Zuzana Michnová, Jarmila Vojtková, Peter Ďurdík, Miriam Čiljaková, Peter Bánovčin
Background: Type 1 diabetes mellitus (DM1) is one of the most frequent and consequential chronic metabolic diseases in children. Hyperglycemia and dyslipidemia are metabolic abnormalities commonly found in young patients with DM1, and both increase the risk of cardiovascular disease, the leading cause of mortality in this population. The aims of our study were: 1) to investigate serum lipid profiles and glycemic control in adolescents with DM1, 2) to estimate the relation between serum lipids and parameters of metabolic compensation, anthropometric and time parameters.
Patients: Our group consisted of 72 children with type 1 diabetes mellitus (29 boys – 40.27 % and 43 girls – 59.72 %) who were hospitalized in 2015 at the Department of Pediatrics, University Hospital in Martin in order to perform control testing, adjust insulin therapy, or set an insulin pump for therapy. The median age of the group was 13.92 years (IQR: 11.00-19.00 years). The year of type 1 diabetes mellitus onset in the population was 8.17 years (IQR: 5.00-10.50 years). The average duration of diabetes in the population was 5.50 years (IQR: 2.00-8.50 years).
Methods: for each child we filled an anamnestic questionnaire and examined basic anthropometric parameters (height, weight). In laboratory examinations we assessed for each patient (samples taken on empty stomach) using standard biochemical blood tests: current glycemia, glycated hemoglobin (HbA1c – was assessed using the immunoinhibitory method), C-peptide, total cholesterol, triacylglyceroles, creatinine, total bilirubin, microalbuminuria. We evaluated the presence of a history of chronic complications (retinopathy, nephropathy, and neuropathy).
Results: diabetes compensation was on average dissatisfactory, HbA1c was 10.19% (IQR: 6.50-16.40%). Diabetic patients had values of total cholesterol: 4.61 mmol/l (IQR: 4.07-5.07 mmol/l) and triacylglycerols 1.20 mg/l (IQR: 0.78- 1.35 mg/l) vs. 0.96 mg/l (0.70-1.04 mg/l). In our group, dyslipidemia was present in 29 children, i.e. 40.28 % (11 boys, 18 girls). In 20 cases (27.8 %), it was isolated hypercholesterolemia, in 5 cases (17.20 %), it was combined hyperlipidaemia, and in 4 children (13.7 %) an isolated hypertriglyceridemia. In diabetic population we didn´t find significant correlation between serum lipid levels and parameters of metabolic compensation, anthropometric and time parameters.
Conclusios: dyslipidemia as one of the major cardiovascular risk factors, is present in adolescents with DM1 early in the course of diabetes. As a preventive measure, serum lipid levels should be measured in DM1 patients without known diagnosis of hyperlipidemia once a year.