title: Estimated insulin sensitivity and cardiovascular disease risk factors in adolescents with and without type 1 diabetes.
abstract: OBJECTIVE
  To test the hypothesis that cardiovascular disease (CVD) risk factors are similar in nondiabetic (non-DM) adolescents compared with those with type 1 diabetes (T1D) in the most insulin-sensitive (IS) tertile, and that CVD risk factors are more atherogenic with decreasing IS in adolescents with T1D.
  
  
  METHODS
  IS for adolescents with T1D (n = 292; age = 15.4 ± 2.1 years; duration = 8.8 ± 3.0 years, hemoglobin A1c = 8.9% ± 1.6%) and non-DM controls (n = 89; age = 15.4 ± 2.1 years) was estimated using the model: log(e)IS = .64725 - 0.02032 (waist [cm]) - 0.09779 (hemoglobin A1c [%]) - 0.00235 (triglycerides [mg/dL]). CVD risk factors (blood pressure, fasting total and low- and high-density lipoprotein-cholesterol (HDL-c), high sensitivity C-reactive protein, and body mass index z score) were compared between all non-DM adolescents and those with T1D in the most IS tertile, and then examined for a linear trend by IS tertile in adolescents with T1D, adjusted for sex, race/ethnicity, and Tanner stage.
  
  
  RESULTS
  Estimated IS was significantly lower in adolescents with T1D compared with those without (T1D = 7.8 ± 2.4, non-DM = 11.5 ± 2.9; P < .0001). CVD risk factors were similar for non-DM compared with the adolescents with T1D with the most IS, except for higher (HDL-c) and diastolic blood pressure in adolescents with T1D (P < .05). Among adolescents with T1D, all CVD risk factors except for (HDL-c), were more atherogenic across decreasing IS tertiles in linear regression analysis (P < .05).
  
  
  CONCLUSIONS
  Adolescents with T1D who are the most IS have similar CVD risk factors compared with non-DM adolescents. CVD risk factors are inversely associated with IS in adolescents with T1D. IS may be an important therapeutic target for reducing CVD risk factors in adolescents with T1D.
authors.affiliation: University of Colorado School of Medicine, Aurora, CO 80045, USA.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Specht
authors.forename: R Paul
authors.initials: RP
authors.lastname: Wadwa
authors.forename: Janet K
authors.initials: JK
authors.lastname: Snell-Bergeon
authors.forename: Kristen J
authors.initials: KJ
authors.lastname: Nadeau
authors.forename: Franziska K
authors.initials: FK
authors.lastname: Bishop
authors.forename: David M
authors.initials: DM
authors.lastname: Maahs
mesh_terms: D000293:Adolescent; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology* / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D012307:Risk Factors