The effects of metabolic control on oxidized low-density lipoprotein antibodies in children and adolescents with type 1 diabetes mellitus

Abstract

To assess the oxidized low-density lipoprotein (oxLDL) antibody status in childhood type 1 diabetes mellitus (T1DM) and to investigate the effect of metabolic control on the oxLDL antibodies. The study included 36 T1DM patients (aged 6.6-18.1 yr) and 20 age- and sex-matched healthy subjects. Serum levels of oxLDL antibodies, lipids, and hemoglobin A1c (HbA1c) were measured. The patients with diabetes were divided into two groups according to their metabolic control levels. Group I (the patient group with good or fairly good metabolic control, n = 21) and group II (the patient group with poor metabolic control, n = 15) included children with diabetes having an actual HbA1c levels of < or = 9 and >9%, respectively. The oxLDL antibody level was higher in T1DM patients than in control subjects [278 (37-1289) vs. 110 (37-235) mU/mL] (p < 0.001). The patients with diabetes in group I had higher antibody levels against oxLDL [488 (51-1289) mU/mL] than both those in group II [183 (37-1207) mU/mL] and control group [110 (37-235) mU/mL] (p < 0.001). oxLDL antibodies were inversely correlated with actual HbA1c levels (r = -0.42, p = 0.01). Increased levels of oxLDL antibodies in pediatric patients indicate that the increased lipid peroxidation in T1DM begins in childhood. oxLDL antibody levels are inversely correlated with actual HbA1c levels in children with diabetes, as shown in adult patients. As metabolic control worsens, the free oxLDL antibody levels decrease perhaps because of immune complex formation and the atherosclerosis risk increases. The risk may be diminished by improving metabolic control as reflected in the correlation between current HbA1c and oxLDL levels.