Long-term lipid abnormalities were significantly associated with higher albumin excretion in a study of 895 adolescents aged 10-16 years with type 1 diabetes.
Data on lipid levels and the possible association between lipids and albumin excretion in teens with type 1 diabetes are limited. But previous studies suggest that the relationship between these values can help clinicians predict the risk of diabetic neuropathy in these patients, wrote Dr. Maria Loredana Marcovecchio of the University of Cambridge (England) and her colleagues.
The researchers reviewed data from 490 boys and 405 girls, whose mean age at baseline was 14.5 years, with type 1 diabetes who were enrolled in an ongoing juvenile diabetes study in the United Kingdom. The data included three consecutive early morning urine samples to determine albumin-creatinine ratios, collected each year for an average of 2.3 years. Nonfasting blood samples were taken to assess lipids. They defined microalbuminuria (MA) as an albumin-creatinine ratio in the 3.5-35 mg/mmol range for boys and in the 4.0-40 mg/mmol range for girls in two of three consecutive urine samples at an annual collection (Diabetes Care 2009 [Epub ahead of print: http://care.diabetesjournals.org
During the follow-up period, 115 teens developed MA. The average concentrations of total cholesterol and non-HDL cholesterol were significantly higher in the teens with MA, compared with teens with normal albumin levels (4.7 mmol/L vs. 4.5 mmol/L and 3.2 mmol/L vs. 2.9 mmol/L, respectively).
Age-related changes in total cholesterol and non-HDL cholesterol in teens older than age 15 or 16 years were higher in the 28 teens with persistent MA compared with the 87 teens with transient MA and compared with teens without MA, the researchers noted. The average age of onset for MA was 15 years, which supports the link between lipids and MA, but the worse glycemic control in teens with MA could be a factor, they added.
During the follow-up period, an average of 19% of the teens had abnormal total cholesterol, 20% had abnormal triglycerides, 26% had abnormal HDL cholesterol, and 10% had abnormal LDL cholesterol. In addition, an average of 2.5% had low HDL cholesterol, 35% had borderline triglycerides, and 13% had borderline LDL cholesterol.
Overall, the association between average lipid levels and average hemoglobin A1c levels was significant (with the exception of HDL cholesterol). The associations were significantly stronger in girls compared with boys. Older age and longer duration of diabetes were significant predictors of all types of lipid abnormalities, and higher body mass index was significantly associated with all lipid abnormalities, except total cholesterol.
The researchers had no financial conflicts to disclose.