| Background and Objective:The incidence of type 1 diabetes mellitus(T1DM)is increasing year by year,and the incidence of chronic complications is high,and the disease burden is heavy.Among all kinds of chronic complications,the cardiovascular complications of T1DM are the most important cause of death and disability.Epidemiological investigation found that dyslipidemia and insulin resistance are independent risk factors for T1DM.There may be an interaction between dyslipidemia and insulin resistance in T1DM.The purpose of this study is to investigate the current situation of blood lipid indexes in children and adolescents with T1DM,including the incidence of dyslipidemia,the correlation between dyslipidemia and blood glucose control level and the relationship between blood lipid indexes and insulin resistance through a correlation study.Methods:Children with T1DM who were hospitalized in the Department of Pediatric Endocrinology of Shandong Provincial Hospital from January 2014 to June 2020 were retrospectively analyzed.Their clinical and laboratory indexes were recorded.Healthy children who received physical examination in the pediatric clinic of Shandong Provincial Hospital at the same time were selected as the control group.They were matched with children with diabetes according to age and gender,and the differences in blood lipid indexes between the two groups were compared.Children with T1DM were divided into groups according to the level of blood glucose control.The differences of blood lipid indexes between the two groups were compared.Insulin sensitivity score(ISS)was used to evaluate the severity of insulin resistance,and the correlation between insulin resistance and lipids was studied.Results:1.A total of 111 children with T1DM were included in the study,with an average age of 9.97±4.25 years,59 of them(53.2%)were male,the median course of disease was 31.8(13.8,57.5)months,and the mean BMI SDS of children with T1DM was 0.24±1.13 The mean height SDS was 0.18±1.32 and the median HbA1c(%)was 8.5(7.3,10.1).2.The median total cholesterol(TC)in T1DM children was 4.31(3.78,4.75),significantly higher than that in normal children(4.19(3.63,4.74),P=0.035).The median LDL-C(1.95,2.71)in children with T1DM was 2.36(1.95,2.71),significantly higher than that in normal children(2.28,1.84,2.54),P=0.041.The average APO A(mmol/L)was 1.19±0.21,which was significantly higher than that of normal children(1.13±0.17,P=0.03).The overall incidence of dyslipidemia in T1DM children was 21.62%,among which 15.3%were hypercholesterolemia and 9.9%were hyper LDL-cholesterolemia,both of which were significantly higher than those in normal children(10.8%,P=0.000;0.9%,P=0.000).3.The median TC(3.87,4.95)and LDL-C(2.26,1.93,2.74)in substandard group were 4.35(3.87,4.95)and 2.26(1.93,2.74),respectively,which were significantly higher than those in standard group(4.28,3.76,4.86),P=0.009;1.89,2.48),P=0.005);The median HDL-C(1.30 mmol/L)in the substandard group was 1.51(1.30,1.76),significantly lower than that in the standard group(1.75(1.39,1.86),P=0.049).4.Correlation analysis showed that TC,sdLDL-C,TG were significantly positively correlated with HbAlc(%)in T1DM children,the correlation coefficients were 0.296,0.203,0.282,0.223,and P values were 0.013,0.046,0.016,0.018,respectively.There was a significant negative correlation between HDL-C and HbA1c(%),with a correlation coefficient of-0.250 and a P value of 0.008.After adjusting for BMI SDS,the correlation trend between TC,sdLDL-C,TG,HDL-C and HbAlc still existed.5.Correlation analysis between ISS and various lipid indexes showed a positive correlation between ISS and HDL-C,with a correlation coefficient of 0.208(P=0.008).Conclusions:1.The main types of dyslipidemia in the population included in this study were hypercholesterolemia and hyper LDL cholesterolemia.Dyslipidemia in children and adolescents with T1DM was not uncommon.2.TC,LDL-C,SDLDL-C,TG were significantly positively correlated with HbAlc(%),while HDL-C was significantly negatively correlated with HbAlc(%).Strengthening blood glucose management can prevent the occurrence of dyslipidemia.3.The degree of insulin resistance estimated by ISS showed a significant negative correlation between the severity of IR and HDL-C. |
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