Pediatr Diabetes

Objective Dyslipidemia contributes to the increased risk of cardiovascular disease in persons with type 1 diabetes (T1D). Weight control is commonly recommended as a treatment for dyslipidemia. However, the extent to which decreases in weight affect the lipid profile in youth with T1D is not known. Therefore, we tested the hypothesis that decreases in BMI-z score (BMIz) were associated with concomitant changes in the lipid profile in youth with T1D. Study Design We studied 1142 youth with incident T1D who had at least 2 fasting lipid measurements over 2 years (initial visit mean: age=10.8±3.9 years, BMIz=0.55±0.97, T1D duration=10.7±7.6 months; 47.5% female, 77.9% non-Hispanic white) in the SEARCH for Diabetes in Youth study. Longitudinal mixed models were used to examine the relationships between changes in BMIz and changes in total, LDL-C, HDL-C, non-HDL cholesterol, and log triglycerides adjusted for initial age, sex, race/ethnicity, clinical site, season of study visit, T1D duration and glycated hemoglobin (HbA1c). Results We found that over 2 years all lipid levels, except LDL-C, increased significantly (p<0.05). Decreases in BMIz were associated with favorable changes in HDL-C and TG only and the magnitude of these changes depended on the initial BMIz value (interaction p<0.05), so that greater improvements are seen in those with higher BMIz. Conclusions Our data suggest that weight loss may be an effective, but limited, therapeutic approach for dyslipidemia in youth with T1D.

25099744

PMC4320680

CDC Public Access