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Risk factors for cardiovascular disease in children with Type I diabetes
T H Lipman1, L L Hayman, C V Fabian
1University of Pennsylvania School of Nursing, St. Christopher's Hospital for Children, Philadelphia, USA.
Insights
Children with Type I diabetes (IDDM) show high rates of hypercholesterolemia, a key predictor of cardiovascular disease (CVD). Good diabetes control and physical activity are linked to better cholesterol levels in at-risk youth.
Area of Science:
- Pediatric Endocrinology
- Cardiovascular Disease Research
- Metabolic Disorders
Background:
- Type I insulin-dependent diabetes mellitus (IDDM) significantly increases the risk of premature atherosclerotic cardiovascular disease (CVD).
- Cardiovascular disease is a leading cause of morbidity and mortality in individuals with IDDM.
Purpose of the Study:
- To determine the prevalence and predictors of hypercholesterolemia in children with IDDM.
- To examine the distribution and interrelationship of cardiovascular disease (CVD) risk factors in this population.
Main Methods:
- An observational, mixed-longitudinal epidemiological study involving 140 children with IDDM.
- Measurement of total cholesterol (TC) and diabetes control in all participants.
- Assessment of standard CVD risk factors in a subsample of 67 children.
Main Results:
- A significantly higher than expected frequency of elevated total cholesterol (TC) was observed (TC > 75th percentile, p < 0.01; TC > 95th percentile, p < 0.0001).
- No overall association between TC and CVD risk factors was found in the total sample.
- In the highest-risk subsample, diabetes control and physical activity were correlated with TC, indicating hypercholesterolemia.
Conclusions:
- Assessing lipid profiles is crucial for children with IDDM.
- Monitoring CVD risk factors in hyperlipidemic children with IDDM is essential.
- Future research should involve longitudinal studies in diverse pediatric IDDM populations.
Background:
The major cause of morbidity and mortality in individuals with Type I insulin-dependent diabetes mellitus (IDDM) is premature and extensive atherosclerotic cardiovascular disease (CVD).
Objectives:
To determine the prevalence and predictors of hypercholesterolemia and to examine the distribution and interrelationship of risk factors for CVD.
Methods:
This observational (mixed-longitudinal) study, guided by an epidemiologic framework, assessed a sample of 140 children with IDDM. Total cholesterol (TC) and diabetes control were measured in the total sample. Standard CVD risk factors were measured in a subsample of 67 children.
Results:
Observed frequency of TC greater than the 75th percentile and greater than the 95th percentile was significantly more than expected (p < 0.01 and p < 0.0001, respectively). In the total sample, TC-CVD risk factor associations were not observed. However, diabetes control and physical activity were correlated with TC in the risk sample of children at highest risk, as demonstrated by hypercholesterolemia.
Conclusions:
Results demonstrate the importance of assessing the lipid profile in children with IDDM and monitoring CVD risk factors in hyperlipidemic children with IDDM. Future research should focus on prospective longitudinal studies in population-based multiethnic samples of children with IDDM.