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

• Published in: Diabetes care Vol. 32; no. 3; pp. 416 - 420
• Main Authors: Guy, John, Ogden, Lorraine, Wadwa, R. Paul, Hamman, Richard F, Mayer-Davis, Elizabeth J, Liese, Angela D, D'Agostino, Ralph Jr, Marcovina, Santica, Dabelea, Dana
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01.03.2009
• Subjects: Adolescent; Analysis; Biological and medical sciences; Blood lipoproteins; Case-Control Studies; Child; Cholesterol; Colorado; Diabetes; Diabetes Mellitus, Type 1 - blood; Diabetes Mellitus, Type 1 - metabolism; Diabetes therapy; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Epidemiology/Health Services Research; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Humans; Lipids - blood; Lipoproteins; Lipoproteins - blood; Lipoproteins, HDL - blood; Male; Medical sciences; Metabolic diseases; Miscellaneous; Proteolipids; Public health. Hygiene; Public health. Hygiene-occupational medicine; South Carolina; Teenagers; Triglycerides - blood; Young Adult; Youth; Colorado; South Carolina; Endocrinopathy; Human; Immunopathology; Nutrition; Lipids; Autoimmune disease; Metabolic diseases; Case control study; Lipoprotein; Epidemiology; Surveillance; Type 1 diabetes; Scientific research; Adolescent; Endocrinology; Public health
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/dc08-1775

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 greater-than-or-equal7.5%] 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.