Longitudinal Lipid Screening and Use of Lipid-Lowering Medications in Pediatric Type 1 Diabetes

Objective

Because cardiovascular disease (CVD) is the leading cause of death in patients with type 1 diabetes (T1D) and dyslipidemia is an important CVD risk factor, we investigated dyslipidemia and its treatment in children with T1D.

Study design

Subjects had T1D (n = 360), repeated lipid measurements (n = 1095; mean, 3.04 ± 0.94; range, 2 to 11), and were seen between 1994 and 2004. Total cholesterol (TC), high-density lipoprotein cholesterol (HDL), and non-HDL cholesterol (non-HDL) were categorized on the basis of published guidelines. Age, diabetes duration, sex, body mass index, HbA1c, and lipid-lowering medication use were recorded. Predictors of TC, HDL, and non-HDL were determined.

Results

Sustained abnormalities existed for TC ≥200 mg/dL (16.9%); HDL <35 mg/dL (3.3%); and non-HDL ≥130 mg/dL (27.8%), ≥160 mg/dL (10.6%), and ≥190 mg/dL (3.3%). Lipid-lowering medications were started on 23 patients. In mixed model longitudinal data analyses, HbA1c was significantly related to TC and non-HDL. Body mass index z-score was inversely related to HDL.

Conclusions

In this retrospective, longitudinal study of pediatric patients with T1D with repeated lipid measurements, sustained abnormal levels for TC, HDL, and non-HDL were present. Prospective longitudinal data for dyslipidemia in youth with T1D are needed.

Abbreviations: ADA, American Diabetes Association, BMI, Body mass index, CVD, Cardiovascular disease, HDL, High-density lipoprotein, TC, Total cholesterol, T1D, Type 1 diabetes