Impact of Physical Activity on Cardiovascular Risk Factors in Children With Type 1 Diabetes
A multicenter study of 23,251 patients
- Antje Herbst, MD1,
- Olga Kordonouri, MD2,
- Karl O. Schwab, MD3,
- Frank Schmidt, MD4,
- Reinhard W. Holl, PHD5 and
- on behalf of the DPV Initiative of the German Working Group for Pediatric Diabetology Germany
- 1Pediatrics, Hospital of Leverkusen, Leverkusen, Germany
- 2Diabetes Center for Children and Adolescents, Children's Hospital auf der Bult, Hannover, Germany
- 3Pediatrics, University of Freiburg, Freiburg, Germany
- 4Pediatrics, University of Halle, Halle, Germany
- 5Epidemiology, University of Ulm, Ulm. Germany
- Address correspondence and reprint requests to Dr. Antje Herbst, MD, Pediatric Diabetology, Hospital of Leverkusen, Am Gesundheitspark 11, 51375 Leverkusen, Germany. E-mail: herbst{at}klinikum-lev.de
Type 1 diabetes is associated with a high risk for early atherosclerotic complications. Patients with type 1 diabetes have a fourfold (in men) to eightfold (in women) excess risk of coronary heart disease compared with that for the general population (1). It has been shown that type 1 diabetic patients aged 20–39 years have a fivefold higher risk of dying from cardio- and cerebrovascular events compared with that for healthy individuals (2). Development of atherosclerotic lesions in healthy subjects begins upon childhood. In children with type 1 diabetes who had died an unnatural death, an asymptomatic increase in the intima-media thickness of the common carotid artery was found (3). Known risk factors for vascular complications are long-standing diabetes, age, poor glycemic control, smoking, hypertension, obesity, and dyslipidemia (4–6). In a recent study, 69% of the pediatric patients with type 1 diabetes were found to have one or more cardiovascular risk factors (7). Thus, there is an urgent need for prevention strategies to reduce these risk factors in childhood and adolescence.
We recently showed that frequency of regular physical activity (RPA) represents an important factor influencing glycohemoglobin and, in girls, BMI (8). The present study focuses on the impact of RPA on further cardiovascular risk factors such as plasma lipids and blood pressure in children with type 1 diabetes.
RESEARCH DESIGN AND METHODS—
Data were provided by the Pediatric Quality Initiative (9) and included anonymous longitudinal data of 23,251 patients (3–18 years) with type 1 diabetes from 209 centers in Germany and Austria. The data are continuously generated by the participating centers using the diabetes data acquisition system for prospective surveillance [DPV] software (Diabetes Software for Prospective Documentation) and after anonymization are transmitted to the Pediatric Quality Initiative for …
