Dyslipidemia in children with type 1 diabetes across age groups in Southern Iran: is it time to rethink guidelines?

BACKGROUND

Current guidelines recommend lipid screening in children with Type 1 Diabetes Mellitus (T1DM) after the age of 10. This study aimed to evaluate the prevalence and predictors of dyslipidemia in pediatric T1DM and determine whether screening before age 10 is warranted.

METHODS

In this cross-sectional study, 187 pediatric patients with T1DM attending the diabetes clinic of Emam Reza Clinic, Shiraz University of Medical Sciences, Iran, were evaluated. Demographic, anthropometric, and clinical data including age, sex, disease duration, lipid profile (following standard protocol), and HbA1c were collected. Dyslipidemia was defined as LDL > 100 mg/dL, HDL < 40 mg/dL, and TG > 100 mg/dL (< 10 years) or > 130 mg/dL (≥ 10 years) Statistical analyses included chi-square, independent t-test/Mann-Whitney U, and binary logistic regression.

RESULTS

The mean age was 11.05 ± 3.52 years; 40.1% (75) were ≤ 10 years old. Dyslipidemia occurred in 46.0% (95% CI: 38.9%-53.2%), with similar prevalence in ≤ 10 years (42.7%, 95% CI: 31.5%-53.9%) and > 10 years (48.2%, 95% CI: 39.0%-57.5%) (p = 0.46). Hypertriglyceridemia was observed in 22.7% of younger vs. 22.3% of older patients (p = 0.95), while LDL dyslipidemia tended to be higher in > 10 years (28.6% vs. 16.0%, p = 0.05). In multivariable analysis, each one-unit increase in HbA1c was associated with higher odds of dyslipidemia (OR: 1.29, 95% CI: 1.04-1.59), as was BMI (OR: 1.10, 95% CI: 1.01-1.21).

CONCLUSIONS

Dyslipidemia is prevalent even in T1DM patients ≤ 10 years. These findings suggest that lipid screening should be considered before age 10 to ensure earlier detection and intervention.

TRIAL REGISTRATION: Not applicable.