Lipid and Lipoprotein Profiles in Youth With and Without Type 1 Diabetes
The SEARCH for Diabetes in Youth Case-Control Study
- John Guy, MPH1,
- Lorraine Ogden, PHD2,
- R. Paul Wadwa, MD3,
- Richard F. Hamman, MD, DRPH1,
- Elizabeth J. Mayer-Davis, PHD4,
- Angela D. Liese, PHD5,
- Ralph D'Agostino, Jr., PHD6,
- Santica Marcovina, PHD7 and
- Dana Dabelea, MD, PHD1
- 1Department of Epidemiology, Colorado School of Public Health, University of Colorado, Denver, Colorado
- 2Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado, Denver, Colorado
- 3Barbara Davis Center, University of Colorado, Denver, Colorado
- 4Nutrition Department, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- 5Department of Epidemiology and Biostatistics and Center for Research in Nutrition and Health Disparities, University of South Carolina, Columbia, South Carolina
- 6Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina
- 7Northwest Lipid Metabolism and Diabetes Research Laboratories, University of Washington, Seattle, Washington
- Corresponding author: Dana Dabelea, dana.dabelea{at}ucdenver.edu
Abstract
OBJECTIVE—The purpose of this study was to compare the lipid profile and the prevalence of lipid abnormalities in youth with and without type 1 diabetes and explore the role of glycemic control on the hypothesized altered lipid profile in youth with type 1 diabetes.
RESEARCH DESIGN AND METHODS—We conducted a cross-sectional analysis of 512 youth with type 1 diabetes (mean duration 4.22 years) and 188 healthy control subjects aged 10–22 years in Colorado and South Carolina. SEARCH for Diabetes in Youth (SEARCH) participants with type 1 diabetes and healthy control subjects recruited from primary care offices in the same geographic regions were invited to attend a research visit. Fasting lipid profiles were compared between youth with type 1 diabetes (stratified according to categories of optimal [A1C <7.5%] and suboptimal [A1C ≥7.5%] glycemic control) and healthy nondiabetic youth, using multiple linear and logistic regression.
RESULTS—Youth with type 1 diabetes and optimal A1C had lipid concentrations that were similar (total cholesterol, LDL cholesterol, and LDL particle size) or even less atherogenic (HDL cholesterol, non-HDL cholesterol, triglyceride, and triglyceride–to–HDL cholesterol ratio) than those observed in nondiabetic youth, whereas youth with suboptimal glycemic control had elevated standard lipid levels (total cholesterol, LDL cholesterol, and non-HDL cholesterol). Youth with type 1 diabetes also had significantly elevated apolipoprotein B levels and more small, dense LDL particles than nondiabetic youth, regardless of glycemic control.
CONCLUSIONS—Youth with type 1 diabetes have abnormal lipid levels and atherogenic changes in lipoprotein composition, even after a relatively short disease duration. As in adults, glycemic control is an important mediator of these abnormalities.
Footnotes
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Published ahead of print at http://care.diabetesjournals.org on 17 December 2008.
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- Accepted December 9, 2008.
- Received September 26, 2008.
- DIABETES CARE
