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Prevalence of Cardiovascular Disease Risk Factors in U.S. Children and Adolescents With Diabetes

The SEARCH for Diabetes in Youth Study

¹ Department of Geriatric Medicine, Pacific Health Research Institute, University of Hawaii at Manoa, Honolulu, Hawaii
² Pacific Health Research Institute, Kona, Hawaii
³ Center for Research in Nutrition and Health Disparities and Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina
⁴ Centers for Disease Control and Prevention/National Center for Chronic Disease Prevention and Health Promotion, Division of Diabetes Translation, Atlanta, Georgia
⁵ Wake Forest University, School of Medicine, Public Health Sciences, Winston-Salem, North Carolina
⁶ Barbara Davis Center for Childhood Diabetes, University of Colorado Health Sciences Center, Denver, Colorado
⁷ Child Health Institute, University of Washington, Seattle, Washington
⁸ Kaiser Permanente, Downey, California
⁹ Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
¹⁰ National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland

Address correspondence and reprint requests to Ronny Bell, PhD, Wake Forest University School of Medicine, Public Health Sciences, Medical Center Blvd., Winston-Salem, NC 27157. E-mail: rbell{at}wfubmc.edu

OBJECTIVE—The purpose of this study was to determine the prevalence and correlates of selected cardiovascular disease (CVD) risk factors among youth aged <20 years with diabetes.

RESEARCH DESIGN AND METHODS—The analysis included 1,083 girls and 1,013 boys examined as part of the SEARCH for Diabetes in Youth study, a multicenter, population-based study of youth 0–19 years of age with diabetes. Diabetes type was determined by a biochemical algorithm based on diabetes antibodies and fasting C-peptide level. CVD risk factors were defined as follows: HDL cholesterol <40 mg/dl; age- and sex-specific waist circumference >90th percentile; systolic or diastolic blood pressure >90th percentile for age, sex, and height or taking medication for high blood pressure; and triglycerides >110 mg/dl.

RESULTS—The prevalence of having at least two CVD risk factors was 21%. The prevalence was 7% among children aged 3–9 years and 25% in youth aged 10–19 years (P < 0.0001), 23% among girls and 19% in boys (P = 0.04), 68% in American Indians, 37% in Asian/Pacific Islanders, 32% in African Americans, 35% in Hispanics, and 16% in non-Hispanic whites (P < 0.0001). At least two CVD risk factors were present in 92% of youth with type 2 and 14% of those with type 1A diabetes (P < 0.0001). In multivariate analyses, age, race/ethnicity, and diabetes type were independently associated with the odds of having at least two CVD risk factors (P < 0.0001).

CONCLUSIONS—Many youth with diabetes have multiple CVD risk factors. Recommendations for weight, lipid, and blood pressure control in youth with diabetes need to be followed to prevent or delay the development of CVD as these youngsters mature.

Abbreviations: ATP III, Adult Treatment Panel III • CVD, cardiovascular disease • FCP, fasting C-peptide • NHANES, National Health and Nutrition Examination Survey • NCEP, National Cholesterol Education Program

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