The Journal of Pediatrics
Volume 156, Issue 6 , Pages 923-929 , June 2010

Overweight Is Highly Prevalent In Children with Type 1 Diabetes And Associates with Cardiometabolic Risk

  • Mariska van Vliet, MD

      Affiliations

    • Department of Pediatrics, Slotervaart Hospital, Amsterdam, The Netherlands
    • Diabetes Center/Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands
    • Both authors contributed equally to this article.
    • ,
  • Josine C. Van der Heyden, MD

      Affiliations

    • Diabeter, Rotterdam, The Netherlands
    • Both authors contributed equally to this article.
    • Corresponding Author InformationReprint requests: Dr Josine van der Heyden, Diabeter, Haringvliet 72, 3011 TG Rotterdam, The Netherlands.
    • ,
  • Michaela Diamant, MD, PhD

      Affiliations

    • Diabetes Center/Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands
    • ,
  • Inès A. Von Rosenstiel, MD

      Affiliations

    • Department of Pediatrics, Slotervaart Hospital, Amsterdam, The Netherlands
    • ,
  • Roger K. Schindhelm, MD, PhD, MEPI

      Affiliations

    • Department of Clinical Chemistry, Isala Clinics, Zwolle, The Netherlands
    • ,
  • Henk J. Aanstoot, MD, PhD

      Affiliations

    • Diabeter, Rotterdam, The Netherlands
    • ,
  • Henk J. Veeze, MD, PhD

      Affiliations

    • Diabeter, Rotterdam, The Netherlands

Received 29 June 2009 ,Revised 6 October 2009 ,Accepted 9 December 2009.

References 

  1. Dietz WH. Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics. 1998;101:518–525
  2. Purnell JQ, Dev RK, Steffes MW, Cleary PA, Palmer JP, Hirsch IB, et al. Relationship of family history of type 2 diabetes, hypoglycemia, and autoantibodies to weight gain and lipids with intensive and conventional therapy in the Diabetes Control and Complications Trial. Diabetes. 2003;52:2623–2629
  3. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus: the Diabetes Control and Complications Trial Research Group. N Engl J Med. 1993;329:977–986
  4. Nathan DM, Cleary PA, Backlund JY, Genuth SM, Lachin JM, Orchard TJ, et al. Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes. N Engl J Med. 2005;353:2643–2653
  5. Influence of intensive diabetes treatment on body weight and composition of adults with type 1 diabetes in the Diabetes Control and Complications Trial. Diabetes Care. 2001;24:1711–1721
  6. Soedamah-Muthu SS, Fuller JH, Mulnier HE, Raleigh VS, Lawrenson RA, Colhoun HM. High risk of cardiovascular disease in patients with type 1 diabetes in the UK: a cohort study using the general practice research database. Diabetes Care. 2006;29:798–804
  7. Berenson GS. Childhood risk factors predict adult risk associated with subclinical cardiovascular disease: the Bogalusa Heart Study. Am J Cardiol. 2002;90:3L–7L
  8. Jarvisalo MJ, Jartti L, Nanto-Salonen K, Irjala K, Ronnemaa T, Hartiala JJ, et al. Increased aortic intima-media thickness: a marker of preclinical atherosclerosis in high-risk children. Circulation. 2001;104:2943–2947
  9. Margeirsdottir HD, Larsen JR, Brunborg C, Overby NC, hl-Jorgensen K. High prevalence of cardiovascular risk factors in children and adolescents with type 1 diabetes: a population-based study. Diabetologia. 2008;51:554–561
  10. Schwab KO, Doerfer J, Hecker W, Grulich-Henn J, Wiemann D, Kordonouri O, et al. Spectrum and prevalence of atherogenic risk factors in 27,358 children, adolescents, and young adults with type 1 diabetes: cross-sectional data from the German diabetes documentation and quality management system (DPV). Diabetes Care. 2006;29:218–225
  11. de Simone G, Devereux RB, Chinali M, Best LG, Lee ET, Galloway JM, et al. Prognostic impact of metabolic syndrome by different definitions in a population with high prevalence of obesity and diabetes: the Strong Heart Study. Diabetes Care. 2007;30:1851–1856
  12. Morrison JA, Friedman LA, Gray-McGuire C. Metabolic syndrome in childhood predicts adult cardiovascular disease 25 years later: the Princeton Lipid Research Clinics Follow-up Study. Pediatrics. 2007;120:340–345
  13. Silverstein J, Klingensmith G, Copeland K, Plotnick L, Kaufman F, Laffel L, et al. Care of children and adolescents with type 1 diabetes: a statement of the American Diabetes Association. Diabetes Care. 2005;28:186–212
  14. Dhuper S, Cohen HW, Daniel J, Gumidyala P, Agarwalla V, St Victor R, et al. Utility of the modified ATP III defined metabolic syndrome and severe obesity as predictors of insulin resistance in overweight children and adolescents: a cross-sectional study. Cardiovasc Diabetol. 2007;6:4
  15. Standards of medical care in diabetes–2006. Diabetes Care. 2006;29(Suppl 1):S4-S42
  16. Verloove-Vanhorick SP. Body index measurements in 1996-7 compared with 1980. Arch Dis Child. 2000;82(2):107–112
  17. Fredriks AM, van Buuren S, Fekkes M, Verloove-Vanhorick SP, Wit JM. Are age references for waist circumference, hip circumference and waist-hip ratio in Dutch children useful in clinical practice?. Eur J Pediatr. 2005;164:216–222
  18. De Man SA, André JL, Bachman H, Grobbee DE, Ibsen KK, Laaser U, et al. Blood pressure in childhood: pooled findings of six European studies. J Hypertens. 1991;9:109–114
  19. Donaghue KC, Chiarelli F, Trotta D, Allgrove J, hl-Jorgensen K. ISPAD clinical practice consensus guidelines 2006-2007 microvascular and macrovascular complications. Pediatr Diabetes. 2007;8:163–170
  20. Kilpatrick ES, Rigby AS, Atkin SL. Insulin resistance, the metabolic syndrome, and complication risk in type 1 diabetes: “double diabetes” in the Diabetes Control and Complications Trial. Diabetes Care. 2007;30:707–712
  21. Weiss R, Dziura J, Burgert TS, Tamborlane WV, Taksali SE, Yeckel CW, et al. Obesity and the metabolic syndrome in children and adolescents. N Engl J Med. 2004;350:2362–2374
  22. van Vliet M, von Rosenstiel I, Schindhelm RK, Brandjes DP, Beijnen JH, Diamant M. The association of elevated alanine aminotransferase and the metabolic syndrome in an overweight and obese pediatric population of multi-ethnic origin. Eur J Pediatr. 2008;168:585–591
  23. Rodriguez BL, Fujimoto WY, Mayer-Davis EJ, Imperatore G, Williams DE, Bell RA, et al. Prevalence of cardiovascular disease risk factors in US children and adolescents with diabetes: the SEARCH for diabetes in youth study. Diabetes Care. 2006;29:1891–1896
  24. Davis TM, Bruce DG, Davis WA. Prevalence and prognostic implications of the metabolic syndrome in community-based patients with type 1 diabetes: the Fremantle Diabetes Study. Diabetes Res Clin Pract. 2007;78:412–417
  25. Kahn R, Buse J, Ferrannini E, Stern M. The metabolic syndrome: time for a critical appraisal: joint statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2005;28:2289–2304
  26. Pambianco G, Costacou T, Orchard TJ. The prediction of major outcomes of type 1 diabetes: a 12-year prospective evaluation of three separate definitions of the metabolic syndrome and their components and estimated glucose disposal rate: the Pittsburgh Epidemiology of Diabetes Complications Study experience. Diabetes Care. 2007;30:1248–1254
  27. Alexander CM, Landsman PB, Teutsch SM, Haffner SM. NCEP-defined metabolic syndrome, diabetes, and prevalence of coronary heart disease among NHANES III participants age 50 years and older. Diabetes. 2003;52:1210–1214
  28. McGill M, Molyneaux L, Twigg SM, Yue DK. The metabolic syndrome in type 1 diabetes: does it exist and does it matter?. J Diabetes Complications. 2008;22:18–23
  29. Pambianco G, Costacou T, Ellis D, Becker DJ, Klein R, Orchard TJ. The 30-year natural history of type 1 diabetes complications: the Pittsburgh Epidemiology of Diabetes Complications Study experience. Diabetes. 2006;55:1463–1469
  30. Colhoun HM, Otvos JD, Rubens MB, Taskinen MR, Underwood SR, Fuller JH. Lipoprotein subclasses and particle sizes and their relationship with coronary artery calcification in men and women with and without type 1 diabetes. Diabetes. 2002;51:1949–1956
  31. Levitan EB, Song Y, Ford ES, Liu S. Is nondiabetic hyperglycemia a risk factor for cardiovascular disease? A meta-analysis of prospective studies. Arch Intern Med. 2004;164:2147–2155
  32. Selvin E, Coresh J, Golden SH, Boland LL, Brancati FL, Steffes MW. Glycemic control, atherosclerosis, and risk factors for cardiovascular disease in individuals with diabetes: the atherosclerosis risk in communities study. Diabetes Care. 2005;28:1965–1973
  33. Schwimmer JB, Pardee PE, Lavine JE, Blumkin AK, Cook S. Cardiovascular risk factors and the metabolic syndrome in pediatric nonalcoholic fatty liver disease. Circulation. 2008;118:277–283
  34. van Vliet M, von Rosenstiel I, Schindhelm RK, Brandjes DP, Beijnen JH, Diamant M. Ethnic differences in cardiometabolic risk profile in an overweight/obese paediatric cohort in the Netherlands: a cross-sectional study. Cardiovasc Diabetol. 2009;8:2
  35. Hinderliter AL, Runge MS. Who's on first? Does hypertension in type I diabetics result from nephropathy or metabolic alterations?. Circulation. 2001;104:508–510
  36. Frontoni S, Bracaglia D, Gigli F. Relationship between autonomic dysfunction, insulin resistance and hypertension, in diabetes. Nutr Metab Cardiovasc Dis. 2005;15:441–449
  37. Schwab KO, Doerfer J, Krebs A, Krebs K, Schorb E, Hallermann K, et al. Early atherosclerosis in childhood type 1 diabetes: role of raised systolic blood pressure in the absence of dyslipidaemia. Eur J Pediatr. 2007;166:541–548
  38. Kershnar AK, Daniels SR, Imperatore G, Palla SL, Petitti DB, Pettitt DJ, et al. Lipid abnormalities are prevalent in youth with type 1 and type 2 diabetes: the SEARCH for Diabetes in Youth Study. J Pediatr. 2006;149:314–319
  39. Loredana MM, Neil DR, Toby PA, Acerini CL, Barrett TG, Cooper JD, et al. Prevalence of abnormal lipid profiles and the relationship with the development of microalbuminuria in adolescents with type 1 diabetes. Diabetes Care. 2009;32:658–663
  40. Nguyen S, McCulloch C, Brakeman P, Portale A, Hsu CY. Being overweight modifies the association between cardiovascular risk factors and microalbuminuria in adolescents. Pediatrics. 2008;121:37–45
  41. Petitti DB, Imperatore G, Palla SL, Daniels SR, Dolan LM, Kershnar AK, et al. Serum lipids and glucose control: the SEARCH for Diabetes in Youth study. Arch Pediatr Adolesc Med. 2007;161:159–165
  42. Purnell JQ, Hokanson JE, Marcovina SM, Steffes MW, Cleary PA, Brunzell JD. Effect of excessive weight gain with intensive therapy of type 1 diabetes on lipid levels and blood pressure: results from the DCCT. Diabetes Control and Complications Trial. JAMA. 1998;280:140–146
  43. White NH, Cleary PA, Dahms W, Goldstein D, Malone J, Tamborlane WV. Beneficial effects of intensive therapy of diabetes during adolescence: outcomes after the conclusion of the Diabetes Control and Complications Trial (DCCT). J Pediatr. 2001;139:804–812
  44. Ahmed ML, Connors MH, Drayer NM, Jones JS, Dunger DB. Pubertal growth in IDDM is determined by HbA1c levels, sex, and bone age. Diabetes Care. 1998;21:831–835
  45. Luna R, varez-Vazquez P, Hervas E, Casteras A, Perez ML, Paramo C, et al. The role of diabetes duration, pubertal development and metabolic control in growth in children with type 1 diabetes mellitus. J Pediatr Endocrinol Metab. 2005;18:1425–1431
  46. Rohrer T, Stierkorb E, Heger S, Karges B, Raile K, Schwab KO, et al. Delayed pubertal onset and development in German children and adolescents with type 1 diabetes: cross-sectional analysis of recent data from the DPV diabetes documentation and quality management system. Eur J Endocrinol. 2007;157:647–653

 The authors declare no conflicts of interest.

PII: S0022-3476(09)01246-3

doi: 10.1016/j.jpeds.2009.12.017

The Journal of Pediatrics
Volume 156, Issue 6 , Pages 923-929 , June 2010

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