Prevalence Of Abnormal Lipid Profiles And The Relationship With The Development Of Microalbuminuria In Adolescents With Type 1 Diabetes

  1. M. Loredana Marcovecchio, MD1,
  2. R. Neil Dalton, PhD2,
  3. A. Toby Prevost, PhD3,
  4. Carlo L. Acerini, MD1,
  5. Timothy G. Barrett, PhD4,
  6. Jason D. Cooper, PhD5,
  7. Julie Edge, MD6,
  8. Andrew Neil, FRCP7,
  9. Julian Shield, MD8,
  10. Barry Widmer, BSc1,
  11. John A. Todd, PhD5 and
  12. David B. Dunger, MD (dbd25{at}cam.ac.uk)1
  1. 1Department of Paediatrics and the Institute of Metabolic Science, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
  2. 2WellChild Laboratory, King's College London, Evelina Children's Hospital, London, UK
  3. 3Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
  4. 4Department of Paediatrics, Birmingham Children's Hospital, Birmingham, UK
  5. 5Juvenile Diabetes Research Foundation/Wellcome Trust Diabetes and Inflammation Laboratory, Department of Medical Genetics, Cambridge Institute for Medical Research, University of Cambridge, Cambridge, UK
  6. 6Department of Paediatric Endocrinology and Diabetes, Oxford Children's Hospital, Headington, Oxford, UK
  7. 7Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
  8. 8Institute of Child Life & Health, University of Bristol, Bristol, UK

    Abstract

    Objective. To explore the prevalence of lipid abnormalities and their relationship with albumin excretion and microalbuminuria (MA) in adolescents with type 1 diabetes.

    Research Design and Methods. The study population comprised 895 young subjects with type 1 diabetes (490 males): age at the baseline assessment (median[range]):14.5[10-21.1]years; diabetes duration 4.8[0.2-17]years. 2194 non-fasting blood samples were collected longitudinally for determination of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), and non-HDL-C. Additional annually collected data on anthropometric parameters, HbA1c, albumin-creatinine ratio (ACR) were available.

    Results. TC, LDL-C, HDL-C and non-HDL-C were higher in girls than in boys (all p<0.001). A significant proportion of subjects presented sustained lipid abnormalities during follow-up: TC>5.2mmol/l (18.6%), non-HDL-C>3.4mmol/l (25.9%), TG>1.7mmol/l (20.1%), LDL>3.4mmol/l (9.6%). Age and duration were significantly related to all lipid parameters (p<0.001); HbA1c was independently related to all parameters (p<0.001) except HDL-C; whereas BMI SDS was related to all parameters (p<0.05) except TC.

    Results. TC and non-HDL-C were independently related to longitudinal changes in ACR (B±SE): 0.03±0.01/1mmol/l; p=0.009 and 0.32±0.14/1mmol/l; p=0.02, respectively. Overall mean TC and non-HDL-C were higher in MA positive (n=115) than in normoalbuminuric subjects (n=780): TC 4.7±1.2 vs 4.5±0.8mmol/l (p=0.04); non-HDL-C 3.2±1.2 vs 2.9±0.8mmol/l (p=0.03).

    Conclusions. In this longitudinal study of adolescents with type 1 diabetes, sustained lipid abnormalities were related to age, duration, BMI and HbA1c. Furthermore, ACR was related to both TC and non-HDL-C, indicating a potential role in the pathogenesis of diabetic nephropathy.

    Footnotes

      • Received September 5, 2008.
      • Accepted January 13, 2009.

    This Article

    1. Published online before print January 26, 2009, doi: 10.2337/dc08-1641
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