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Published on: February 28, 2013
[Cardiovascular risk factors in children with type 1 diabetes and their relationship with the glycemic control]
Adela V Abregu1, Teresita del R Carrizo, Maria M Prado
1Cátedra de Práctica Hospitalaria, Facultad de Bioquímica, Química y Farmacia, Universidad Nacional de Tucumán. vabregu@arnet.com.ar
Insights
Children with type 1 diabetes have higher cardiovascular disease risks. Poor glycemic control in pediatric diabetics is linked to dyslipidemia and elevated fibrinogen, emphasizing early detection and strict metabolic management.
Area of Science:
- Pediatrics
- Endocrinology
- Cardiology
Context:
- Type 1 diabetes (T1D) significantly increases cardiovascular disease (CVD) risk in children.
- Pediatric T1D management requires understanding associated cardiovascular risk factors.
- Glycemic control is a critical determinant of long-term health outcomes in diabetic children.
Purpose:
- To assess cardiovascular risk factors in children with T1D.
- To investigate the association between glycemic control and CVD risk markers.
- To compare risk factors between well-controlled and poorly controlled diabetic children and healthy controls.
Summary:
- Diabetic children (5-15 years) exhibited elevated total cholesterol, LDL-cholesterol, and HDL-cholesterol compared to controls.
- Eighty-three percent of diabetic children had poor glycemic control (HbA1c ≥ 8%).
- Poor glycemic control correlated with higher plasma fibrinogen levels, while lipid profiles showed minimal differences except for HDL-cholesterol.
Impact:
- Identifies dyslipidemia and hyperglycemia as primary CVD risk factors in pediatric T1D.
- Highlights the need for early screening of cardiovascular risk markers in diabetic children.
- Underscores the importance of stringent metabolic control to mitigate CVD risk in this population.
Abstract:
Diabetics have an increased risk of cardiovascular disease (CVD). The objective of this work was to evaluate the cardiovascular risk factors in infant-juvenile type 1 diabetics and their association with the degree of glycemic control. A total of 52 patients, aged 5-15 years, were studied and compared with 37 control subjects. The degree of glycemic control, lipid profile, plasma fibrinogen, microalbuminuria and blood pressure were investigated. The patients were grouped in diabetics with good glycemic control [DGGC, glycosilated hemoglobin (HbA1c) < 8%] and poor glycemic control [DPGC, HA1c > or = 8%]. Diabetic patients presented incremented values of total cholesterol (4.1 +/- 0.9 vs. 3.1 +/- 0.7 mmol/l, p = 0.0008), LDL-cholesterol (2.4 +/- 0.9 vs. 1.7 +/- 0.7 mmol/l, p = 0.0001), HDL-cholesterol (1.2 +/- 0.3 vs. 1.0 +/- 0.2 mmol/l, p = 0.0002), with respect to control group. Eighty three per cent of diabetics showed a poor glycemic control. There were not significant differences in lipid profile between DGGC and DPGC, excepting HDL-cholesterol which was higher in DPGC group (p = 0.007). Plasma fibrinogen levels were similar in diabetics and controls, but they were higher in DPGC than in DGGC (265 +/- 46 vs. 229 +/- 22 mg/dl, p = 0.02). Three patients with microalbuminuria and none with hypertension were detected. In these patients the most pronounced risk factors for CVD were dyslipidemia and hyperglycemia, which justify the need for the early detection of these factors as well as strict metabolic control.
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