Background: Non-high-density lipoprotein cholesterol (non-HDL-C) has been shown to be a suitable predictor of cardiovascular risk.
Objective and hypotheses: We aimed to investigate factors influencing non-HDL-C levels in children with type 1diabetes (T1D, registered at the German/Austrian DPV database, n=26358) in order to increase the rare use of lipid-lowering therapies. Recommendations for acceptable (<120 mg/dl), borderline-high (120139 mg/dl), and high (≧140 mg/dl) non-HDL-C levels in children at high cardiovascular risk were considered.
Results: Non-HDL-C levels were generally higher in children aged >10 years than ≤10 years and also higher in females than in males. Non-HDL-C levels increased with worsening glycaemic control, elevated non-HDL-C levels and age. The rate of non-HDL-C levels ≧120 mg/dl was more than 25% and of levels ≧140 mg/dl still 10%, irrespective of glycaemic control, weight, age, and gender. However, the rate of non-HDL-C levels ≧140 mg/dl was even 25% in overweight girls aged >10 years.
Conclusion: Considering the non-HDL-C treatment goal <120 mg/dl for children with diabetes-related high cardiovascular risk, it can be assumed that more than a quarter of children with T1D require intensified lifestyle interventions. Further 10% of all T1D children and even 25% of overweight adolescent girls need immediate lipid-lowering treatment in parallel with lifestyle changes, because there is no reasonable perspective of reaching their non-HDL-C goal by improved glycaemic control or weight loss alone.
Funding: DPV initiative was supported by the German Federal Ministry of Education and Research as part of the competence net diabetes (grant FKZ 01GI1106) integrated into the German Center for Diabetes Research (DHZ), the German Competence Net Obesity (grant FKZ 01GI1130), and the European Foundation for the Study of Diabetes (EFSD).
01 - 03 Oct 2015
European Society for Paediatric Endocrinology