Partial Clinical Remission Reduces Lipid-Based Cardiovascular Risk in Adult Patients With Type 1 Diabetes

Area of Science:

• Cardiology
• Endocrinology
• Metabolic Diseases

Background:

• Established atherosclerotic cardiovascular disease (ASCVD) risk factors are known for type 2 diabetes (T2D), but not for type 1 diabetes (T1D).
• The effect of partial clinical remission (PR) on short-term ASCVD risk in T1D remains unclear.
• Understanding early ASCVD risk phenotypes in T1D is crucial for preventative strategies.

Purpose of the Study:

• To investigate the impact of PR on the earliest ASCVD risk phenotype in adult T1D.
• To compare lipid phenotypes of T1D, T2D, and control groups using factor analysis.
• To stratify the T1D cohort into remitters and non-remitters based on PR criteria.

Main Methods:

• Study included 203 adults: 86 T2D, 77 T1D (49 remitters, 28 non-remitters), and controls.
• PR defined as insulin-dose adjusted HbA1c ≤9; obesity as BMI ≥30 kg/m².
• Factor analysis of seven lipid parameters (TC, LDL, HDL, non-HDL, TC/HDL, TG, TG/HDL) into two factors (TC*LDL and HDL*TG) explaining 90% of variance.

Main Results:

• Remitters showed similar TC/HDL and TG/HDL ratios to controls, unlike non-remitters.
• Non-remitters had significantly higher TC/HDL and lower TG/HDL compared to remitters.
• Factor analysis revealed a linear increase in dyslipidemia scores from controls to T2D, with remitters resembling controls and non-remitters resembling T2D.

Conclusions:

• Partial clinical remission in T1D is associated with a favorable early lipid profile.
• This favorable lipid phenotype in T1D remitters may indicate reduced long-term cardiovascular disease (CVD) risk.
• Findings highlight the importance of achieving PR in T1D for metabolic health and CVD prevention.