Algorithm-based cholesterol monitoring in children with type 1 diabetes.
OBJECTIVE
To facilitate child-specific and diabetes-related cholesterol control, we developed a monitoring algorithm derived from population-based reference values.


METHODS
Low-density lipoprotein (LDL)-, non-high-density lipoprotein (HDL)-, and HDL cholesterol percentile values were calculated for children with type 1 diabetes (T1D) and their peers without T1D within algorithm-based categories of sex, age: 1-10 vs >10-<18 years, body mass index: <90th vs ≥90th percentile, and hemoglobin A1c <6%, 6%-<7.5%, 7.5%-9%, >9%. Analyses included 26 147 patients sampled from a German/Austrian population-based registry for T1D (Diabetes Documentation and Quality Management System) and 14 057 peers without diabetes participating in the national Health Interview and Examination Survey for Children and Adolescents in Germany.


RESULTS
Reference percentile values for cholesterol were derived as a diagnostic algorithm aimed at supporting long-term cholesterol control. Taking account of a patient's sex, age-group, weight-, and hemoglobin A1c-category, the flowcharts of the algorithm developed separately for LDL-, non-HDL-, and HDL cholesterol allow comparing his/her cholesterol levels with population-based reference percentile values of peers without T1D.


CONCLUSIONS
The population-based algorithmic approach applied to LDL-, non-HDL-, and HDL cholesterol allows referencing children with T1D with regard to their peers without T1D and, if necessary, suggests corrections of glycemic control to optimize long-term cholesterol levels.
Department of Pediatrics and Adolescent Medicine, University Medical Center, Freiburg, Germany.
K Otfried
KO
Schwab
Department of Pediatrics and Adolescent Medicine, University Medical Center, Freiburg, Germany.
Jürgen
J
Doerfer
Department of Epidemiology and Health Reporting, Robert Koch Institute, Berlin, Germany;
Christa
C
Scheidt-Nave
Department of Epidemiology and Health Reporting, Robert Koch Institute, Berlin, Germany;
Bärbel-Maria
BM
Kurth
Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany.
Andreas
A
Hungele
Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany.
Nicole
N
Scheuing
Department of Pediatrics and Adolescent Medicine, University Medical Center, Freiburg, Germany.
Andreas
A
Krebs
Department of Pediatrics and Adolescent Medicine, University of Jena, Jena, Germany.
Axel
A
Dost
Division of Pediatric Endocrinology, Department of General Pediatrics and Neonatology, Saarland University Medical Center, Homburg, Germany.
Tilman R
TR
Rohrer
University Children's Hospital, Vienna, Austria.
Edith
E
Schober
Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany.
Reinhard W
RW
Holl
D000293:Adolescent; D000465:Algorithms; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002784:Cholesterol / Q000097:blood*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D003661:Decision Support Techniques; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications*; D050171:Dyslipidemias / Q000097:blood / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012016:Reference Values
D015415:Biomarkers; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D002784:Cholesterol