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Cardiometabolic risk factors ‘highly prevalent’ in children with Type 1 diabetes

J Pediatr 2010; 156: 923–929

Results from a Dutch study show that children with Type 1 diabetes have a high prevalence of various cardiometabolic risk factors and the metabolic syndrome.

The increasing prevalence of overweight and obesity has been linked to adverse cardiovascular (CV) outcomes and higher incidence of Type 2 diabetes in many studies, but the influence of weight gain on CV morbidity and mortality in patients with Type 1 diabetes is less clear.

To investigate further, Josine Van der Heyden (Diabeter, Rotterdam) and colleagues assessed the prevalence of cardiometabolic risk factors and the metabolic syndrome, and levels of alanine aminotransferase in 283 consecutive patients with Type 1 diabetes aged 3 to 18 years (median age 12.8 years).

Cardiometabolic risk factors measured included smoking, obesity, poor glycemic control, high low-density lipoprotein (LDL) cholesterol, high triglycerides, low high-density lipoprotein (HDL) cholesterol, and microalbuminuria.

The team reports in The Journal of Pediatrics that 38.5% of the children were overweight (body mass index [BMI] Z-score= 1.1 or more), 9.2% of whom were obese (BMI Z-score=2.0 or more).

Median glycated hemoglobin (HbA1c) levels were 8.2%, and 73.9% of the children had an HbA1c level of 7.5% or more. Microalbuminuria was observed in 17.7% of the children, and 17.3%, 28.6%, and 21.2% had high triglycerides, high LDL cholesterol, and low HDL cholesterol, respectively.

Overall, 13.1% of the children had hypertension. However, when overweight/obese children were compared with normal weight children significantly more had hypertension, at 23.9% versus 5.7%.

In addition, significantly more overweight/obese children had the metabolic syndrome and alanine aminotransferase levels above 30 IU/l, at 25.7% versus 6.3% and 15.6% versus 4.5%, respectively.

"Longitudinal studies are needed to assess the future risk for CV disease in patients with Type 1 diabetes mellitus with established cardiometabolic risk factors in childhood," conclude the authors.
"These studies should determine which combination of cardiometabolic risk factors best predict adverse outcomes."

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MedWire ( is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2010