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Exp Clin Endocrinol Diabetes 2021; 129(07): 510-518
DOI: 10.1055/a-0950-9677
Article

Losing Track of Lipids in Children and Adolescents with Type 1 Diabetes: Towards Individualized Patient Care

Josine C. van der Heyden
1   Diabeter, Center for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, The Netherlands
2   Department of Pediatrics, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands
,
Erwin Birnie
1   Diabeter, Center for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, The Netherlands
3   Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
,
Sarah A. Bovenberg
1   Diabeter, Center for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, The Netherlands
,
Pim Dekker
1   Diabeter, Center for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, The Netherlands
,
Henk J. Veeze
1   Diabeter, Center for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, The Netherlands
,
Dick Mul
1   Diabeter, Center for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, The Netherlands
,
Henk-Jan Aanstoot
1   Diabeter, Center for Pediatric and Adolescent Diabetes Care and Research, Rotterdam, The Netherlands
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Abstract

Aim To assess 1) the prevalence of children and adolescents with type 1 diabetes (T1D) changing from low-risk into borderline-high-risk lipid levels or from borderline-high-risk into high-risk lipid levels (‘lose track of lipids’) and 2) the power of a risk score including the determinants HbA1c, body mass index (BMI), gender, age, diabetes duration and ethnicity in predicting which patients lose track of lipids.

Methods 651 children and adolescents with T1D were included in this longitudinal retrospective cohort study. Lipid dynamics and the impact of the risk score on losing track of lipids were evaluated. Kaplan-Meier analysis was used to estimate screening intervals.

Results 31–43% percent of the patients had lost track of one or more lipids at the next lipid measurement. This happened more frequently in patients with a low-risk lipid level at start. Depending on the lipid parameter, 5% of patients with low-risk lipid levels lost track of lipids after 13–23 months. The risk score based on concomitant information on the determinants was moderately able to predict which patients would lose track of lipids on the short term.

Conclusions A considerable number of children and adolescents with T1D loses track of lipids and does so within a 2-year screening interval. The predictive power of a risk score including age, BMI, gender, HbA1c, diabetes duration and ethnicity is only moderate. Future research should focus on another approach to the determinants used in this study or other determinants predictive of losing track of lipids on the short term.

Key words

type 1 diabetes - children - dyslipidemia - HbA1c - longitudinal

Supplementary Material



Publication History

Received: 14 January 2019
Received: 24 May 2019

Accepted: 05 June 2019

Article published online:
04 July 2019

© 2019. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Livingstone SJ, Looker HC, Hothersall EJ. et al. Risk of cardiovascular disease and total mortality in adults with type 1 diabetes: Scottish registry linkage study. PLoS Med 2012; 9: e1001321
    CrossrefPubMedGoogle Scholar
  • 2 Lind M, Svensson AM, Kosiborod M. et al. Glycemic control and excess mortality in type 1 diabetes. N Engl J Med 2014; 371: 1972-1982
    CrossrefPubMedGoogle Scholar
  • 3 Cohen JC, Boerwinkle E, Mosley Jr. TH. et al. Sequence variations in PCSK9, low LDL, and protection against coronary heart disease. N Engl J Med 2006; 354: 1264-1272
    CrossrefPubMedGoogle Scholar
  • 4 McGill Jr. HC, McMahan CA, Gidding SS. Preventing heart disease in the 21st century: Implications of the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) study. Circulation 2008; 117: 1216-1227
    CrossrefPubMedGoogle Scholar
  • 5 Maahs DM, Daniels SR, de Ferranti SD. et al. Cardiovascular disease risk factors in youth with diabetes mellitus: A scientific statement from the American Heart Association. Circulation 2014; 130: 1532-1558
    CrossrefPubMedGoogle Scholar
  • 6 Miller M, Ginsberg HN, Schaefer EJ. Relative atherogenicity and predictive value of non-high-density lipoprotein cholesterol for coronary heart disease. Am J Cardiol 2008; 101: 1003-1008
    CrossrefPubMedGoogle Scholar
  • 7 Maahs DM, Wadwa RP, McFann K. et al. Longitudinal lipid screening and use of lipid-lowering medications in pediatric type 1 diabetes. J Pediatr 2007; 150: 146-150 150 e141-142
    CrossrefPubMedGoogle Scholar
  • 8 Reh CM, Mittelman SD, Wee CP. et al. A longitudinal assessment of lipids in youth with type 1 diabetes. Pediatr Diabetes 2011; 12: 365-371
    CrossrefPubMedGoogle Scholar
  • 9 Edge JA, James T, Shine B. Longitudinal screening of serum lipids in children and adolescents with Type 1 diabetes in a UK clinic population. Diabet Med 2008; 25: 942-948
    CrossrefPubMedGoogle Scholar
  • 10 Maahs DM, Dabelea D, D'Agostino Jr. RB. et al. Glucose control predicts 2-year change in lipid profile in youth with type 1 diabetes. J Pediatr 2013; 162: 101-107 e101
    CrossrefPubMedGoogle Scholar
  • 11 Schwab KO, Doerfer J, Naeke A. et al. Influence of food intake, age, gender, HbA1c, and BMI levels on plasma cholesterol in 29,979 children and adolescents with type 1 diabetes--reference data from the German diabetes documentation and quality management system (DPV). Pediatr Diabetes 2009; 10: 184-192
    CrossrefPubMedGoogle Scholar
  • 12 Katz ML, Kollman CR, Dougher CE. et al. Influence of HbA1c and BMI on lipid trajectories in youths and young adults with type 1 diabetes. Diabetes Care 2017; 40: 30-37
    CrossrefPubMedGoogle Scholar
  • 13 Schwab KO, Doerfer J, Scheidt-Nave C. et al. Algorithm-based cholesterol monitoring in children with type 1 diabetes. J Pediatr 2014; 164: 1079-1084 e1072
    CrossrefPubMedGoogle Scholar
  • 14 Frontini MG, Srinivasan SR, Xu J. et al. Usefulness of childhood non-high density lipoprotein cholesterol levels versus other lipoprotein measures in predicting adult subclinical atherosclerosis: The Bogalusa Heart Study. Pediatrics 2008; 121: 924-929
    CrossrefPubMedGoogle Scholar
  • 15 Rohrer T, Stierkorb E, Heger S. et al. Delayed pubertal onset and development in German children and adolescents with type 1 diabetes: Cross-sectional analysis of recent data from the DPV diabetes documentation and quality management system. Eur J Endocrinol 2007; 157: 647-653
    CrossrefPubMedGoogle Scholar
  • 16 Eissa MA, Mihalopoulos NL, Holubkov R. et al. Changes in Fasting Lipids during Puberty. J Pediatr 2016; 170: 199-205
    CrossrefPubMedGoogle Scholar
  • 17 Talma H, Schonbeck Y, van Dommelen P. et al. Trends in menarcheal age between 1955 and 2009 in the Netherlands. PLoS One 2013; 8: e60056
    CrossrefPubMedGoogle Scholar
  • 18 Joustra SD, van der Plas EM, Goede J. et al. New reference charts for testicular volume in Dutch children and adolescents allow the calculation of standard deviation scores. Acta Paediatr 2015; 104: e271-e278
    CrossrefPubMedGoogle Scholar
  • 19 National High Blood Pressure Education Program Working Group on High Blood Pressure in C, Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 2004; 114: 555-576
    CrossrefPubMedGoogle Scholar
  • 20 Cole TJ, Bellizzi MC, Flegal KM. et al. Establishing a standard definition for child overweight and obesity worldwide: International survey. BMJ 2000; 320: 1240-1243
    CrossrefPubMedGoogle Scholar
  • 21 http://www.partnerschapovergewicht.nl/images/Organisatie/PON_Zorgstandaard_Obesitas_2011_A4_v1_04.pdf
  • 22 Rewers MJ, Pillay K, de Beaufort C. et al. ISPAD Clinical Practice Consensus Guidelines 2014. Assessment and monitoring of glycemic control in children and adolescents with diabetes. Pediatr Diabetes 2014; 15 Suppl 20 102-114
    CrossrefPubMedGoogle Scholar
  • 23 Expert Panel on Integrated Guidelines for Cardiovascular H, Risk Reduction in C, Adolescents et al. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics 2011; 128 Suppl S213-S256
    CrossrefPubMedGoogle Scholar
  • 24 Donaghue KC, Wadwa RP, Dimeglio LA. et al. ISPAD Clinical Practice Consensus Guidelines 2014. Microvascular and macrovascular complications in children and adolescents. Pediatr Diabetes 2014; 15 Suppl 20 257-269
    PubMedGoogle Scholar
  • 25 Shah AS, Maahs DM, Stafford JM. et al. Predictors of dyslipidemia over time in youth with type 1 diabetes: for the search for diabetes in youth study. Diabetes Care 2017; 40: 607-613
    CrossrefPubMedGoogle Scholar
  • 26 Nicklas TA, von Duvillard SP, Berenson GS. Tracking of serum lipids and lipoproteins from childhood to dyslipidemia in adults: the Bogalusa Heart Study. Int J Sports Med 2002; 23 Suppl 1 S39-S43
    Article in Thieme ConnectPubMedGoogle Scholar
  • 27 Webber LS, Srinivasan SR, Wattigney WA. et al. Tracking of serum lipids and lipoproteins from childhood to adulthood. The Bogalusa Heart Study. Am J Epidemiol 1991; 133: 884-899
    CrossrefPubMedGoogle Scholar
  • 28 Cook S, Auinger P, Huang TT. Growth curves for cardio-metabolic risk factors in children and adolescents. J Pediatr 2009; 155: S6 e15-S6 e126
    CrossrefPubMedGoogle Scholar
  • 29 Moran A, Jacobs Jr. DR, Steinberger J. et al. Insulin resistance during puberty: Results from clamp studies in 357 children. Diabetes 1999; 48: 2039-2044
    CrossrefPubMedGoogle Scholar
  • 30 Szadkowska A, Pietrzak I, Mianowska B. et al. Insulin sensitivity in Type 1 diabetic children and adolescents. Diabet Med 2008; 25: 282-288
    CrossrefPubMedGoogle Scholar
  • 31 Edge JA, Dunger DB, Matthews DR. et al. Increased overnight growth hormone concentrations in diabetic compared with normal adolescents. J Clin Endocrinol Metab 1990; 71: 1356-1362
    CrossrefPubMedGoogle Scholar
  • 32 Chiarelli F, Giannini C, Mohn A. Growth, growth factors and diabetes. Eur J Endocrinol 2004; 151 Suppl 3 U109-U117
    CrossrefPubMedGoogle Scholar
  • 33 Mantovani A, Mingolla L, Rigolon R. et al. Nonalcoholic fatty liver disease is independently associated with an increased incidence of cardiovascular disease in adult patients with type 1 diabetes. Int J Cardiol 2016; 225: 387-391
    CrossrefPubMedGoogle Scholar
  • 34 Targher G, Bertolini L, Padovani R. et al. Prevalence of non-alcoholic fatty liver disease and its association with cardiovascular disease in patients with type 1 diabetes. J Hepatol 2010; 53: 713-718
    CrossrefPubMedGoogle Scholar
  • 35 Petit JM, Pedro L, Guiu B. et al. Type 1 diabetes is not associated with an increased prevalence of hepatic steatosis. Diabet Med 2015; 32: 1648-1651
    CrossrefPubMedGoogle Scholar
  • 36 Kummer S, Klee D, Kircheis G. et al. Screening for non-alcoholic fatty liver disease in children and adolescents with type 1 diabetes mellitus: a cross-sectional analysis. Eur J Pediatr 2017; 176: 529-536
    CrossrefPubMedGoogle Scholar
  • 37 Targher G, Day CP, Bonora E. Risk of cardiovascular disease in patients with nonalcoholic fatty liver disease. N Engl J Med 2010; 363: 1341-1350
    CrossrefPubMedGoogle Scholar
  • 38 Yan Y, Hou D, Zhao X. et al. Childhood Adiposity and Nonalcoholic Fatty Liver Disease in Adulthood. Pediatrics 2017; 139: e20162738
    CrossrefPubMedGoogle Scholar
  • 39 Schwandt A, Hermann JM, Rosenbauer J. et al. Longitudinal trajectories of metabolic control from childhood to young adulthood in type 1 diabetes from a large german/austrian registry: a group-based modeling approach. Diabetes Care 2017; 40: 309-316
    CrossrefPubMedGoogle Scholar
  • 40 Dathan-Stumpf A, Vogel M, Rieger K. et al. Serum lipid levels were related to socio-demographic characteristics in a German population-based child cohort. Acta Paediatr 2016; 105: e360-e367
    CrossrefPubMedGoogle Scholar
  • 41 Shi Y, de Groh M, Bancej C. Socioeconomic gradients in cardiovascular risk in Canadian children and adolescents. Health Promot Chronic Dis Prev Can 2016; 36: 21-31
    CrossrefPubMedGoogle Scholar
  • 42 Idzior-Walus B, Mattock MB, Solnica B. et al. Factors associated with plasma lipids and lipoproteins in type 1 diabetes mellitus: The EURODIAB IDDM Complications Study. Diabet Med 2001; 18: 786-796
    CrossrefPubMedGoogle Scholar
  • 43 Marcovecchio ML, Tossavainen PH, Heywood JJ. et al. An independent effect of parental lipids on the offspring lipid levels in a cohort of adolescents with type 1 diabetes. Pediatr Diabetes 2012; 13: 463-469
    CrossrefPubMedGoogle Scholar
  • 44 Chen E, Martin AD, Matthews KA. Trajectories of socioeconomic status across children’s lifetime predict health. Pediatrics 2007; 120: e297-e303
    CrossrefPubMedGoogle Scholar
  • 45 Non AL, Rewak M, Kawachi I. et al. Childhood social disadvantage, cardiometabolic risk, and chronic disease in adulthood. Am J Epidemiol 2014; 180: 263-271
    CrossrefPubMedGoogle Scholar
  • 46 Zheng W, Chen Y, Zhao A. et al. Associations of sedentary behavior and physical activity with physical measurements and dyslipidemia in school-age children: a cross-sectional study. BMC Public Health 2016; 16: 1186
    CrossrefPubMedGoogle Scholar
  • 47 Verstraeten R, Lachat C, Ochoa-Aviles A. et al. Predictors of validity and reliability of a physical activity record in adolescents. BMC Public Health 2013; 13: 1109
    CrossrefPubMedGoogle Scholar
  • 48 Margeirsdottir HD, Stensaeth KH, Larsen JR. et al. Early signs of atherosclerosis in diabetic children on intensive insulin treatment: a population-based study. Diabetes Care 2010; 33: 2043-2048
    CrossrefPubMedGoogle Scholar
  • 49 Guy J, Ogden L, Wadwa RP. et al. Lipid and lipoprotein profiles in youth with and without type 1 diabetes: the SEARCH for Diabetes in Youth case-control study. Diabetes Care 2009; 32: 416-420
    CrossrefPubMedGoogle Scholar
  • 50 Bjornstad P, Eckel RH, Pyle L. et al. Relation of combined non-high-density lipoprotein cholesterol and apolipoprotein B with atherosclerosis in adults with type 1 diabetes mellitus. Am J Cardiol 2015; 116: 1057-1062
    CrossrefPubMedGoogle Scholar
  • 51 Bjornstad P, Nguyen N, Reinick C. et al. Association of apolipoprotein B, LDL-C and vascular stiffness in adolescents with type 1 diabetes. Acta Diabetol 2015; 52: 611-619
    CrossrefPubMedGoogle Scholar
  • 52 Yu-Poth S, Zhao G, Etherton T. et al. Effects of the National Cholesterol Education Program’s Step I and Step II dietary intervention programs on cardiovascular disease risk factors: A meta-analysis. Am J Clin Nutr 1999; 69: 632-646
    CrossrefPubMedGoogle Scholar
  • 53 Obarzanek E, Kimm SY, Barton BA. et al. Long-term safety and efficacy of a cholesterol-lowering diet in children with elevated low-density lipoprotein cholesterol: Seven-year results of the Dietary Intervention Study in Children (DISC). Pediatrics 2001; 107: 256-264
    CrossrefPubMedGoogle Scholar
  • 54 Patton SR. Adherence to diet in youth with type 1 diabetes. J Am Diet Assoc 2011; 111: 550-555
    CrossrefPubMedGoogle Scholar
  • 55 Mayer-Davis EJ, Nichols M, Liese AD. et al. Dietary intake among youth with diabetes: The SEARCH for Diabetes in Youth Study. J Am Diet Assoc 2006; 106: 689-697
    CrossrefPubMedGoogle Scholar
  • 56 Nordestgaard BG, Langsted A, Mora S. et al. Fasting is not routinely required for determination of a lipid profile: Clinical and laboratory implications including flagging at desirable concentration cutpoints-A Joint Consensus Statement from the European Atherosclerosis Society and European Federation of Clinical Chemistry and Laboratory Medicine. Clin Chem 2016; 62: 930-946
    CrossrefPubMedGoogle Scholar
  • 57 Langsted A, Freiberg JJ, Nordestgaard BG. Fasting and nonfasting lipid levels: Influence of normal food intake on lipids, lipoproteins, apolipoproteins, and cardiovascular risk prediction. Circulation 2008; 118: 2047-2056
    CrossrefPubMedGoogle Scholar
  • 58 Shomaker LB, Tanofsky-Kraff M, Savastano DM. et al. Puberty and observed energy intake: boy, can they eat!. Am J Clin Nutr 2010; 92: 123-129
    CrossrefPubMedGoogle Scholar