Prevalence and Determinants of Occurrence of Dyslipidemia in Subjects with Type 1 Diabetes Mellitus.

Abstract

To describe the prevalence and determinants of occurrence of dyslipidemia in children and adolescents with type 1 diabetes mellitus (T1DM). A cross-sectional study was conducted in the diabetic clinic of a tertiary care referral hospital over two years. Subjects with T1DM aged 2-18 y had assessment of Lipid profile after 12h of fasting. Glycemic control was assessed by glycosylated hemoglobin (HbA1C). Modifiable and nonmodifiable determining factors were assessed during clinic visit as per standard criteria. Body mass index (BMI)more than 23rd adult equivalent and 27th adult equivalent were considered as overweight and obesity, respectively. Lipid parameters were considered as abnormal if: Low density lipoprotein (LDL) > 100mg/dL, high density lipoprotein (HDL) < 40mg/dL, triglycerides > 100mg/dL (< 10 y) and > 130mg/dL (> 10 y). A total of 171 subjects (mean age: 11.8 ± 3.5 y, M:F = 75:96) were recruited during the study period. The mean fasting LDL level, HDL level, and triglyceride level observed in the study sample were 106.6 ± 26.9mg/dL(62% abnormal), 52.6 ± 14.3mg/dL (9.4% abnormal), and 85.3 ± 39.4mg/dL (10.5% abnormal), respectively; 115 (67.3%) of the subjects had at least one abnormality in the serum lipid profile. On multivariate analysis, HbA1C was the most significant factor in determining the occurrence of dyslipidemia (p < 0.05). HbA1C was 9.9 ± 1.6 in subjects with abnormal LDL versus 9.1 ± 1.5 in those with normal LDL (p < 0.05). Prevalence of dyslipidemia in the study children and adolescents with T1DM was 67.3%. HbA1C remains the most important modifiable determinant of the occurrence of dyslipidemia.