Abstract
Uncontrolled type-1 diabetes (T1DM) can lead to dyslipidaemia and albuminuria, which may promote cardiovascular injuries. However, some lipidemic factors could be useful in predicting cardiac dysfunction. Seventy-eight adolescents under insulin treatment due to a 6-year history of T1DM and were retrospectively examined. Glycemia, lipidemia, and albuminuria were measured in addition to development of cardiovascular abnormalities Both girls and boys showed higher HbA1c and fasting blood glucose and 27.1% females and 33.3% males exhibited microalbuminuria though their plasma levels of total cholesterol (TC), triglycerides (TG), and low-density lipoproteins (LDL) and high-density lipoproteins (HDL lipoproteins were in the normal range. They exhibited a preserved systolic function, but 50% of females and 66.6% of males had developed diastolic failures. Interestingly, girls with diastolic dysfunction showed significantly lower concentrations of HDL and higher TC/HDL and TG/HDL ratios. In fact, low HDL levels (OR 0.93; 95% CI 0.88–0.99; p = 0.029) and high TC/HDL (OR 2.55; 95% CI 1.9–5.45; p = 0.016) and TG/HDL (OR 2.74; 95% CI 1.12–6.71; p = 0.028) ratios associated with the development of diastolic complications. The cut-off values for HDL, TC/HDL, and TG/HDL were 49 mg/dL, 3.0 and 1.85, respectively. HDL and TC/HDL and TG/HDL ratios may be useful for predicting diastolic dysfunction in girls with uncontrolled T1DM.
Highlights
Type 1 diabetes (T1DM) is characterized by a deficient insulin production caused by T-cell-mediated autoimmune destruction of pancreatic β-cells
There is a lack of diagnosis and prognosis for cardiovascular disease (CVD) in T1DM subjects, and even within the first decade of diagnosis, children and adolescents with T1DM have a high occurrence of heart failure and impaired cardiac function subsequent to coronary artery disease, hypertension, and/or diabetic cardiomyopathy (DCM) [6]
We retrospectively studied a population of young T1DM patients (n = 78) under insulin therapy (Supplementary material, Figure S1)
Summary
Type 1 diabetes (T1DM) is characterized by a deficient insulin production caused by T-cell-mediated autoimmune destruction of pancreatic β-cells. T1DM is the predominant form of diabetes during childhood and adolescence though it can be present in adulthood. The major cause of morbidity and, eventually, premature mortality in subjects with T1DM is cardiovascular disease (CVD) [3]. In population-based studies, between 14% and 45% of children with T1DM present two or more CVD risk factors including hypertension, dyslipidaemia, inflammation, obesity, and nephropathy [4]. There is a lack of diagnosis and prognosis for CVD in T1DM subjects, and even within the first decade of diagnosis, children and adolescents with T1DM have a high occurrence of heart failure and impaired cardiac function subsequent to coronary artery disease, hypertension, and/or diabetic cardiomyopathy (DCM) [6]. Girls with T1DM may have poor long-term clinical outcome (insulin requirements, glycemic control, and CVD) and lower generic and disease-specific quality of life than boys [8,9,10]
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