Lipid and Lipoprotein Profiles in Youth with and Without Type 1 Diabetes: The SEARCH Case-Control Study

  1. John Guy, MPH1,
  2. Lorraine Ogden, PhD2,
  3. R. Paul Wadwa, MD3,
  4. Richard F. Hamman, MD, Dr.PH1,
  5. Elizabeth J. Mayer-Davis, PhD4,
  6. Angela D. Liese, PhD5,
  7. Ralph D'Agostino, Jr., PhD6,
  8. Santica Marcovina, PhD7 and
  9. Dana Dabelea, MD, PhD (Dana.Dabelea{at}uchsc.edu)1
  1. 1Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver
  2. 2Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Denver
  3. 3Barbara Davis Center, University of Colorado Denver
  4. 4Nutrition Department, University of North Carolina at Chapel Hill
  5. 5Department of Epidemiology and Biostatistics and Center for Research in Nutrition and Health Disparities, University of South Carolina, Columbia, South Carolina
  6. 6Department of Public Health Sciences, Wake Forest University School of Medicine, North Carolina
  7. 7Northwest Lipid Metabolism and Diabetes Research Laboratories, University of Washington

    Abstract

    Objective: 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: Cross-sectional analysis of 512 youth with type 1 diabetes (mean duration 4.22 years) and 188 healthy controls age 10-22 years in Colorado and South Carolina. SEARCH youth 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 non-diabetic 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-C, and LDL particle size) or even less atherogenic (HDL-C, non-HDL-C, triglyceride, triglyceride/HDL-C ratio) than those observed in non-diabetic youth, while youth with suboptimal glycemic control had elevated standard lipid levels (total, LDL-C and non-HDL-C). Youth with type 1 diabetes also had significantly elevated Apo B levels and more small/dense LDL particles than non-diabetic 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

      • Received September 26, 2008.
      • Accepted December 9, 2008.

    This Article

    1. Published online before print December 17, 2008, doi: 10.2337/dc08-1775
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