Document Detail


Prevalence and phenotypic distribution of dyslipidemia in type 1 diabetes mellitus: effect of glycemic control.
MedLine Citation:
PMID:  11025785     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Data on the prevalence of dyslipidemia in type 1 diabetes mellitus are scarce and are based on total triglyceride and total cholesterol concentrations alone. OBJECTIVE: To assess the effect of glycemic optimization on the prevalence of dyslipidemia and low-density lipoprotein cholesterol (LDL-C) concentrations requiring intervention in patients with type 1 diabetes. PATIENTS: A total of 334 adults with type 1 diabetes and 803 nondiabetic control subjects. METHODS: Levels of glycosylated hemoglobin, total cholesterol, total triglyceride, high-density lipoprotein cholesterol (HDL-C), and LDL-C were assessed at baseline and after 3 to 6 months of intensive therapy with multiple insulin doses. RESULTS: Levels of LDL-C greater than 4.13 mmol/L (>160 mg/dL) and total triglyceride greater than 2.25 mmol/L (>200 mg/dL) and low HDL-C levels (<0.9 mmol/L [<35 mg/dL] in men or <1.1 mmol/L [<45 mg/dL] in women) were found in 16%, 5%, and 20% of patients and 13%, 6%, and 9% of controls, respectively (P<.001 for HDL-C). Diabetic women showed more hypercholesterolemia than nondiabetic women (15.6% vs 8.5%; P =.04). After glycemic optimization (mean +/- SD glycosylated hemoglobin decrease, 2.2 +/- 1.96 percentage points), the prevalence of LDL-C levels greater than 4.13 mmol/L (>160 mg/dL) became lower in diabetic men than in nondiabetic men (9.7% vs 17.5%; P =.04), but women showed frequencies of dyslipidemia similar to their nondiabetic counterparts. The proportion of patients with LDL-C concentrations requiring lifestyle (>2.6 mmol/L [>100 mg/dL]) or drug (>3.4 mmol/L [>130 mg/dL]) intervention decreased from 78% and 42% to 66% and 26%, respectively. CONCLUSIONS: Low HDL-C is the most frequent dyslipidemic disorder in patients with poorly controlled insulin-treated type 1 diabetes, and a high proportion show LDL-C levels requiring intervention. Less favorable lipid profiles could explain the absence of sex protection in diabetic women. The improvement caused by glycemic optimization puts forward intensive therapy as the initial treatment of choice for dyslipidemia in poorly controlled type 1 diabetes.
Authors:
A Pérez; A M Wägner; G Carreras; G Giménez; J L Sánchez-Quesada; M Rigla; J A Gómez-Gerique; J M Pou; A de Leiva
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of internal medicine     Volume:  160     ISSN:  0003-9926     ISO Abbreviation:  Arch. Intern. Med.     Publication Date:  2000 Oct 
Date Detail:
Created Date:  2000-10-19     Completed Date:  2000-10-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372440     Medline TA:  Arch Intern Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  2756-62     Citation Subset:  AIM; IM    
Affiliation:
Department of Endocrinology and Nutrition, Hospital de Sant Pau, S Antonio M Claret 167, 08025 Barcelona, Spain. aperez@santpau.es
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Arteriosclerosis / blood,  diagnosis,  genetics
Blood Glucose / metabolism*
Cholesterol, HDL / blood
Cholesterol, LDL / blood
Cross-Sectional Studies
Diabetes Mellitus, Type 1 / blood,  diagnosis,  genetics*
Drug Administration Schedule
Female
Hemoglobin A, Glycosylated / metabolism
Humans
Hyperlipoproteinemia Type I / blood,  diagnosis,  genetics*
Insulin / administration & dosage*,  adverse effects
Life Style
Male
Middle Aged
Phenotype*
Risk Factors
Triglycerides / blood
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Cholesterol, HDL; 0/Cholesterol, LDL; 0/Hemoglobin A, Glycosylated; 0/Triglycerides; 11061-68-0/Insulin
Comments/Corrections
Comment In:
Arch Intern Med. 2001 Jun 11;161(11):1461-2   [PMID:  11386905 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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