Overweight adolescents with type 2 diabetes have significantly higher lipoprotein abnormalities than those with type 1 diabetes

Abstract

Aim Diabetes-associated glucoregulatory derangements may precipitate atherogenesis in childhood and CVD risk, particularly with obesity. We aimed to delineate lipoprotein profile differences between children with type 1 and 2 diabetes who are overweight/obese. Methods Data were obtained from electronic medical records of patients ≥85th BMI percentile with type 1 (n=159) and type 2 (n=77) diabetes, ages 12–19y. Group differences were evaluated by correlations and general linear modeling analysis, adjusting for BMI, HbA1c, and diabetes duration. Results There were no group differences in TC, LDL, or non-HDL. Fewer subjects with type 1 diabetes had low HDL (17 vs. 30%; P<0.05). While no difference in HbA1c level was observed between groups, HbA1c was positively correlated with TC (P≤0.0001), LDL (P≤0.0001), non-HDL (P≤0.0001), ApoB100 (P≤0.0001), and LDL pattern B (P≤0.0001). In adjusted models, apoB100 (85.4 vs. 91.3mg/dl; P<0.05) and incidence of LDL pattern B (21 vs. 42%; P<0.01) were lower in subjects with type 1 diabetes. BMI was inversely correlated with HDL, HDL-2 and HDL-3 (all P≤0.0001). The correlation of BMI with HDL-2 and HDL-3 were attenuated when evaluating subjects by diabetes type. Conclusions Despite having no difference in absolute LDL levels, children with type 2 diabetes were more likely to have small, dense LDL particle pattern, higher apo B100 and lower total HDL, HDL-2, and HDL-3 fractions. Furthermore, poor glycemic control was associated with abnormal lipoprotein profiles in patients with both type 1 and 2 diabetes.

mGluR2/3 activation of the SIRT1 axis preserves mitochondrial function in diabetic neuropathy

“…In this study, HDL was increased in the more acute STZ model of diabetes (Table ) but reduced in the more chronic LCR obesity model (Table ). This is similar to humans, where HDL levels are relatively preserved in young T1DM and reduced in chronic T2DM . PGC‐1 α is increased by treatment with LY379269 (Fig.…”

Higher hemoglobin A1C and atherogenic lipoprotein profiles in children and adolescents with type 2 diabetes mellitus

“…Our group has previously demonstrated that overweight and obese children with T2DM have significantly more atherogenic lipoprotein profiles even when compared to overweight and obese children with T1DM [7] , suggesting an inherently increased risk for atherogenicity in children with T2DM. This has been also supported by a larger multi-center trial [12] .…”

“…The clustering of risk factors such as insulin resistance, increased body mass index (BMI), and physical inactivity are more prevalent in children with T2DM than in those with T1DM [5] , [6] and has generated significant information on the pathophysiologic link between T2D and CVD. Moreover, overweight/obese children with T2DM have a higher risk of adverse lipoprotein profiles compared to overweight/obese T1DM children [7] .…”

“…The number and size of LDL particles play a role in atherogenicity [8] , [14] , [15] , [16] . To our knowledge, few studies have reported on the lipoprotein profiles of children with T2DM [7] , [12] , [13] .…”

The small dense LDL particle/large buoyant LDL particle ratio is associated with glucose metabolic status in pregnancy

“…With aggravating insulin resistance, the concentration and mean size of VLDL-P increase, whereas LDL and HDL particle sizes decrease [ 23 ]. Abnormal lipoprotein profiles, including higher small dense LDL and lower large buoyant HDL fractions, indicate poor glycemic control in overweight adolescents with type 2 diabetes [ 24 ]. A recent article by Mackey et al [ 25 ] described the association between lipoprotein particles and the incidence of type 2 diabetes in a multicenter prospective cohort study, indicating that the number and size of VLDL-P were significantly associated with the incidence of type 2 diabetes in patients with atherosclerosis.…”