Mechanisms and early patterns of dyslipidemia in pediatric type 1 and type 2 diabetes
Department of Pediatrics, Division of Endocrinology; Department of Population and Quantitative Health Sciences
Cardiovascular Diseases | Endocrine System Diseases | Endocrinology, Diabetes, and Metabolism | Immune System Diseases | Lipids | Nutritional and Metabolic Diseases | Pediatrics
Objectives: The is no consensus on the early patterns of lipid-based cardiovascular disease (CVD) risk in youth with either type 1 diabetes (T1D) or type 2 diabetes (T2D). The aim was to determine the differences in CVD risk, using lipid profiles, in children and adolescents with either T1D or T2D at the time of their first lipid assessment, after stratifying the T1D cohort into remitters and non-remitters based on their honeymoon history.
Methods: A cross-sectional study of 249 subjects consisting of 73 controls, 53 T2D subjects, and 123 T1D subjects stratified into remitters (n=44), and non-remitters (n=79). Partial clinical remission (PCR) was defined as insulin-dose adjusted HbA1c of < /=9. Pubertal status was determined by Tanner staging.
Results: After adjusting for age, sex, BMI, race, and pubertal status, T2D patients had significantly higher LDL-C compared to the controls (p=0.022), the remitters (p=0.029), but not the non-remitters (103.1 +/- 5.9 mg/dL vs. 91.4 +/- 4.2 mg/dL, p=0.49). Similarly, T2D patients had significantly higher non-HDL-C compared to the controls (p=0.006), the remitters (p=0.0002), but not the non-remitters (137.6 +/- 7.1 mg/dL vs. 111.71 +/- 5.0 mg/dL, p=0.053). Total cholesterol was also significantly higher in T2D patients compared to the controls (p=0.0005), the remitters (p=0.006) but not the non-remitters (183.5 +/- 6.6 mg/dL vs. 166.2 +/- 4.8 mg/dL, p=0.27).
Conclusions: Lack of the honeymoon phase in children and adolescents with T1D confers early and significantly increased lipid-based cardiovascular risk to these patients that is similar to the elevated cardiovascular risk seen in T2D.
cardiovascular disease risk, children, dyslipidemia, honeymoon phase, type 1 diabetes, type 2 diabetes
DOI of Published Version
Nwosu BU, Villalobos-Ortiz TR, Jasmin GA, Parajuli S, Zitek-Morrison E, Barton BA. Mechanisms and early patterns of dyslipidemia in pediatric type 1 and type 2 diabetes. J Pediatr Endocrinol Metab. 2020 Nov 26;33(11):1399-1408. doi: 10.1515/jpem-2020-0220. PMID: 33027052. Link to article on publisher's site
Journal of pediatric endocrinology and metabolism : JPEM
Nwosu BU, Villalobos-Ortiz TR, Jasmin G, Parajuli S, Zitek-Morrison E, Barton BA. (2020). Mechanisms and early patterns of dyslipidemia in pediatric type 1 and type 2 diabetes. Population and Quantitative Health Sciences Publications. https://doi.org/10.1515/jpem-2020-0220. Retrieved from https://escholarship.umassmed.edu/qhs_pp/1383