Document Type : Original Article
Authors
- . Neda Mostofizadeh
- . Mahin Hashemipour
- . Marjan Roostazadeh
- . Elham Hashemi‑Dehkordi
- . Armindokht Shahsanai 1
- . Mohsen Reisi 2
1 Community and Family Medicine Department, Isfahan University of Medical Sciences, Isfahan University of Medical Sciences
2 Pediatric Pulmonology, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
BACKGROUND: Type 1 diabetes mellitus (T1DM) and its related comorbidities are considered an
important health issue. This study aimed to evaluate the impact of glycemic control on lipid profile
variables in children with T1DM.
MATERIALS AND METHODS: This study included 274 children (≤19 years of age) with T1DM who
had referred to the outpatient clinics of endocrinology in Emam‑Hossein Hospital of Isfahan, Iran.
Based on American Diabetes Association criteria, patients were divided into two groups including
optimal glycemic control (OGC) and poor glycemic control (PGC). Mean lipid level and frequencies
of lipid profile abnormalities between the two studied groups were compared.
RESULTS: Mean age of the studied population was 13 ± 5.9 years and 133 (48.5%) were boys. A total
of 162 (59.1%) and 112 (40.9%) patients had PGC and OGC, respectively. Hypercholesterolemia was
the most common dyslipidemia in both groups (33 [29.1%] of OGC and 63 [39.1%] of PGC patients).
The frequency of high low‑density lipoprotein (LDL) was significantly higher in patients with PGC
than those with OCG (P = 0.007). The frequencies of hypercholesterolemia, hypertriglyceridemia,
and low levels of high‑density lipoprotein were also higher in PGC group, but did not reach the
significant threshold.
CONCLUSION: It is suggested that glycemic control is in association with lipid profile abnormality
in patients with T1DM. High LDL was significantly more frequent in patients with PGC than those
with OGC. It is recommended to investigate the role of glycemic control on other cardiometabolic
risk factors of T1DM patients. Our findings could be used for planning preventative strategies for
reducing T1DM‑related cardiovascular disease.
Keywords
- Maahs DM, West NA, Lawrence JM, Mayer‑Davis EJ.
Epidemiology of type 1 diabetes. Endocrinol Metab Clin North
Am 2010;39:481‑97.
2. Kelishadi R, Motlagh ME, Roomizadeh P, Abtahi SH, Qorbani M,
Taslimi M, et al. First report on path analysis for cardiometabolic
components in a nationally representative sample of pediatric
population in the Middle East and North Africa (MENA): The
CASPIAN‑III study. Ann Nutr Metab 2013;62:257‑65.
3. Tan T, Xiang Y, Chang C, Zhou Z. Alteration of regulatory T cells
in type 1 diabetes mellitus: A comprehensive review. Clin Rev
Allergy Immunol 2014;47:234‑43.
4. Krantz JS, Mack WJ, Hodis HN, Liu CR, Liu CH, Kaufman FR,
et al. Early onset of subclinical atherosclerosis in young persons
with type 1 diabetes. J Pediatr 2004;145:452‑7.
5. Lee SI, Patel M, Jones CM, Narendran P. Cardiovascular disease
and type 1 diabetes: Prevalence, prediction and management in
an ageing population. Ther Adv Chronic Dis 2015;6:347‑74.
6. Kim SH, Jung IA, Jeon YJ, Cho WK, Cho KS, Park SH, et al. Serum
lipid profiles and glycemic control in adolescents and young
adults with type 1 diabetes mellitus. Ann Pediatr Endocrinol
Metab 2014;19:191‑6.
7. Giuffrida FM, Guedes AD, Rocco ER, Mory DB, Dualib P,
Matos OS, et al. Heterogeneous behavior of lipids according to
hbA1c levels undermines the plausibility of metabolic syndrome
in type 1 diabetes: Data from a nationwide multicenter survey.
Cardiovasc Diabetol 2012;11:156.
8. Fatani SH, Babakr AT, NourEldin EM, Almarzouki AA. Lipid
peroxidation is associated with poor control of type‑2 diabetes
mellitus. Diabetes Metab Syndr 2016;10:S64‑7.
9. Mishra N, Singh N. Blood viscosity, lipid profile, and lipid
peroxidation in type‑1 diabetic patients with good and poor
glycemic control. N Am J Med Sci 2013;5:562‑6.
10. Feitosa AC, Feitosa‑Filho GS, Freitas FR, Wajchenberg BL,
Maranhão RC. Lipoprotein metabolism in patients with type 1
diabetes under intensive insulin treatment. Lipids Health Dis
2013;12:15.
11. Shamir R, Kassis H, Kaplan M, Naveh T, Shehadeh N. Glycemic
control in adolescents with type 1 diabetes mellitus improves
lipid serum levels and oxidative stress. Pediatr Diabetes
2008;9:104‑9.
12. Vaid S, Hanks L, Griffin R, Ashraf AP. Body mass index and
glycemic control influence lipoproteins in children with type 1
diabetes. J Clin Lipidol 2016;10:1240‑7.
13. Alberti KG, Zimmet PZ. Definition, diagnosis and classification
of diabetes mellitus and its complications. Part 1: Diagnosis and
classification of diabetes mellitus provisional report of a WHO
consultation. Diabet Med 1998;15:539‑53.
14. American Diabetes Association. Standards of medical care in
diabetes‑‑2014. Diabetes Care 2014;37 Suppl 1:S14‑80.
15. 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;29:218‑25.
16. al‑Naama LM, Kadhim M, al‑Aboud MS. Lipid profile in children
with insulin dependent diabetes mellitus. J Pak Med Assoc
2002;52:29‑34. - 17. Rahma S, Rashid JA, Farage AH. The significance of lipid
abnormalities in children with insulin dependent diabetes
mellitus. Iraqi Postgrad Med J 2006;5:289–94.
18. Zabeen B, Balsa AM, Islam N, Parveen M, Nahar J, Azad K, et al.
Lipid profile in relation to glycemic control in type 1 diabetes
children and adolescents in Bangladesh. Indian J Endocrinol
Metab 2018;22:89‑92.
19. Herman WH, Aubert RE, Engelgau MM, Thompson TJ, Ali MA,
Sous ES, et al. Diabetes mellitus in Egypt: Glycaemic control
and microvascular and neuropathic complications. Diabet Med
1998;15:1045‑51.
20. Kantoosh MM, Naiem AM, El‑Sayad M, Nashat M. Dyslipidemia
and lipid peroxidation in type 1 diabetic children with good
glycemic control: Response to antioxidant therapy. Alex J Pediatr
2002;16:357–64.
21. van Vliet M, van der Heyden JC, Diamant M, von Rosenstiel IA,
Schindhelm RK, Heymans MW, et al. Overweight children
with type 1 diabetes have a more favourable lipid profile than
overweight non‑diabetic children. Eur J Pediatr 2012;171:493‑8.
22. Guy J, Ogden L, Wadwa RP, Hamman RF, Mayer‑Davis EJ,
Liese AD, et al. Lipid and lipoprotein profiles in youth with and
without type 1 diabetes: The SEARCH for diabetes in youth
case‑control study. Diabetes Care 2009;32:416‑20.
23. Maahs DM, Wadwa RP, McFann K, Nadeau K, Williams MR,
Eckel RH, et al. Longitudinal lipid screening and use of
lipid‑lowering medications in pediatric type 1 diabetes. J Pediatr
2007;150:146‑50, 150.e1‑2.
24. 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;353:2643‑53.
25. Delamater A. Clinical use of hemoglobin A1c to improve diabetes
management. Clin Diabetes 2006;24:6‑8.
26. American Association of Clinical Endocrinologists. The American
Association of Clinical Endocrinologists medical guidelines for the
management of diabetes mellitus: The AACE system of intensive
diabetes self‑management‑2000 update. Endocr Pract 2000;6:43‑84.
27. Hoerger TJ, Segel JE, Gregg EW, Saaddine JB. Is glycemic control
improving in U.S. Adults? Diabetes Care 2008;31:81‑6.
28. Spellman CW. Achieving glycemic control: Cornerstone in the
treatment of patients with multiple metabolic risk factors. J Am
Osteopath Assoc 2009;109:S8‑13.