TRANSLATIONAL AND CLINICAL MEDICINE - Georgian Medical Journal

Background: Diabetes mellitus in children and adolescents increases the risk of developing dyslipidemia. 

The aim of our study is to determine the relationship between HbA1c and lipid profile indicators in a Georgian population of children with type 1 diabetes.Methods

The study was based on biochemical data obtained from 230 children and adolescents with type 1 diabetes and 383 age-comparable controls from the Megalab clinic population. The participants were 9 to 18 years old; the mean age in the T1D group was 13.22±2.82 years.

Biochemical assessment was performed after a 12-hour overnight fast. We studied: Serum total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), glycated hemoglobin (HbA1c). The following lipid indices were assessed: non-HDL-C, TG/HDL-C,  log10(TG/HDL-C), HDL-C/LDL-C, TC/HDL-C, LDL-C/HDL-C, and non-HDL-C/HDL-C. Statistical analysis was performed using SPSS - 23.

Results: A statistically significant positive correlation was observed between HbA1c and the following indicators: Total cholesterol (TC): r=0.527; LDL-C: r=0.441; triglycerides (TG): r=0.446; non-HDL-C: r=0.522**; HbA1c also showed a low-significant positive correlation with atherogenic indices -TC/HDL-C: r=0.321, LDL-C/HDL-C: r=0.256, non-HDL-C/HDL-C: r=0.321, TG/HDL-C: r=0.369, log(TG/HDL-C): r=0.328, LDL-C–HDL-C: r=0.385**. ( p<0.001)This indicates that an increase in HbA1c in children with type 1 diabetes is associated with a worsening of the atherogenic profile.

In the case of HDL-C: r=−0.009; p=0.895 - a statistically significant relationship was not observed.

 In the T1DM group, significantly increased compared to controls -  TC: 153.15 vs 175.92 mg/dL, LDL-C: 89.83 vs106.99 mg/dL; TG: 71.15 mg/dL vs 119.28 mg/dL HDL was reduced in the T1D group by 45.07 mg/dL vs: 49.09 mg/dL. Non–HDL-C -104.06 vs 130.84 mg/dL reflects an increase in atherogenic fractions. In all cases (p<0.001).

All indices were significantly higher in the T1D group: TC/HDL-C: 3.16 vs 4.14; LDL/HDL-C: 1.87 vs 2.55; Non-HDL/HDL-C: 2.16 vs 3.14; TG/HDL-C: 1.47 vs 2.95; log(TG/HDL): 0.16 vs 0.38, indicating a markedly atherogenic profile, LDL-C–HDL-C: 40.75 vs 61.92 mg/dL increase reflects a strengthening of the atherogenic imbalance.

Conclusions

1. Glycemic control in children with type 1 diabetes mellitus has a significant impact on lipid metabolism and determines the formation of an atherogenic lipid profile.
2. In Georgian children with type 1 diabetes, the lipid profile is significantly more atherogenic than in healthy controls and is characterized by higher total cholesterol, LDL-C, triglycerides, and non-HDL-C, lower HDL-C, and increased atherogenic indices. The TC/HDL-C, LDL-C/HDL-C, non-HDL-C/HDL-C, and TG/HDL-C indices are all significantly higher in the diabetes group.
3. Changes in the lipid spectrum indicate early cardiovascular risk formation and justify active prevention and monitoring already in childhood.
4. These data indicate the early formation of cardiovascular risk and emphasize the importance of preventive measures in childhood.

type 1 diabetes, children, lipid spectrum, cardiovascular risk, lipid indices, atherogenic profile

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