ASSESSMENT OF THE LIPID SPECTRUM IN GEORGIAN CHILDREN WITH TYPE 1 DIABETES MELLITUS.

BACKGROUND

Children and adolescents with type 1 diabetes mellitus (T1DM) are at increased risk of future cardiovascular disease, and dyslipidemia is one of the major modifiable contributors to this risk. In recent years, atherogenic lipid indices have been considered more sensitive markers of cardiovascular risk than isolated lipid parameters.

OBJECTIVE

To assess the lipid spectrum in Georgian children with T1DM and to determine the association between glycemic control and dyslipidemia.

METHODS

This retrospective cross-sectional study included 230 children and adolescents aged 9-18 years (mean age 13.22±2.82 years) with T1DM from the Megalab clinical cohort. Dyslipidemia was defined as one or more abnormal lipid or lipoprotein values according to pediatric criteria. The following parameters and indices were evaluated: total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), non-HDL-C, TC/HDL-C, LDL-C/HDL-C, non-HDL-C/HDL-C, TG/HDL-C, atherogenic index of plasma [AIP = log10(TG/HDL-C)], and LDL-C minus HDL-C. Statistical analysis was performed using SPSS version 23.

RESULTS

Participants with inadequate glycemic control (HbA1c≥7%; n=72) had significantly higher TC, LDL-C, TG, non-HDL-C, and all assessed atherogenic indices except HDL-C, compared with those with HbA1c<7% (n=158). In logistic regression analysis, age (B=0.12; p=0.028). OR = 1.12(95% CI: 1.01-1.24) and HbA1c (B=0.20; p=0.002), OR=1.22(95% CI: 1.08-1.39) were independent predictors of dyslipidemia, while sex was not.

CONCLUSIONS

In children with T1DM, inadequate glycemic control (HbA1c≥7%) is associated with a more unfavorable atherogenic lipid profile. Atherogenic lipid indices are clinically important in children with T1DM because they reflect the overall effect of atherogenic lipoproteins better than any single lipid parameter alone. HbA1c is an independent predictor of dyslipidemia in children with T1DM.