Dyslipidemia and cardiovascular disease risk factors in patients with type 1 diabetes: A single-center experience

Table 1 Baseline characteristics of the study cohort (1998)

	All, n = 170	Males, n = 86	Females, n = 84	P value
Age in yr	12.6 ± 5.6	12.4 ± 6.0	12.6 ± 5.1	0.854
Age at diabetes diagnosis	8.1 ± 4.4	8.0 ± 4.7	8.2 ± 4.1	0.735
Diabetes duration	4.4 ± 4.0	4.4 ± 4.2	4.3 ± 3.8	0.828
HbA1c, %	8.4 ± 1.4	8.6 ± 1.4	8.2 ± 1.4	0.064
HbA1c in mmol/L	68.3	70.5	66.1
Pubertal stage, n (%)
Tanner 1	79 (46.5)	47 (54.7)	32 (38.1)	0.291
Tanner 2	11 (6.5)	4 (4.7)	7 (8.3)
Tanner 3	19 (11.2)	8 (9.3)	11 (13.1)
Tanner 4	12 (7.1)	5 (5.8)	7 (8.3)
Tanner 5	49 (28.8)	22 (25.6)	27 (32.1)
Menarche		NA	48 (57.1)
Age at menarche		NA	13.3 ± 1.3
Ethnicity, n (%)
Ashkenazi Jew	102 (60.0)	47 (54.7)	55 (65.5)	0.120
North African Jew	19 (11.2)	7 (8.1)	12 (14.3)
Oriental Jew	19 (11.2)	10 (11.6)	9 (10.7)
Yemenite Jew	16 (9.4)	12 (14)	4 (4.8)
Ethiopian Jew	4 (2.4)	2 (2.3)	2 (2.4)
Arab	10 (5.9)	8 (9.3)	2 (2.4)
Cardiovascular disease risk factors in patients, n (%)
Overweight	20 (11.8)	9 (10.5)	11 (13.1)	0.864
Obesity	8 (4.7)	4 (4.7)	4 (4.8)
Systolic pre-hypertension, ≥ 90th to the 95th percentile	15 (8.8)	8 (9.3)	7 (8.3)	0.336
Systolic stage 1 hypertension, ≥ 95th to the < 99th percentile	19 (11.2)	12 (14)	7 (8.3)
Systolic stage 2 hypertension, ≥ 99th percentile	8 (4.7)	5 (5.8)	3 (3.6)
Diastolic pre-hypertension, ≥ 90th to the 95th percentile	3 (1.8)	2 (2.3)	1 (1.2)	0.670
Diastolic stage 1 hypertension, ≥ 95th to the < 99th percentile	7 (4.1)	3 (3.5)	4 (4.8)
Diastolic stage 2 hypertension, ≥ 99th percentile	1 (0.6)	1 (1.2)	0 (0)
Pre-hypertension, systolic and/or diastolic ≥ 90th to the 95th percentile	15 (8.8)	9 (10.5)	6 (7.1)	0.426
Stage 1 hypertension, systolic and/or diastolic ≥ 95th to the < 99th percentile	23 (13.5)	12 (14)	11 (13.1)
Stage 2 hypertension, systolic and/or diastolic ≥ 99th percentile	9 (5.3)	6 (7)	3 (3.6)
Lipid profile1	n = 144	n = 71	n = 73
LDL-c, n (%)				0.049
< 75th percentile	63 (43.8)	27 (38)	36 (49.3)
75th-90th percentile	47 (32.6)	21 (29.6)	26 (35.6)
Borderline elevated 90th-95th percentile	10 (6.9)	7 (8.1)	3 (4.1)
Elevated > 95th	24 (16.7)	16 (18.6)	8 (11)
Triglycerides, n (%)				0.393
< 75th percentile	31 (21.5)	12 (16.9)	19 (26)
75th-90th percentile	59 (41)	30 (42.3)	29 (39.7)
Borderline elevated 90th-95th percentile	16 (11.1)	7 (9.9)	9 (12.3)
Elevated > 95th	38 (26.3)	22 (30.9)	16 (21.9)
HDL-c, n (%)				0.728
Normal level > 10th percentile	127 (88.2)	62 (87.3)	65 (89%)
Borderline low 5th -10th percentile	9 (6.2)	4 (5.6)	5 (6.8)
Low level < 5th percentile	8 (5.5)	5 (6.9)	3 (4.1)
Positive family history of cardiovascular risk factors in a first-degree relative, n (%)
Cardiovascular disease risk factors
Type 2 diabetes	51 (30)	23 (26.7)	28 (33.3)	0.349
Premature coronary artery disease	24 (14.1)	10 (11.6)	14 (16.7)	0.346
Dyslipidemia	32 (18.8)	17 (19.8)	15 (17.9)	0.750
Hypertension	33 (19.4)	16 (18.6)	17 (20.2)	0.778
Cerebrovascular accident	4 (2.4)	4 (4.7)	0 (0)	0.035

Data are expressed as the number (percent) or as mean ± standard deviation. P values are between males and females. Highlighted in bold are significant values.

¹Lipid profiles were available for 144 patients (71 males, 73 females). Only one female patient used statins. First-degree relatives included parents and siblings. Premature coronary artery disease (i.e. heart attack, treated angina, interventions for coronary artery disease, stroke, or sudden cardiac death) in male relatives < 55 years or female relatives < 65 years. HbA1c: Hemoglobin A1c; HDL-c: High-density lipoprotein cholesterol; LDL-c: Low-density lipoprotein cholesterol.

Table 2 Characteristics of the study cohort at the last visit

	All, n = 170	Males, n = 86	Females, n = 84	P value
Age in yr	26.3 ± 5.7	26.5 ± 6.0	26.0 ± 5.5	0.540
Diabetes duration in yr	18.2 ± 5.6	18.6 ± 5.5	17.8 ± 5.8	0.375
Duration follow-up in yr	13.7 ± 3.7	14.1 ± 3.6	13.4 ± 3.9	0.222
HbA1c, %	8.0 ± 1.4	8.2 ± 1.6	7.9 ± 1.1	0.164
HbA1c in mmol/L	63.9	66.1	62.8
Smoker, n (%)	13 (7.6)	7 (8.1)	6 (7.1)	0.807
Oral contraceptive use, n (%)			11 (13.1)
Cardiovascular disease risk factors in patients1, n (%)	All, n = 149	Males, n = 74	Females, n = 75
Diabetes only	13 (8.7)	5 (6.8)	8 (10.7)	0.578
+ 1	41 (27.5)	21 (28.4)	20 (26.7)
+ 2	62 (41.6)	28 (37.8)	34 (45.3)
+ 3	27 (18.1)	16 (21.6)	11 (14.7)
+ 4	6 (4.0)	4 (5.4)	2 (2.7)
Cardiovascular disease risk factors in patients, n (%)
Overweight/obesity, n = 158	63/158 (39.9)	32 (40)	31 (39.7)	0.974
Hypertension, n = 152	37 (24.3)	26 (35.1)	11 (14.1)	0.003
Systolic BP > 130 mmHg	28 (18.4)	22 (29.7)	6 (7.7)	< 0.001
Diastolic BP > 80 mmHg	21 (13.8)	16 (21.6)	5 (6.4)	0.007
Dyslipidemia	113 (66.5)	57 (66.3)	56 (66.7)	0.957
LDL-c > 100 mg/dL	83 (48.8)	43 (50.0)	40 (47.6)	0.641
Triglycerides > 150 mg/dL	27 (15.9)	11 (12.7)	16 (19.0)	0.279
HDL-c < 40 mg/dL (males) and < 50 mg/dL (females)	39 (22.9)	15 (17.4)	24 (28.5)	0.099
Statin use2	29 (18.2)	18 (22.5)	11 (13.9)	0.316

Data are expressed as number (percent) or as mean ± standard deviation. P values are between males and females. Significant values are highlighted in bold.

¹Data on cardiovascular disease risk factors were available for 149 patients (74 males, 75 females).

²Data on medications other than insulin (statins) were documented in the medical records of 159 patients (80 males, 79 females). BP: Blood pressure; HbA1c: Hemoglobin A1c; HDL-c; High-density lipoprotein cholesterol; LDL-c; Low-density lipoprotein cholesterol.

Table 3 Factors associated with dyslipidemia (1998-last visit)

	β (SE)	P value	95%CI
Low-density lipoprotein cholesterol
Diastolic blood pressure 1998	11.4 (4.7)	0.003	2.0, 20.7
Positive family history of cardiovascular disease	20.7 (6.8)	0.017	7.2, 34.1
Triglycerides
Diastolic blood pressure 1998	23.8 (9.1)	0.01	5.8, 41.8
Positive family history of cardiovascular disease	31.0 (13.1)	0.02	5.0, 57.0
High-density lipoprotein cholesterol
Diastolic blood pressure 1998	-4.8 (2.1)	0.022	-8.9, -0.7
Total cholesterol
Positive family history of CVD	23.1 (8.3)	0.006	6.6, 39.5

The following variables were entered into each of the four stepwise linear regression models for long-term outcomes of the lipid profile (total cholesterol, triglycerides, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol): sex, age at diagnosis, ethnicity, positive family history of type 2 diabetes, positive family history of cardiovascular disease (CVD), positive family history of dyslipidemia, positive family history of hypertension, body mass index-standard deviation scores 1998, diastolic and systolic blood pressure categories according to percentiles 1998, Tanner pubertal stage 1998, duration of diabetes 1998, and the mean HbA1c from 1998 to the last visit.