP) >or=90th percentile, obesity >97th percentile, active smoking, and HbA1c >or=7.5% were considered as cvRF.


RESULTS
65% had no or 1 cvRF. HbA1c >/=7.5% was the most frequently occurring cvRF followed by BP >or=90th percentile, dyslipidemia, smoking, and BMI >97th percentile. Age at diabetic onset ranged from 7.7 to 9.2 years and diabetes duration from 4.1 to 6.6 years. CvRF showed differences in disfavour of females except smoking and HDL-C <35 mg/dL (0.91 mmol/L). Rate of females was 45% with 0 cvRF and 60% with 4 to 5 cvRF. TC/HDL-C ratio showed no clear association to the number of cvRF.


CONCLUSIONS
35% of a pediatric T1DM population develops 2 or more cvRF thus increasing their cv risk in adulthood. With increasing numbers of cvRF, the percentage of girls is rising from 45% to 60% which might contribute to an assimilation of survival rates in female and male adults. TC/HDL ratio does not predict the extent of cardiovascular risk in pediatric T1DM.
Schwab
K Otfried
KO
Department of Pediatrics and Adolescence Medicine, Freiburg University Hospital, Freiburg, Germany. karl.otfried.schwab@uniklinikfreiburg.de
Doerfer
Juergen
J
Marg
Wolfgang
W
Schober
Edith
E
Holl
Reinhard W
RW
D000293:Adolescent; D017668:Age of Onset; D050197:Atherosclerosis / Q000097:blood / Q000453:epidemiology*; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000453:epidemiology*; D050171:Dyslipidemias / Q000097:blood / Q000453:epidemiology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D009765:Obesity / Q000097:blood / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human