Division of Endocrinology, Department of Pediatrics; Department of Quantitative Health Sciences
Endocrine System Diseases | Endocrinology, Diabetes, and Metabolism | Lipids | Pediatrics | Reproductive and Urinary Physiology
Importance: The physiologic changes in lipids during puberty in type 1 diabetes (T1D) is unclear as subjects in previous studies were not stratified by partial clinical remission (PCR) status.
Aim: To determine the effect of PCR on lipid changes during puberty in youth with T1D.
Subjects and Methods: A retrospective cross-sectional study of 194 subjects consisting of 71 controls of age 12.9±1.3y and 123 subjects with T1D stratified into remitters (n=44, age 13.0±0.8y) and non-remitters (n=79, age 11.2±0.6y). PCR was defined as insulin-dose adjusted HbA1c of ≤9. Pubertal status was determined by Tanner staging.
Results: Among the pubertal cohort, low-density lipoprotein cholesterol concentration was significantly higher in the non-remitters compared to the remitters, 91.1±25.6mg/dL vs 77.2±25.8mg/dL, p=0.018; and the normal-weight controls, 91.1±25.6mg/dL vs 70.4±22.9 mg/dL, p=0.009; but was similar between the overweight/obese controls and non-remitters, 89.7±28.9mg/dL vs 91.1± 25.6mg/dL, p=0.81, and similarly between the normal-weight controls and remitters, 70.4±22.9mg/dL vs 77.2±25.8mg/dL, p=0.39. Total cholesterol was also significantly higher in the non-remitters compared to the remitters, 167.8±30.5 mg/dL vs 149.8±32.1mg/dL, p=0.012; and normal-weight controls, 167.8±30.5mg/dL vs 143.2±30.1mg/dL, p=0.011; but similar between the non-remitters and overweight/obese controls, p=0.098; and remitters and normal-weight controls, p=0.51. Non-HDL cholesterol was equally significantly higher in non-remitters compared to remitters, 111.3±30.1mg/dL vs 95.9±29.1mg/dL, p=0.028; and normal-weight controls, 111.3±30.1mg/dL vs 86.2± 32.2mg/dL, p=0.028; but similar between non-remitters and overweight/obese controls, p=0.48; and remitters versus normal-weight controls, p=0.39.
Conclusions: Puberty-related reductions in LDL, TC, and non-HDL occur in remitters and normal-weight controls, but not in non-remitters and overweight/obese controls.
type 1 diabetes, children, partial clinical remission, honeymoon phase, cardiovascular disease risk, dyslipidemia
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Copyright 2019. This article has been published under the terms of the Creative Commons Attribution Non-Commercial, No-Derivatives License (CC BY-NC-ND; https://creativecommons.org/licenses/by-nc-nd/4.0/).
DOI of Published Version
This is the authors' final, peer-reviewed version of the article as prepared for publication in: Benjamin Udoka Nwosu, Shwetha Rupendu, Emily Zitek-Morrison, Deepa Patel, Tony R Villalobos-Ortiz, Gabrielle Jasmin, Bruce A Barton, Pubertal lipid levels are significantly lower in youth with type 1 diabetes who experienced partial clinical remission, Journal of the Endocrine Society, https://doi.org/10.1210/js.2019-00016
Journal of the Endocrine Society
Nwosu, Benjamin U.; Rupendu, Shwetha; Zitek-Morrison, Emily; Patel, Deepa; Villalobos-Ortiz, Tony R.; Jasmin, Gabrielle; and Barton, Bruce A., "Pubertal lipid levels are significantly lower in youth with type 1 diabetes who experienced partial clinical remission" (2019). Endocrinology/Diabetes. 64.
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.