Endocrine Abstracts

JOINT1832

Background: Type 1 diabetes (T1D) is characterized by disrupted carbohydrate and lipid metabolism, predisposing individuals to cardiovascular disease and early death. Understanding lipid variations during childhood is crucial for assessing cardiovascular risk in T1D. A recent study from our team shows that lipid concentrations in healthy children vary across ages 5–17. Building on this, the current study aimed to assess the HDL, LDL, triglycerides, and remnant cholesterol profile in Danish children with T1D compared to healthy children, using age-adjusted z-scores.

Methods: Participants with type 1 diabetes (T1D) were recruited for the Copenhagen T1D 2016 cross-sectional cohort. Of the 256 participants diagnosed with T1D for at least one year, those younger than five or older than 17 years (n=32) were excluded to enable comparison with previously collected z-score data from a healthy control group, leaving 224 for analysis.

Results: The T1D cohort had significantly higher z-scores for total cholesterol in girls (median=0.374, median control=0.051; P<0.001) and LDL in girls (median=0.287, median control=0.019, P=0.029) as well as triglycerides in girls (median=0.428, median control=0.009, P<0.001) and boys (median=0.356, median control=-0.018, P=0.002) and remnant cholesterol in girls (median=0.651, median control=0.049, P<0.001) and boys (median=0.452, median control=0.080, P<0. 001). After adjusting for BMI z-score, the effect of BMI on all cholesterol z-scores was similar in both cohorts. Patients with T1D with an average weight (BMI z-score=0), had significantly elevated total cholesterol z-scores compared to the control cohort in girls (Δz-score=0.382, P=0.002), triglyceride in girls (Δz-score=0.330, P=0.006) and boys (Δz-score=0.314, P=0.002) and remnant cholesterol in girls (Δz-score=0.489, P<0.001) and boys (Δz-score=0.583, P<0.001). Non-compliance with the International Society for Pediatric and Adolescent Diabetes (ISPAD) LDL guidelines, whit an upper limit of 2.6 mmol/l, was 36% in the T1D cohort, compared to 31% in the control cohort.

Conclusions: This study highlights significant cholesterol differences in children with T1D through the novel application of age-adjusted z-scores, which provide a more precise comparison of lipid profiles between children with T1D and their healthy peers.