Nine-year longitudinal study of cardiovascular risk factors in spanish children and adolescents with type 1 diabetes

Objectives: To analyse the prevalence, evolution of cardiovascular risk factors (CVRF) and their relationship with follow-up of metabolic control in pediatric patients with Type 1 Diabetes (T1DM). Patients and methods: Longitudinal ambispective study including 75 children and adolescents with T1DM diagnosed from 1996 to 2003 and followed-up for nine years. Family history of CVRF was registered. Data from the second, sixth and ninth year after diagnosis were analysed. Results: Family history of CVRF was found in 46.6% of the patients. The prevalence of HbA1c > 7.5% in the second, sixth and ninth year after diagnosis was 45.3%, 53.3% y 56%, respectively. The prevalence of obesity (BMI>2SDS) in the three visits was 5.3%, 5.3% y 6.7%, respectively. Hypertension (BP > p90) was found in 14.6%, 8% and 13.3% of the patients in the three visits, respectively. Total cholesterol > 200mg/dl: 25.3%, 13.3% and 16%; high density cholesterol lipoprotein < 40mg/dl: 1.3%, 1.3% and 4%; low density cholesterol lipoprotein > 100mg/dl: 38.6%, 34.6% and 38.6%; triglyceride > 150mg/dl: 0%, 1.3% and 2.6%, respectively. There was a significant increase in the prevalence of TG/HDL-C >= 2 between the sixth and the ninth year after diagnosis (1.3% and 9.3%, P < .05). A persistent HbA1c >= 7.5% showed a statistically significant relationship to a 0.94 decrease in HDL-C z-score between the second and the sixth year, and a persistent HbA1c < 7.5% was significantly associated with a 0.55 increase in HDL-C z-score (P = .015) in the same period. Conclusions: A non-optimal metabolic control in first years of DM1 is associated with a decrease in HDL-C z-score. TG/HDL-C ratio could be an early marker of cardiovascular risk. (C) 2014 Asociacion Espanola de Pediatria. Published by Elsevier Espana, S.L.U. All rights reserved.