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. 2008 Mar;93(3):735-42.
doi: 10.1210/jc.2007-2176. Epub 2007 Dec 18.

Prevalence and determinants of elevated apolipoprotein B and dense low-density lipoprotein in youths with type 1 and type 2 diabetes

John J Albers  1 , Santica M Marcovina, Giuseppina Imperatore, Beverly M Snively, Jeanette Stafford, Wilfred Y Fujimoto, Elizabeth J Mayer-Davis, Diana B Petitti, Catherine Pihoker, Larry Dolan, Dana M Dabelea
Affiliations

Prevalence and determinants of elevated apolipoprotein B and dense low-density lipoprotein in youths with type 1 and type 2 diabetes

John J Albers et al. J Clin Endocrinol Metab. 2008 Mar.

Abstract

Objective: The objective of the study was to assess the prevalence and determinants of elevated apolipoprotein B (apoB) and dense low-density lipoprotein (LDL) in United States youth with type 1 or type 2 diabetes.

Methods: We conducted cross-sectional analyses of apoB concentrations, LDL density, and prevalence of elevated apoB levels and dense LDL from the SEARCH for Diabetes in Youth study, a six-center U.S.-based study of youth with diabetes onset younger than 20 years of age (2657 with type 1 and 345 with type 2).

Results: Among youth with type 1 diabetes, 11% had elevated apoB (>or=100 mg/dl, 1.95 mm/liter), 8% had dense LDL (relative flotation rate<or=0.237), and 12% had elevated LDL-cholesterol (>or=130 mg/dl, 3.36 mm/liter). In contrast, among youth with type 2 diabetes, 36% had elevated apoB, 36% had dense LDL, but only 23% had elevated LDL-cholesterol. Dense LDL and apoB each increased with hemoglobin A1c in both types. Among type 1 diabetics in poor glycemic control (hemoglobin A1c>or=9.5%), 28% had elevated apoB, and 18% had dense LDL, whereas 72% of poorly controlled type 2 diabetics had elevated apoB and 62% had dense LDL.

Conclusions: In youth with type 1 diabetes, elevated apoB and dense LDL were not highly prevalent, whereas elevated apoB and dense LDL were common lipoprotein abnormalities in youth with type 2 diabetes. The prevalence of these risk factors substantially increased with poor glycemic control in both groups, stressing the importance of achieving and maintaining an optimal glucose control.

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Figures

Figure 1
Figure 1
Relationship of apoB with HbA1c in youth with T1 or T2 diabetes. Curves were determined using locally weighted regression smoothing (Loess).
Figure 2
Figure 2
Relationship of LDL Rf with HbA1c in youth with T1 or T2 diabetes. Curves were determined using locally weighted regression smoothing (Loess).
Figure 3
Figure 3
A, Mean lipoprotein cholesterol profiles after density gradient ultracentrifugation of plasma in youth with T1 or T2 diabetes. B, Difference plot of cholesterol profiles, T2 minus T1. Vertical bars are 95% CI for the differences.
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