Nine-year longitudinal study of cardiovascular risk factors in Spanish children and adolescents with type 1 diabetes☆

Abstract Objectives To analyse the prevalence, evolution of cardiovascular risk factors (CVRF) and their relationship with follow-up of metabolic control in paediatric patients with Type 1 Diabetes (T1DM). Patients and methods A longitudinal ambispective study was conducted including 75 children and adolescents with T1DM diagnosed from 1996 to 2003 and followed-up for nine years. Family history of CVRF was registered. Data from the second, sixth and ninth year after diagnosis were analysed. Results Family history of CVRF was found in 46.6% of the patients. The prevalence of HbA1c > 7.5% in the second, sixth and ninth year after diagnosis was 45.3%, 53.3% and 56%, respectively. The prevalence of obesity (BMI > 2SDS) in the three visits was 5.3%, 5.3% and 6.7%, respectively. Hypertension (BP > p90) was found in 14.6%, 8% and 13.3% of the patients in the three visits, respectively. The levels of various parameters were the following: Total cholesterol > 200 mg/dL: 25.3%, 13.3% and 16%; high density cholesterol lipoprotein   100 mg/dL: 38.6%, 34.6% and 38.6%; triglyceride > 150 mg/dL: 0%, 1.3% and 2.6%, respectively. There was a significant increase in the prevalence of TG/HDL-C ≥ 2 between the sixth and the ninth year after diagnosis (1.3% and 9.3%, P z -score between the second and the sixth year, and a persistent HbA1c  z -score (P  = 0.015) in the same period. Conclusions A non-optimal metabolic control in the first year of DM1 is associated with a decrease in HDL-C z -score. TG/HDL-C ratio could be an early marker of cardiovascular risk.