Abstract
Objective. The adverse role of dyslipidemia in predicting cardiovascular outcomes has not been elucidated extensively among type 1 diabetics in the literature. Methods. We assessed dyslipidemia and its correlation to other cardiac risk factors in adolescents with type 1 diabetes. Total thirty type 1 adolescent diabetics were evaluated for their metabolic profile, including serum lipids and echocardiography was performed. Results. The average age of the cohort was 14.3 ± 3.09 yr with disease duration of 5.35 ± 2.94 yr. The mean HbA1C was 8.01%. The mean serum cholesterol, LDL, HDL, and triglyceride were normal. Serum cholesterol was high in patients with longer disease duration (P = 0.011, r = 0.41), high systolic blood pressure (P = 0.04, r = 0.32), and elevated HbA1C > 8% (P = 0.038, r = 0.33). Higher lipid values were associated with poorer carotid artery distensibility (P > 0.05) and higher carotid artery intimomedial thickness (cIMT) (P < 0.05 for cholesterol and LDL). Hyperglycemia adversely affected ejection fractions, though serum lipids did not show any significant effect on left ventricular parameters. Conclusions. Dyslipidemia and hyperglycemia can serve as biomarkers for cardiovascular dysfunction in at-risk adolescents with type 1 diabetes. Carotid artery parameters are adjunctive tools which may be affected early in the course of macrovascular disease.
Highlights
Atherosclerotic lesions presenting as fatty streaks in blood vessels in childhood can progress in adolescence in the presence of risk factors like hyperlipidemia, hypertension, and diabetes mellitus (DM) [1]
Future studies comparing diabetic population with healthy controls will be needed on a larger scale to reinforce the results of this first pilot study. Both serum cholesterol and low density lipoprotein (LDL) were established as cardiac risk factors, in addition to HbA1C and blood pressure
(2) Patients with type 1 diabetes need to be screened for dyslipidemia around puberty
Summary
Atherosclerotic lesions presenting as fatty streaks in blood vessels in childhood can progress in adolescence in the presence of risk factors like hyperlipidemia, hypertension, and diabetes mellitus (DM) [1]. Hyperglycemia causes nonenzymatic glycation of proteins leading to formation of advanced glycation end products (AGEs) which are thought to be implicated in both microvascular and macrovascular complications of diabetes. They promote cross linking of proteins which can manifest as decreased cardiac compliance [2]. Diabetes promotes the expression of E-selectin and vascular cell adhesion molecule (VCAM) by the endothelial cells. These promote leucocyte adhesion to the vessels which accumulate lipids and release proinflammatory cytokines, promoting plaque formation [3, 5]
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