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Impact of long-term glycemic control on changes of lipid profile in children and adolescents with 1 type diabetes mellitus


Authors: J. Kostolanská 1;  V. Jakuš 2;  Ľ. Barák 3;  A. Staníková 4
Authors‘ workplace: I. detská klinika Lekárskej fakulty UK a DFNsP Bratislava, Slovenská republika, prednostka doc. MUDr. Oľga Červeňová, PhD. 1;  Ústav lekárskej chémie, biochémie a klinickej biochémie Lekárskej fakulty UK Bratislava, Slovenská republika, prednostka prof. Ing. Zdeňka Ďuračková, PhD. 2;  Detské diabetologické centrum SR pri I. detskej klinike UK a DFNsP Bratislava, Slovenská republika, vedúci pracoviska MUDr. Ľubomír Barák, CSc. 3;  Detská otorinolaryngologická klinika Lekárskej fakulty UK a DFNsP Bratislava, Slovenská republika, prednostka prof. MUDr. Janka Jakubíková, CSc. 4
Published in: Vnitř Lék 2011; 57(6): 533-539
Category: Original Contributions

Overview

Introduction:
Abnormalities in lipid metabolism contribute significantly to the increased occurrence of cardiovascular events in individuals with T1DM compared to healthy subjects. Disorder of lipid metabolism in T1DM is heavily dependent on maintaining of blood glucose values near the physiological range. DCCT study confirmed that patients with well compensated diabetes have similar lipid spectrum to the healthy subjects one.

Aims:
We aimed to study relations of lipid profile parameters (cholesterol of high density HDL, cholesterol of low density LDL, total cholesterol - TC, triglycerides - TAG) to age, duration of T1DM (DD), blood glucose, HbA1c and if the blood pressure (BP), BMI corrected for age (BMIc) and daily insulin doses per kilogram (DI) in 30 patients with T1DM with good long-term glycemic compensation. We aimed also to find mathematical models of lipid profile parameters dependence of the parameters of glycemic control, age, duration of DM1T, blood pressure (systolic and diastolic BPs, BPd, respectively) BMIc and DI.

Results:
HbA1c levels were significantly higher in diabetic patients compared to controls (p < 0.01), HDL were higher in diabetics than in controls (not significantly). LDL levels were in diabetics similar to controls. TAG was significantly lower in diabetics than in controls (p < 0.01). HDL significantly positively correlated with HbA1c (r = 0.372, p < 0.05) and negatively with BPs (r = -0.373, p < 0.05), TAG correlated with age (r = 0.546, p < 0.01), DD (r = 0.577, p < 0.001) and BPs (r = 0.407, p < 0.05). We also found a statistically appropriate mathematical models of the relationship of HDL and TAG with the parameters: age, DD, glucose, HbA1c, BP, BMIc, DI (r = 0.785, r2 = 0.616, p < 0.01, R = 0.758; r2 = 0.574, p < 0.05, respectively).

Conclusion:
The changes in HDL and TAG values in juvenile diabetics are significantly affected by particularly long-term glycemic control and insulin therapy.

Key words:
HbA1c - total cholesterol - HDL - LDL - triglycerides - blood pressure - insulin doses


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