title: Influence of HbA1c and BMI on Lipid Trajectories in Youths and Young Adults With Type 1 Diabetes.
abstract: To assess the influence of HbA1cand BMI (measured as BMI z score [zBMI]) on LDL, HDL, and non-HDL trajectories as youths with type 1 diabetes age into early adulthood.
  
  
  
  Dynamic, retrospective cohort study examining changes in lipid values in 572 youths with type 1 diabetes followed longitudinally for a median of 9.3 years. Through longitudinal modeling, we describe the relationship of HbA1cand zBMI on lipid values as subjects age after adjusting for other relevant factors, including lipid-lowering medication use.
  
  
  
  The median number of lipid assessments was 7 (range 2-39). Every 1% increase in HbA1cwas associated with an ∼2-6 mg/dL increase in LDL levels, with a greater increase in LDL levels as subjects progressed from prepubertal to postpubertal age ranges. A 1-SD increase in BMI was associated with a mean LDL increase of 2.1 mg/dL when subjects were 10 years old and increased to a mean of 8.2 mg/dL when subjects were 19 years old. The association between changes in HbA1clevel and zBMI and changes in non-HDL levels as youths aged were similar to the associations found with LDL. The influence of HbA1cand zBMI on HDL levels was small and not dependent on age.
  
  
  
  Changes in HbA1clevel and zBMI modestly impact LDL and non-HDL cholesterol and have greater impacts as children age. Addressing elevations in HbA1cand zBMI as children enter into adolescence and beyond may lead to improvements in lipid levels.
authors: Section on Genetics and Epidemiology, Joslin Diabetes Center, Boston, MA michelle.katz@joslin.harvard.edu.
authors: Michelle L
authors: ML
authors: Katz
authors: Jaeb Center for Health Research, Tampa, FL.
authors: Craig R
authors: CR
authors: Kollman
authors: Section on Genetics and Epidemiology, Joslin Diabetes Center, Boston, MA.
authors: Carly E
authors: CE
authors: Dougher
authors: Jaeb Center for Health Research, Tampa, FL.
authors: Mohamed
authors: M
authors: Mubasher
authors: Section on Genetics and Epidemiology, Joslin Diabetes Center, Boston, MA.
authors: Lori M B
authors: LM
authors: Laffel
mesh_terms: D000293:Adolescent; D000375:Aging / Q000097:blood*; D015992:Body Mass Index; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000503:physiopathology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D008055:Lipids / Q000097:blood*; D008137:Longitudinal Studies; D008297:Male; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin; D008055:Lipids; C517652:hemoglobin A1c protein, human