Dyslipidemia and cardiovascular disease risk factors in patients with type 1 diabetes: A single-center experience

Abstract

Background: Type 1 diabetes (T1D) contributes to altered lipid profiles and increases the risk of cardiovascular disease (CVD). Youth with T1D may have additional CVD risk factors within the first decade of diagnosis.

Aim: To examine risk factors for dyslipidemia in young subjects with T1D.

Methods: Longitudinal and cross-sectional retrospective study of 170 young subjects with T1D (86 males; baseline mean age 12.2 ± 5.6 years and hemoglobin A1c 8.4% ± 1.4%) were followed in a single tertiary diabetes center for a median duration of 15 years. Predictors for outcomes of lipid profiles at last visit (total cholesterol [TC], triglycerides [TGs], low-density lipoprotein-cholesterol [LDL-c], and high-density lipoprotein-cholesterol [HDL-c]) were analyzed by stepwise linear regression models.

Results: At baseline, 79.5% of the patients had at least one additional CVD risk factor (borderline dyslipidemia/dyslipidemia [37.5%], pre-hypertension/hypertension [27.6%], and overweight/obesity [16.5%]) and 41.6% had multiple (≥ 2) CVD risk factors. A positive family history of at least one CVD risk factor in a first-degree relative was reported in 54.1% of the cohort. Predictors of elevated TC: family history of CVD (β[SE] = 23.1[8.3], P = 0.006); of elevated LDL-c: baseline diastolic blood pressure (DBP) (β[SE] = 11.4[4.7], P = 0.003) and family history of CVD (β[SE] = 20.7[6.8], P = 0.017); of elevated TGs: baseline DBP (β[SE] = 23.8[9.1], P = 0.010) and family history of CVD (β[SE] = 31.0[13.1], P = 0.020); and of low HDL-c levels: baseline DBP (β[SE] = 4.8[2.1], P = 0.022]).

Conclusion: Our findings suggest that elevated lipid profiles are associated with DBP and a positive family history of CVD. It is of utmost importance to prevent and control modifiable risk factors such as these, as early as childhood, given that inadequate glycemic control and elevation in blood pressure intensify the risk of dyslipidemia.

Keywords: Cardiovascular disease risk factors; Children and adolescents; Dyslipidemia; Family history of cardiovascular disease risk factors; Hypertension; Type 1 diabetes.

Figure 1

Number and distribution of multiple cardiovascular disease risk factors (overweight/obesity, pre-hypertension/hypertension, dyslipidemia [elevated low-density lipoprotein-cholesterol/elevated triglyceride/low high-density lipoprotein-cholesterol] and positive family history for cardiometabolic diseases) categorized by sex in childhood and adolescence. No significant differences between males and females (P = 0.210). Bar graphs in black represent the entire cohort, males in white, and females in gray.

Figure 2

Number and distribution of multiple cardiovascular disease risk factors (overweight/obesity, pre-hypertension/hypertension, dyslipidemia [elevated low-density lipoprotein-cholesterol/elevated triglyceride/low high-density lipoprotein-cholesterol] and positive family history for cardiometabolic diseases) categorized by sex at young adulthood. No significant differences between males and females (P = 0.275). Bar graphs in black represent the entire cohort, males in white and females in gray.