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. 1994 Aug;71(2):108–113. doi: 10.1136/adc.71.2.108

Circulating lipids and glycaemic control in insulin dependent diabetic children.

K Azad 1, J M Parkin 1, S Court 1, M F Laker 1, K G Alberti 1
PMCID: PMC1029937  PMID: 7944528

Abstract

The prevalence of dyslipidaemia in children with insulin dependent diabetes mellitus (IDDM) and its relation to glycaemic control was studied in a group of 51 diabetic children and a control population of 132 schoolchildren. The prevalence of dyslipidaemia in the fasting state was increased in the diabetic group (39%) compared with control subjects (17%). Serum cholesterol concentration alone was raised in 25% of diabetic subjects while serum cholesterol and triglycerides were raised in 14%, compared with 16% and 0.7% respectively in control subjects. Serum total cholesterol (5.1 v 4.5 mmol/l), low density lipoprotein cholesterol (3.2 v 2.6 mmol/l), non-esterified fatty acids (0.91 v 0.50 mmol/l), and triglycerides (0.94 v 0.76 mmol/l) were higher in diabetic children. Serum total cholesterol, triglycerides, and apolipoprotein (apo)B concentrations increased with worsening control, while serum high density lipoprotein cholesterol and apoA-I concentrations were unaltered. There were also positive correlations between glycated haemoglobin and total cholesterol, triglycerides, and apoB in diabetic children. Thus, abnormalities in circulating lipids are common in young subjects with IDDM but largely disappear if blood glucose concentrations are reasonably controlled.

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Selected References

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  1. Albers J. J., Marcovina S. M., Kennedy H. International Federation of Clinical Chemistry standardization project for measurements of apolipoproteins A-I and B. II. Evaluation and selection of candidate reference materials. Clin Chem. 1992 May;38(5):658–662. [PubMed] [Google Scholar]
  2. Alberti K. G., Gries F. A. Management of non-insulin-dependent diabetes mellitus in Europe: a concensus view. Diabet Med. 1988 Apr;5(3):275–281. doi: 10.1111/j.1464-5491.1988.tb00984.x. [DOI] [PubMed] [Google Scholar]
  3. Assmann G., Schulte H. Relation of high-density lipoprotein cholesterol and triglycerides to incidence of atherosclerotic coronary artery disease (the PROCAM experience). Prospective Cardiovascular Münster study. Am J Cardiol. 1992 Sep 15;70(7):733–737. doi: 10.1016/0002-9149(92)90550-i. [DOI] [PubMed] [Google Scholar]
  4. Austin M. A., Breslow J. L., Hennekens C. H., Buring J. E., Willett W. C., Krauss R. M. Low-density lipoprotein subclass patterns and risk of myocardial infarction. JAMA. 1988 Oct 7;260(13):1917–1921. [PubMed] [Google Scholar]
  5. Austin M. A., King M. C., Vranizan K. M., Newman B., Krauss R. M. Inheritance of low-density lipoprotein subclass patterns: results of complex segregation analysis. Am J Hum Genet. 1988 Dec;43(6):838–846. [PMC free article] [PubMed] [Google Scholar]
  6. Azad K., Court S., Parkin J. M., Laker M. F., Alberti K. G. Lipid levels in schoolchildren in north east England: effects of feeding and age. Ann Clin Biochem. 1994 May;31(Pt 3):233–239. doi: 10.1177/000456329403100303. [DOI] [PubMed] [Google Scholar]
  7. BIERMAN E. L., DOLE V. P., ROBERTS T. N. An abnormality of nonesterified fatty acid metabolism in diabetes mellitus. Diabetes. 1957 Nov-Dec;6(6):475–479. doi: 10.2337/diab.6.6.475. [DOI] [PubMed] [Google Scholar]
  8. Betteridge D. J., Dodson P. M., Durrington P. N., Hughes E. A., Laker M. F., Nicholls D. P., Rees J. A., Seymour C. A., Thompson G. R., Winder A. F. Management of hyperlipidaemia: guidelines of the British Hyperlipidaemia Association. Postgrad Med J. 1993 May;69(811):359–369. doi: 10.1136/pgmj.69.811.359. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Chase H. P., Glasgow A. M. Juvenile diabetes mellitus and serum lipids and lipoprotein levels. Am J Dis Child. 1976 Oct;130(10):1113–1117. doi: 10.1001/archpedi.1976.02120110075010. [DOI] [PubMed] [Google Scholar]
  10. Cohn J. S., McNamara J. R., Cohn S. D., Ordovas J. M., Schaefer E. J. Postprandial plasma lipoprotein changes in human subjects of different ages. J Lipid Res. 1988 Apr;29(4):469–479. [PubMed] [Google Scholar]
  11. Court J. M., Dunlop M., Hill M. A study of plasma-lipid concentrations in diabetic children. J Hum Nutr. 1978 Aug;32(4):285–288. doi: 10.3109/09637487809143326. [DOI] [PubMed] [Google Scholar]
  12. Durrington P. N., Ishola M., Hunt L., Arrol S., Bhatnagar D. Apolipoproteins (a), AI, and B and parental history in men with early onset ischaemic heart disease. Lancet. 1988 May 14;1(8594):1070–1073. doi: 10.1016/s0140-6736(88)91895-8. [DOI] [PubMed] [Google Scholar]
  13. Ewald U., Gustafson S., Tuvemo T., Vessby B. Increased high density lipoproteins in diabetic children. Eur J Pediatr. 1984 Aug;142(3):154–156. doi: 10.1007/BF00442440. [DOI] [PubMed] [Google Scholar]
  14. Ewald U., Tuvemo T., Vessby B., Wålinder O. Serum apolipoproteins A-I, A-II and B in diabetic children and matched healthy controls. Acta Paediatr Scand. 1982 Jan;71(1):15–18. doi: 10.1111/j.1651-2227.1982.tb09365.x. [DOI] [PubMed] [Google Scholar]
  15. Fontbonne A., Eschwège E., Cambien F., Richard J. L., Ducimetière P., Thibult N., Warnet J. M., Claude J. R., Rosselin G. E. Hypertriglyceridaemia as a risk factor of coronary heart disease mortality in subjects with impaired glucose tolerance or diabetes. Results from the 11-year follow-up of the Paris Prospective Study. Diabetologia. 1989 May;32(5):300–304. doi: 10.1007/BF00265546. [DOI] [PubMed] [Google Scholar]
  16. Friedewald W. T., Levy R. I., Fredrickson D. S. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972 Jun;18(6):499–502. [PubMed] [Google Scholar]
  17. Heding L. G. Radioimmunological determination of human C-peptide in serum. Diabetologia. 1975 Dec;11(6):541–548. doi: 10.1007/BF01222104. [DOI] [PubMed] [Google Scholar]
  18. Howard B. V. Lipoprotein metabolism in diabetes mellitus. J Lipid Res. 1987 Jun;28(6):613–628. [PubMed] [Google Scholar]
  19. Kobbah M., Vessby B., Tuvemo T. Serum lipids and apolipoproteins in children with type 1 (insulin-dependent) diabetes during the first two years of the disease. Diabetologia. 1988 Apr;31(4):195–200. doi: 10.1007/BF00290584. [DOI] [PubMed] [Google Scholar]
  20. Krolewski A. S., Kosinski E. J., Warram J. H., Leland O. S., Busick E. J., Asmal A. C., Rand L. I., Christlieb A. R., Bradley R. F., Kahn C. R. Magnitude and determinants of coronary artery disease in juvenile-onset, insulin-dependent diabetes mellitus. Am J Cardiol. 1987 Apr 1;59(8):750–755. doi: 10.1016/0002-9149(87)91086-1. [DOI] [PubMed] [Google Scholar]
  21. Lloyd B., Burrin J., Smythe P., Alberti K. G. Enzymic fluorometric continuous-flow assays for blood glucose, lactate, pyruvate, alanine, glycerol, and 3-hydroxybutyrate. Clin Chem. 1978 Oct;24(10):1724–1729. [PubMed] [Google Scholar]
  22. Lopes-Virella M. F., Wohltmann H. J., Loadholt C. B., Buse M. G. Plasma lipids and lipoproteins in young insulin-dependent diabetic patients: relationship with control. Diabetologia. 1981 Sep;21(3):216–223. doi: 10.1007/BF00252657. [DOI] [PubMed] [Google Scholar]
  23. Mann J. I., Hughson W. G., Holman R. R., Honour A. J., Thorogood M., Smith A., Baum J. D. Serum lipids in treated diabetic children and their families. Clin Endocrinol (Oxf) 1978 Jan;8(1):27–33. doi: 10.1111/j.1365-2265.1978.tb01347.x. [DOI] [PubMed] [Google Scholar]
  24. National Cholesterol Education Program (NCEP): highlights of the report of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents. Pediatrics. 1992 Mar;89(3):495–501. [PubMed] [Google Scholar]
  25. Patsch J. R., Miesenböck G., Hopferwieser T., Mühlberger V., Knapp E., Dunn J. K., Gotto A. M., Jr, Patsch W. Relation of triglyceride metabolism and coronary artery disease. Studies in the postprandial state. Arterioscler Thromb. 1992 Nov;12(11):1336–1345. doi: 10.1161/01.atv.12.11.1336. [DOI] [PubMed] [Google Scholar]
  26. Salzer B., Stavljenić A., Jürgens G., Dumić M., Radica A. Polymorphism of apolipoprotein E, lipoprotein(a), and other lipoproteins in children with type I diabetes. Clin Chem. 1993 Jul;39(7):1427–1432. [PubMed] [Google Scholar]
  27. Sentí M., Pedro-Botet J., Nogués X., Rubiés-Prat J. Influence of intermediate-density lipoproteins on the accuracy of the Friedewald formula. Clin Chem. 1991 Aug;37(8):1394–1397. [PubMed] [Google Scholar]
  28. Sosenko J. M., Breslow J. L., Miettinen O. S., Gabbay K. H. Hyperglycemia and plasma lipid levels: a prospective study of young insulin-dependent diabetic patients. N Engl J Med. 1980 Mar 20;302(12):650–654. doi: 10.1056/NEJM198003203021202. [DOI] [PubMed] [Google Scholar]
  29. Steinbrecher U. P., Witztum J. L. Glucosylation of low-density lipoproteins to an extent comparable to that seen in diabetes slows their catabolism. Diabetes. 1984 Feb;33(2):130–134. doi: 10.2337/diab.33.2.130. [DOI] [PubMed] [Google Scholar]
  30. Stewart M. W., Laker M. F., Dyer R. G., Game F., Mitcheson J., Winocour P. H., Alberti K. G. Lipoprotein compositional abnormalities and insulin resistance in type II diabetic patients with mild hyperlipidemia. Arterioscler Thromb. 1993 Jul;13(7):1046–1052. doi: 10.1161/01.atv.13.7.1046. [DOI] [PubMed] [Google Scholar]
  31. Strobl W., Widhalm K., Schober E., Frisch H., Pollak A., Westphal G. Apolipoproteins and lipoproteins in children with type I diabetes: relation to glycosylated serum protein and HbA1. Acta Paediatr Scand. 1985 Nov;74(6):966–971. doi: 10.1111/j.1651-2227.1985.tb10066.x. [DOI] [PubMed] [Google Scholar]
  32. Taskinen M. R., Packard C. J., Shepherd J. Effect of insulin therapy on metabolic fate of apolipoprotein B-containing lipoproteins in NIDDM. Diabetes. 1990 Sep;39(9):1017–1027. doi: 10.2337/diab.39.9.1017. [DOI] [PubMed] [Google Scholar]
  33. Wald N. J., Law M., Watt H. C., Wu T., Bailey A., Johnson A. M., Craig W. Y., Ledue T. B., Haddow J. E. Apolipoproteins and ischaemic heart disease: implications for screening. Lancet. 1994 Jan 8;343(8889):75–79. doi: 10.1016/s0140-6736(94)90814-1. [DOI] [PubMed] [Google Scholar]
  34. Warnick G. R., Albers J. J. A comprehensive evaluation of the heparin-manganese precipitation procedure for estimating high density lipoprotein cholesterol. J Lipid Res. 1978 Jan;19(1):65–76. [PubMed] [Google Scholar]
  35. Webber L. S., Srinivasan S. R., Wattigney W. A., Berenson G. S. Tracking of serum lipids and lipoproteins from childhood to adulthood. The Bogalusa Heart Study. Am J Epidemiol. 1991 May 1;133(9):884–899. doi: 10.1093/oxfordjournals.aje.a115968. [DOI] [PubMed] [Google Scholar]
  36. Winocour P. H., Durrington P. N., Ishola M., Anderson D. C. Lipoprotein abnormalities in insulin-dependent diabetes mellitus. Lancet. 1986 May 24;1(8491):1176–1178. doi: 10.1016/s0140-6736(86)91159-1. [DOI] [PubMed] [Google Scholar]
  37. al Muhtaseb N., al Yousuf A., Bajaj J. S. Apolipoprotein A-I, A-II, B, C-II, and C-III in children with insulin-dependent diabetes mellitus. Pediatrics. 1992 May;89(5 Pt 1):936–941. [PubMed] [Google Scholar]

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