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Prevalence of cardiovascular risk factors in youth with type 1 diabetes and elevated body mass index

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Abstract

Aim

The prevalence of cardiovascular risk factors in children with type 1 diabetes and elevated BMI in the USA is poorly defined. We aimed to test the hypothesis that children with type 1 diabetes who are overweight or obese have increased frequencies of hypertension, dyslipidemia, and micro-/macroalbuminuria compared to their healthy weight peers.

Methods

We studied 11,348 children 2 to <18 years of age enrolled in T1D Exchange between September 2010 and August 2012 with type 1 diabetes for ≥1 year and BMI ≥ 5th age-/sex-adjusted percentile (mean age 12 years, 49 % female, 78 % non-Hispanic White). Overweight and obesity were defined based on Centers for Disease Control and Prevention criteria. Diagnoses of hypertension, dyslipidemia, and micro-/macroalbuminuria were obtained from medical records. Logistic and linear regression models were used to assess factors associated with weight status.

Results

Of the 11,348 participants, 22 % were overweight and 14 % obese. Hypertension and dyslipidemia were diagnosed in 1.0 % and 3.8 % of participants, respectively; micro-/macroalbuminuria was diagnosed in 3.8 % of participants with available data (n = 7,401). The odds of either hypertension or dyslipidemia were higher in obese than healthy weight participants [OR 3.5, 99 % confidence interval (CI) 2.0–6.1 and 2.2, 99 % CI 1.6–3.1, respectively]. Obese participants tended to be diagnosed with micro-/macroalbuminuria less often than healthy weight participants (OR 0.6, 99 % CI 0.4–1.0).

Conclusions

Obese children with type 1 diabetes have a higher prevalence of hypertension and dyslipidemia than healthy weight children with type 1 diabetes. The possible association of obesity with lower micro-/macroalbuminuria rates warrants further investigation.

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Abbreviations

T1D:

Type 1 diabetes

BMI:

Body mass index

CVD:

Cardiovascular disease

SMBG:

Self-monitoring of blood glucose

HbA1c:

Hemoglobin A1c

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Acknowledgments

This work was supported through the Leona M. and Harry B. Helmsley Charitable Trust.

Conflict of interest

The authors do not have any conflict of interest.

Ethical standard

This human study has been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Human and Animal Rights disclosure

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

Informed Consent disclosure

Informed consent was obtained from all patients for being included in the study.

Author information

Authors and Affiliations

  1. Baylor College of Medicine, 6621 Fannin St, Houston, TX, 77030, USA

    Maria J. Redondo

  2. Jaeb Center for Health Research, 15310 Amberly Drive, Suite 350, Tampa, FL, 33647, USA

    Nicole C. Foster, Stephanie N. DuBose & Roy W. Beck

  3. Children’s Hospital of Pittsburgh of UPMC, 4401 Penn Avenue, Pittsburgh, PA, 15224, USA

    Ingrid M. Libman

  4. Joslin Diabetes Center, 1 Joslin Place, Boston, MA, 02215, USA

    Sanjeev N. Mehta & Joanne M. Hathway

  5. School of Medicine and Biomedical Sciences at the University at Buffalo, State University of New York, 402 Crofts Hall, Buffalo, NY, 14260, USA

    Kathleen E. Bethin & Michelle A. Ecker

  6. University of Minnesota, 516 Delaware St. SE, Minneapolis, MN, USA

    Brandon M. Nathan

  7. Stanford University School of Medicine, 300 Pasteur Dr, Stanford, CA, 94305, USA

    Avni C. Shah

  8. Yale University, 333 Cedar St, New Haven, CT, 06520, USA

    William V. Tamborlane

  9. Nationwide Children’s Hospital, 700 Children’s Dr, Columbus, OH, 43205, USA

    Robert P. Hoffman

  10. University of California at San Francisco, 513 Parnassus Ave, San Francisco, CA, 94143, USA

    Jenise C. Wong

  11. Barbara Davis Center for Childhood Diabetes, 1775 N. Ursula St, Aurora, CO, 80045, USA

    David M. Maahs

  12. Indiana University School of Medicine, 702 Barnhill Dr, Indianapolis, IN, 46202, USA

    Linda A. DiMeglio

Authors
  1. Maria J. Redondo
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  2. Nicole C. Foster
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  3. Ingrid M. Libman
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  4. Sanjeev N. Mehta
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  5. Joanne M. Hathway
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  6. Kathleen E. Bethin
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  7. Brandon M. Nathan
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  8. Michelle A. Ecker
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  9. Avni C. Shah
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  10. Stephanie N. DuBose
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  11. William V. Tamborlane
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  12. Robert P. Hoffman
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  13. Jenise C. Wong
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  14. David M. Maahs
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  15. Roy W. Beck
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  16. Linda A. DiMeglio
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Corresponding author

Correspondence to Nicole C. Foster.

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Managed by Massimo Federici.

For the T1D Exchange Clinic Network.

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Redondo, M.J., Foster, N.C., Libman, I.M. et al. Prevalence of cardiovascular risk factors in youth with type 1 diabetes and elevated body mass index. Acta Diabetol 53, 271–277 (2016). https://doi.org/10.1007/s00592-015-0785-1

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  • DOI: https://doi.org/10.1007/s00592-015-0785-1

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