Heterogeneous behavior of lipids according to HbA1c levels undermines the plausibility of metabolic syndrome in type 1 diabetes: data from a nationwide multicenter survey
| العنوان: | Heterogeneous behavior of lipids according to HbA1c levels undermines the plausibility of metabolic syndrome in type 1 diabetes: data from a nationwide multicenter survey |
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| المؤلفون: | Fernando Ma Giuffrida, Eloa R. Rocco, Carlos Antonio Negrato, Sergio Atala Dib, Denise Barretto Mory, Roberta A Cobas, Reine M Chaves-Fonseca, Odelisa S Matos, Patricia Dualib, Marília B. Gomes, Alexis D Guedes |
| المصدر: | Cardiovascular Diabetology, Vol 11, Iss 1, p 156 (2012) Cardiovascular Diabetology |
| بيانات النشر: | BMC, 2012. |
| سنة النشر: | 2012 |
| مصطلحات موضوعية: | Adult, Male, medicine.medical_specialty, lcsh:Diseases of the circulatory (Cardiovascular) system, endocrine system diseases, Adolescent, Cross-sectional study, Endocrinology, Diabetes and Metabolism, Type 2 diabetes, Disease cluster, Cardiovascular risk factor, Young Adult, Risk Factors, Internal medicine, Diabetes mellitus, medicine, Humans, Original Investigation, Dyslipidemias, Glycated Hemoglobin, Type 1 diabetes, business.industry, Case-control study, nutritional and metabolic diseases, medicine.disease, Lipids, Metabolic syndrome, Cross-Sectional Studies, Diabetes Mellitus, Type 1, Dyslipidemia, Cardiovascular Diseases, lcsh:RC666-701, Case-Control Studies, lipids (amino acids, peptides, and proteins), Female, Cardiology and Cardiovascular Medicine, business, Brazil |
| الوصف: | Background Cardiovascular risk factors (CVRF) may cluster in type 1 diabetes, analogously to the metabolic syndrome described in type 2 diabetes. The threshold of HbA1c above which lipid variables start changing behavior is unclear. This study aims to 1) assess the behavior of dyslipidemia according to HbA1c values; 2) detect a threshold of HbA1c beyond which lipids start to change and 3) compare the clustering of lipids and other non-lipid CVRF among strata of HbA1c individuals with type 1 diabetes. Methods Effects of HbA1c quintiles (1st: ≤7.4%; 2nd: 7.5-8.5%; 3rd: 8.6-9.6%; 4th: 9.7-11.3%; and 5th: >11.5%) and covariates (gender, BMI, blood pressure, insulin daily dose, lipids, statin use, diabetes duration) on dyslipidemia were studied in 1275 individuals from the Brazilian multi-centre type 1 diabetes study and 171 normal controls. Results Body size and blood pressure were not correlated to lipids and glycemic control. OR (99% CI) for high-LDL were 2.07 (1.21-3.54) and 2.51 (1.46-4.31), in the 4th and 5th HbA1c quintiles, respectively. Hypertriglyceridemia increased in the 5th quintile of HbA1c, OR 2.76 (1.20-6.37). OR of low-HDL-cholesterol were 0.48 (0.24-0.98) and 0.41 (0.19-0.85) in the 3rd and 4th HbA1c quintiles, respectively. HDL-cholesterol correlated positively (0.437) with HbA1c in the 3rd quintile. HDL-cholesterol and insulin dose correlated inversely in all levels of glycemic control. Conclusions Correlation of serum lipids with HbA1c is heterogeneous across the spectrum of glycemic control in type 1 diabetes individuals. LDL-cholesterol and triglycerides worsened alongside HbA1c with distinct thresholds. Association of lower HDL-cholesterol with higher daily insulin dose is consistent and it points out to a role of exogenous hyperinsulinemia in the pathophysiology of the CVRF clustering. These data suggest diverse pathophysiological processes depending on HbA1c, refuting a unified explanation for cardiovascular risk in type 1 diabetes. |
| اللغة: | English |
| تدمد: | 1475-2840 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::244f8699ed3a93d633cb0ec2e1aafbb5Test http://www.cardiab.com/content/11/1/156Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....244f8699ed3a93d633cb0ec2e1aafbb5 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14752840 |
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