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- Title
Determinants of Cardiovascular Risk in 7000 Youth With Type 1 Diabetes in the Australasian Diabetes Data Network.
- Authors
Couper, Jenny J; Jones, Timothy W; Chee, Melissa; Barrett, Helen L; Bergman, Philip; Cameron, Fergus; Craig, Maria E; Colman, Peter; Davis, Elizabeth E; Donaghue, Kim C; Fegan, P Gerry; Hamblin, P Shane; Holmes-Walker, D Jane; Jefferies, Craig; Johnson, Stephanie; Mok, Meng Tuck; King, Bruce R; Sinnott, Richard; Ward, Glenn; Wheeler, Benjamin J
- Abstract
<bold>Context: </bold>Cardiovascular disease occurs prematurely in type 1 diabetes. The additional risk of overweight is not well characterized.<bold>Objective: </bold>The primary aim was to measure the impact of body mass index (BMI) in youth with type 1 diabetes on cardiovascular risk factors. The secondary aim was to identify other determinants of cardiovascular risk.<bold>Design: </bold>Observational longitudinal study of 7061 youth with type 1 diabetes followed for median 7.3 (interquartile range [IQR] 4-11) years over 41 (IQR 29-56) visits until March 2019.<bold>Setting: </bold>15 tertiary care diabetes centers in the Australasian Diabetes Data Network.Participants were aged 2 to 25 years at baseline, with at least 2 measurements of BMI and blood pressure.<bold>Main Outcome Measure: </bold>Standardized systolic and diastolic blood pressure scores and non-high-density lipoprotein (HDL) cholesterol were co-primary outcomes. Urinary albumin/creatinine ratio was the secondary outcome.<bold>Results: </bold>BMI z-score related independently to standardized blood pressure z- scores and non-HDL cholesterol. An increase in 1 BMI z-score related to an average increase in systolic/diastolic blood pressure of 3.8/1.4 mmHg and an increase in non-HDL cholesterol (coefficient + 0.16 mmol/L, 95% confidence interval [CI], 0.13-0.18; P < 0.001) and in low-density lipoprotein (LDL) cholesterol. Females had higher blood pressure z-scores, higher non-HDL and LDL cholesterol, and higher urinary albumin/creatinine than males. Indigenous youth had markedly higher urinary albumin/creatinine (coefficient + 2.15 mg/mmol, 95% CI, 1.27-3.03; P < 0.001) and higher non-HDL cholesterol than non-Indigenous youth. Continuous subcutaneous insulin infusion was associated independently with lower non-HDL cholesterol and lower urinary albumin/creatinine.<bold>Conclusions: </bold>BMI had a modest independent effect on cardiovascular risk. Females and Indigenous Australians in particular had a more adverse risk profile.
- Subjects
TYPE 1 diabetes; OVERWEIGHT children; SYSTOLIC blood pressure; INDIGENOUS youth; CARDIOVASCULAR diseases risk factors; HYPERTENSION
- Publication
Journal of Clinical Endocrinology & Metabolism, 2021, Vol 106, Issue 1, p133
- ISSN
0021-972X
- Publication type
journal article
- DOI
10.1210/clinem/dgaa727