The association of low-density lipoprotein cholesterol with elevated arterial stiffness in adolescents and young adults with type 1 and type 2 diabetes: The SEARCH for Diabetes in Youth study

Details

• Alternative Title:
  Pediatr Diabetes
• Personal Author:
  Gourgari, Evgenia ; Stafford, Jeanette M. ; D’Agostino, Ralph ; Dolan, Lawrence M. ; Lawrence, Jean M. ; Marcovina, Santica ; Merjaneh, Lina ; Mottl, Amy K. ; Shah, Amy S. ; Dabelea, Dana
• Description:
  Aim:
  
  Our aim was to explore the relationship of Low-Density Lipoprotein Cholesterol (LDL-C) with subclinical cardiovascular disease (CVD) in youth with T1D and T2D. We hypothesized the association of LDL-C with elevated arterial stiffness (AS) would be partially accounted by the co-occurrence of other CVD factors.
  
  Method:
  
  We included 1376 youth with T1D and 157 with T2D from the SEARCH study. CVD risk factors including LDL-C, waist to height ratio (WHtR), mean arterial pressure (MAP), HbA1c, albumin to creatinine ratio (ACR), and insulin sensitivity (IS) score were measured at both visits. At follow up, elevated carotid-femoral AS was defined as levels above 6.8 m/s. Multivariable logistic regression evaluated the odds of elevated AS as a function of the average CVD risk factors.
  
  Results:
  
  At follow up, age was 18.0 ± 4.1 and 21.6 ± 3.5 years and duration of diabetes was 7.8 ± 1.9 and 7.7 ± 1.9 years in T1D and T2D, respectively. Elevated AS was found in 8.4% of T1D and 49.0% of T2D participants. Each SD increase in LDL-C was associated with 1.28 increased odds (95% CI 1.05–1.54, P = .013) of elevated AS in youth with T1D. The association was similar but not statistically significant in T2D. WHtR, IS, and MAP were associated with elevated AS in both groups. Adjustment for WHtR or IS attenuated to non-significance the relationship between LDL-C and AS in T1D.
  
  Conclusions:
  
  Obesity and insulin resistance attenuate the association of high LDL-C with AS suggesting they partially account for the adverse effects of LDL-C on cardiovascular health in youth with T1D.
  
  
• Subjects:
  Adolescent Adolescents Adult Age Factors Age Of Onset Article AS Cardiovascular Disease Cardiovascular Diseases Cholesterol Cholesterol, LDL Cohort Studies Diabetes Mellitus, Type 1 Diabetes Mellitus, Type 2 Diabetic Angiopathies Glycated Hemoglobin A Heart Disease Risk Factors Humans Insulin Resistance Low-density Lipoprotein Cholesterol Obesity Type 1 Diabetes Type 2 Diabetes United States Vascular Stiffness Young Adult

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• Source:
  Pediatr Diabetes. 21(5):863-870
• Pubmed ID:
  32304144
• Pubmed Central ID:
  PMC7709736
• Document Type:
  Journal Article
• Funding:
  P30 DK057516/DK/NIDDK NIH HHSUnited States/ ; U18 DP002710/DP/NCCDPHP CDC HHSUnited States/ ; U18DP006138/ACL/ACL HHSUnited States/ ; UL1 TR000154/TR/NCATS NIH HHSUnited States/ ; U01 DP000244/DP/NCCDPHP CDC HHSUnited States/ ; UL1 TR000062/TR/NCATS NIH HHSUnited States/ ; U18 DP002709/DP/NCCDPHP CDC HHSUnited States/ ; U18DP006131/ACL/ACL HHSUnited States/ ; U18 DP006131/DP/NCCDPHP CDC HHSUnited States/ ; HIR 10-001/HX/HSRD VAUnited States/ ; U18DP006139/ACL/ACL HHSUnited States/ ; UC4 DK108173/DK/NIDDK NIH HHSUnited States/ ; U01 DP000247/DP/NCCDPHP CDC HHSUnited States/ ; U18 DP006139/DP/NCCDPHP CDC HHSUnited States/ ; U18 DP002714/DP/NCCDPHP CDC HHSUnited States/ ; UL1 TR001409/TR/NCATS NIH HHSUnited States/ ; KL2 TR001432/TR/NCATS NIH HHSUnited States/ ; U01 DP000248/DP/NCCDPHP CDC HHSUnited States/ ; U18 DP006136/DP/NCCDPHP CDC HHSUnited States/ ; U18DP006134/ACL/ACL HHSUnited States/ ; U18 DP006138/DP/NCCDPHP CDC HHSUnited States/ ; UL1 TR001425/TR/NCATS NIH HHSUnited States/ ; UL1 TR002319/TR/NCATS NIH HHSUnited States/ ; UL1 TR000077/TR/NCATS NIH HHSUnited States/ ; U18 DP006134/DP/NCCDPHP CDC HHSUnited States/ ; R01 DK127208/DK/NIDDK NIH HHSUnited States/ ; UL1 TR000423/TR/NCATS NIH HHSUnited States/ ; U18DP006136/ACL/ACL HHSUnited States/ ; UL1 TR001450/TR/NCATS NIH HHSUnited States/ ; U01 DP000250/DP/NCCDPHP CDC HHSUnited States/ ; U18 DP006133/DP/NCCDPHP CDC HHSUnited States/ ; U01 DP000246/DP/NCCDPHP CDC HHSUnited States/ ; U01 DP000254/DP/NCCDPHP CDC HHSUnited States/ ; U18DP006133/ACL/ACL HHSUnited States/ ; U18 DP002708/DP/NCCDPHP CDC HHSUnited States/
• Volume:
  21
• Issue:
  5
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:a1c22f99af3161acddb5561099f3ba9f4dbef4bd56e693bb689873900cf794c9
• Download URL:
  https://stacks.cdc.gov/view/cdc/98091/cdc_98091_DS1.pdf
• File Type:
  [PDF - 87.18 KB ]