title: Lipoprotein subfraction cholesterol distribution is more atherogenic in insulin resistant adolescents with type 1 diabetes.
abstract: Adolescents with type 1 diabetes (T1D) often have a less atherogenic-appearing fasting lipid profile than controls, despite increased rates of cardiovascular disease (CVD) as adults. We previously reported an atherogenic lipoprotein subfraction cholesterol distribution associated with insulin resistance (IR) in T1D adults. We sought to determine if T1D youth have more atherogenic profile than controls via a cross-sectional study.
  
  
  
  Following 3 days of controlled diet and restricted exercise, fasting plasma samples were drawn from 28 T1D youth [50% female, age 15.3 ± 2 yr, body mass index (BMI) 48%ile; diabetes duration 73 ± 52 months, hemoglobin A1c (HbA1c) 8.3 ± 1.4%] and 17 non-diabetic controls (47% female, age: 15.0 ± 2 yr, BMI 49%ile) prior to a hyperinsulinemic euglycemic clamp. Lipoproteins were fractionated by fast protein liquid chromatography (FPLC) and lipoprotein cholesterol distribution determined. Outcome measures were IR assessed by glucose infusion rate (GIR) and FPLC lipoprotein subfraction cholesterol distribution.
  
  
  
  T1D youth were more IR (GIR 9.1 ± 3.6 vs. 14.7 ± 3.9 mg/kg/min, p < 0.0001) and had more cholesterol distributed as small dense low density lipoprotein-cholesterol (LDL-C) and less as large buoyant high density lipoprotein-cholesterol (HDL-C) than controls (p < 0.05), despite no differences in the fasting lipid panel. T1D girls lacked the typical female less-atherogenic profile, whereas control girls tended to have a shift toward less dense LDL-C and HDL-C vs. control boys. Among T1D, IR but not HbA1c was associated with a more atherogenic lipoprotein profile.
  
  
  
  Normal weight T1D youth, especially females, had more atherogenic LDL-C and HDL-C distributions which correlated with lower insulin sensitivity. IR may contribute to the increased CVD burden in T1D.
authors.affiliation: Barbara Davis Center for Childhood Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.|Department of Pediatrics, Division of Pediatric Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.|Center for Women's Health Research, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
authors.forename: Melanie
authors.initials: M
authors.lastname: Cree-Green
authors.affiliation: Barbara Davis Center for Childhood Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
authors.forename: David M
authors.initials: DM
authors.lastname: Maahs
authors.affiliation: Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
authors.forename: Annie
authors.initials: A
authors.lastname: Ferland
authors.affiliation: Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
authors.forename: John E
authors.initials: JE
authors.lastname: Hokanson
authors.affiliation: Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
authors.forename: Hong
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Pediatrics, Division of Pediatric Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Pyle
authors.affiliation: Department of Pediatrics, Division of Pediatric Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.|Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Kinney
authors.affiliation: Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
authors.forename: Martina
authors.initials: M
authors.lastname: King
authors.affiliation: Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Eckel
authors.affiliation: Barbara Davis Center for Childhood Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.|Department of Pediatrics, Division of Pediatric Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.|Center for Women's Health Research, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
authors.forename: Kristen J
authors.initials: KJ
authors.lastname: Nadeau
mesh_terms: D000293:Adolescent; D001786:Blood Glucose; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008074:Lipoproteins / Q000097:blood*; D008297:Male; D012737:Sex Factors
chemical_list: D001786:Blood Glucose; D008074:Lipoproteins
keywords: cardiovascular disease; insulin resistance; lipids; pediatrics; type 1 diabetes