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Published on: July 5, 2022
Cardiovascular risk factors in children and adolescents with type 1 diabetes in Italy: a multicentric observational
Elena Fornari1, Claudia Piona1, Ivana Rabbone2
1Pediatric Diabetes and Metabolic Disorders Unit, University of Verona, Verona, Italy.
Insights
Over 30% of children and adolescents with Type 1 Diabetes have cardiovascular risk factors (CVRFs). Inadequate physical activity and high HbA1c levels are linked to increased CVRF prevalence, necessitating early detection and intervention.
Area of Science:
- Pediatric Endocrinology
- Cardiovascular Health
- Metabolic Disorders
Background:
- Type 1 Diabetes (T1D) management requires monitoring for cardiovascular risk factors (CVRFs) in pediatric populations.
- Early identification of CVRFs is crucial for preventing long-term cardiovascular complications in youth with T1D.
Purpose of the Study:
- To determine the prevalence of CVRFs in a large cohort of children and adolescents with T1D.
- To identify factors associated with the presence of CVRFs in this population.
Main Methods:
- A cohort of 2021 subjects aged 2-18 years with T1D was studied across 17 Italian centers.
- Data collected included anthropometrics, blood pressure, HbA1c, lipid profile, physical activity, and socio-economic status.
- Binary logistic regression analyzed associations between CVRFs and variables like age, disease duration, gender, HbA1c, and physical activity.
Main Results:
- 32.5% of subjects had one CVRF, 6.7% had two, and 0.6% had three, with no significant age-group differences.
- Elevated HbA1c and insufficient physical activity were associated with a higher likelihood of having at least one major CVRF.
- The association varied by age group, with physical activity being significant in younger children and HbA1c in older adolescents.
Conclusions:
- More than 30% of pediatric T1D patients exhibit at least one major CVRF.
- Early screening for CVRFs is recommended to guide therapeutic interventions and mitigate cardiovascular risk.
- Targeted interventions focusing on glycemic control and physical activity are essential for this vulnerable group.
Aims:
To assess the prevalence of cardiovascular risk factors (CVRFs) and to identify the variables associated with CVRFs in a cohort of children and adolescents with Type 1 Diabetes.
Methods:
2021 subjects, 2-18 year-old, were recruited in 17 Italian Pediatric Diabetes Centers. Anthropometric, blood pressure, biochemical (HbA1c, lipid profile, ACR), insulin therapy, physical activity level, smoking and family socio-economic status data were collected. CVRFs prevalence and their distribution were analyzed according to age and binary logistic regression was performed with positivity for at least one major CVRF (BMI-SDS > +2SD, blood pressure > 90th percentile, LDL cholesterol>100 mg/dL) as dependent variable and age, duration of illness, gender, HbA1c and physical activity, as independent variables.
Results:
The prevalence of CVFRs not at the recommended target was respectively: 32.5% one CVRF, 6.7% two CVRFs and 0.6% three CVRFs, with no significant differences across the 3 age groups (2-10, 10-15, 15-18 years). In the total sample, HbA1c and inadequate physical activity were associated with a higher probability of having at least one major CVRF. This probability was associated with physical activity in the 2-10-year-old group, with physical activity and HbA1c in the 10-15-year-old group and with HbA1c only in subjects older than 15 years.
Conclusions:
More than 30% of subjects had at least a major CVRF. Early detection of CVRFs may be useful to enforce the therapeutic intervention in this subgroup, in order to reduce the risk to develop cardiovascular complications.
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