Prevalence of dyslipidemia in children and adolescents with diabetes mellitus type I

ABSTRACT

Dyslipidemia is frequently observed in patients with diabetes mellitus and has led to development of screening programs and intervention studies. Dyslipidemia has been identified as an important risk factor for coronary heart disease. 128 patients with type I diabetes attending a single pediatric endocrine clinic underwent anthropometric and biochemical assessment. Anthropometric measurements followed WHO criteria. Blood samples were analyzed for glycated hemoglobin [HbA1C], cholesterol [chol], triglycerides [TG], low density lipoprotein [LDL] and high density lipoprotein [HDL], and blood pressure was recorded. Patients' mean age was 12.6 +/- 4.1 years. Patients' mean age at the onset of diabetes was 7.1 +/- 2.8 years. Mean duration of diabetes was 6.9 +/- 3.2 years. 48.5% of patients had some form of dyslipidemia. 21.4% had isolated hypertriglyceridemia, 11.6% isolated hypercholesterolemia and 15.5% mixed hyperlipidemia. Factors associated with dyslipidemia included longer duration of diabetes, higher mean age, higher mean HbA1C [p 0.001]. Hypertriglyceridemia was more frequent in female patients and subjects with higher BMI [p<0.05]. The mean value of TG 199.9 +/- 74.1 mg/dl, TC 178.5 +/- 29 mg/dl and LDL 141.2 +/- 37 were significantly higher in patients with poor metabolic control [mean value of HbA1C 9.3 +/- 1.8] than the diabetic patients with better control [mean value of HbA1C 7.1 +/- 0.77], TG 156.8 +/- 55.9 mg/dl; TC 143.5 +/- 37.6 mg/dl and LDL 108 +/- 21.2. Our findings indicated that type I diabetic patients with poor metabolic control are at higher risk of developing dyslipidemia. However, given the well documented problems of lifestyle regulation and compliance in optimizing control especially in this age group, we need to develop alternative and simple interventional strategies to improve outcome. Monitoring of lipids should be extended and yearly screening of patients for dyslipidemia recommended