Glucose Control Predicts 2-Year Change in Lipid Profile in Youth with Type 1 Diabetes
Published Date:Jul 11 2012
Source:J Pediatr. 2012; 162(1).
Pubmed Central ID:PMC3807690
Funding:1U18DP002709/DP/NCCDPHP CDC HHS/United States
1UL1RR026314-01/RR/NCRR NIH HHS/United States
K23 DK075360/DK/NIDDK NIH HHS/United States
M01 RR00069/RR/NCRR NIH HHS/United States
M01RR00037/RR/NCRR NIH HHS/United States
P30 DK048520/DK/NIDDK NIH HHS/United States
P30 DK57516/DK/NIDDK NIH HHS/United States
U01 DP000246/DP/NCCDPHP CDC HHS/United States
U01 DP000247/DP/NCCDPHP CDC HHS/United States
U01 DP000248/DP/NCCDPHP CDC HHS/United States
U01 DP000250/DP/NCCDPHP CDC HHS/United States
U01DP000245/DP/NCCDPHP CDC HHS/United States
U18DP000247-06A1/DP/NCCDPHP CDC HHS/United States
U18DP002714/DP/NCCDPHP CDC HHS/United States
U48/CCU519239/PHS HHS/United States
U48/CCU819241-3/PHS HHS/United States
U48/CCU919219/PHS HHS/United States
U58/CCU919219/PHS HHS/United States
U58CCU919256/PHS HHS/United States
UL1 TR000077/TR/NCATS NIH HHS/United States
UL1RR029882/RR/NCRR NIH HHS/United States
To test the hypothesis that a change in A1c over a follow-up interval of approximately 2 years would be associated with concomitant changes in fasting lipids in individuals with type 1 diabetes (T1D).
All subjects with T1D diagnosed 2002–2005 in the SEARCH for Diabetes in Youth study with at least two study visits approximately 12 and 24-months after an initial visit were included (age at initial visit=10.6±4.1 years, 48% female, diabetes duration=10±7 months, 76% non-Hispanic White, A1c=7.7±1.4%). Longitudinal mixed models were fit to examine the relationship between change in A1c and change in lipid levels (total cholesterol [TC], high-density lipoprotein-cholesterol [HDL-c], low-density lipoprotein-cholesterol [LDL-c], log triglycerides [TG], and non-high-density lipoprotein-cholesterol [non-HDL-c]) with adjustment for possible confounders.
Change in A1c over time was significantly associated with changes in TC, HDL-c, LDL-c, TG, and non-HDL-c over the range of A1c values. For example, for a person with an A1c of 10% and then a 2% decrease in A1c 2-years later (to 8%), the model predicted concomitant changes in TC (−0.29 mmol/l, −11.4 mg/dl), HDL-c (0.03 mmol/l, 1.3 mg/dl), LDL-c (−0.23 mmol/l, −9.0 mg/dl), and non-HDL-c (−0.32 mmol/l, −12.4 mg/dl), and an 8.5% decrease in TG (mmol/l).
Improved glucose control over a 2-year follow-up was associated with a more favorable lipid profile, but may be insufficient to normalize lipids in dyslipidemic T1D youth needing to decrease lipids to goal.
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