Cardiovascular Risk Factors among Youth with and without Type 2 Diabetes: Differences and Possible Mechanisms

  1. Nancy A. West, PhD (nancy.west{at}ucdenver.edu)1,
  2. Richard F. Hamman, MD1,
  3. Elizabeth J. Mayer-Davis, PhD2,
  4. Ralph B. D'Agostino, Jr, PhD3,
  5. Santica M. Marcovina, PhD4,
  6. Angela D. Liese, PhD2,
  7. Philip S. Zeitler, MD5,
  8. Stephen R. Daniels, MD5 and
  9. Dana Dabelea, MD1
  1. 1Department of Preventive Medicine, University of Colorado Denver, Denver, Colorado
  2. 2Department of Epidemiology and Biostatistics and Center for Research in Nutrition and Health Disparities, University of South Carolina, Columbia, South Carolina
  3. 3Wake Forest University School of Medicine, Winston-Salem, North Carolina
  4. 4Northwest Lipid Metabolism and Diabetes Research Laboratories, University of Washington, Seattle, Washington
  5. 5Department of Pediatrics, University of Colorado Denver, Denver, Colorado

    Abstract

    Objective: Compare cardiovascular disease (CVD) risk factors among recently-diagnosed youth with type 2 diabetes and non-diabetic youth and investigate whether demographic, behavioral or metabolic factors might account for observed differences.

    Research Design and Methods: Data from 106 type 2 diabetic and 189 non-diabetic multi-ethnic youth, ages 10-22 years were analyzed. Prevalence of CVD risk factors were age- and race/ethnicity-adjusted using direct standardization. Multiple linear regression models were sequentially adjusted for demographic, behavioral (dietary saturated fat intake and physical activity), and metabolic (body adiposity and glycemia) factors to explore possible mechanisms associated with differences in CVD risk factors between the case and control groups.

    Results: Compared to controls, youth with type 2 diabetes had a higher prevalence of elevated blood pressure, obesity, large waist circumference, low HDL cholesterol, high triglycerides, and high albumin-creatinine ratio (p<.05 for each risk factor). Type 2 diabetic youth also had higher levels of apolipoprotein B, fibrinogen, interleukin-6 (IL-6), C-reactive protein, and leptin; lower adiponectin levels; and denser LDL particles (p< .05 for each risk factor). Adjustment for BMI, waist circumference, and hemoglobin A1csubstantially attenuated differences in the CVD risk factors between the case/control groups except for fibrinogen and IL-6, which remained significantly higher in type 2 diabetic youth.

    Conclusions: Compared to control youth, type 2 diabetic youth have a less favorable CVD risk factor profile. Adiposity and glycemia are important contributors to differences in CVD risk profiles among type 2 diabetic and control youth. Inflammatory and prothrombotic factors may also play an important role.

    Footnotes

      • Received August 4, 2008.
      • Accepted October 15, 2008.

    This Article

    1. Published online before print October 22, 2008, doi: 10.2337/dc08-1442
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