Apolipoprotein B as a long‐term predictor of mortality in type 1 diabetes mellitus: a 15‐year follow up

Stettler, Christoph; Suter, Yves; Allemann, Sabin; Zwahlen, Marcel; Christ, Emanuel; Diem, Peter

doi:10.1111/j.1365-2796.2006.01690.x

Cited by 19 publications

(9 citation statements)

References 51 publications

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“…ApoB100 binds in a 1:1 ratio each circulating pro-atherogenic moiety, (LDL, VLDL, and IDL), and therefore, mirrors the total burden of the atherogenic cholesterol in the circulation. Increased serum apoB100 concentrations are established to be strong predictors for ischemic cardiovascular events [37]. Our findings coincide with that of a recent study reporting greater elevated apoB100 in children with type 2 diabetes relative to children with type 1 diabetes [30].…”

Section: 0 Discussionsupporting

confidence: 91%

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

Hanks

Pelham

Vaid

et al. 2016

Diabetes Research and Clinical Practice

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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.

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Section: 0 Discussionsupporting

confidence: 91%

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

Hanks

Pelham

Vaid

et al. 2016

Diabetes Research and Clinical Practice

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“…18,19 ApoB levels also were strongly linked to CV risk in patients with T1D in a 15-year follow-up study in Switzerland. 20 It is unclear why we did not observe a relationship between T1D and apoB levels in our study, although it is possible that the negative consequences of diabetes on apoB may be confined to older patients.…”

Section: Discussioncontrasting

confidence: 58%

Impact of Type 1 Diabetes and Body Weight Status on Cardiovascular Risk Factors in Adolescent Children

Krishnan

Copeland

Bright

et al. 2010

J of Clinical Hypertension

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Type 1 diabetes (T1D) is a risk factor for cardiovascular disease. However, it is unclear whether increased body weight amplifies that risk in T1D patients. This is a crosssectional study examining the presence of cardiovascular risk factors in normal and overweight children, both with and without T1D. Sixty-six children (aged 16AE2.2 years) were included in one of the following groups: (T1D and normal weight, T1D and overweight, healthy and normal weight, and healthy and overweight). A fasting blood sample was analyzed for lipid profile (triglyceride, cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol), apolipoprotein B (apoB), and apolipoprotein C-III (apoC-III) levels. Body composition was determined by dual energy x-ray absorptiometry and vascular elasticity by HDI ⁄ Pulsewave CR-2000 (Hypertension Diagnostics, Eagan, MN). Statistical analyses examined the effect of T1D and body weight status and their interactions on cardiovascular risk parameters. In this study, the authors were unable to demonstrate an additive effect of body weight status and T1D on cardiovascular risk profile. However, subgroup analysis of patients with T1D revealed higher apoC-III levels in overweight patients with T1D (P=.0453) compared with normal-weight diabetic children. Most notably, there was a direct relationship of small artery elasticity to body weight status. This seemingly paradoxical observation supports recent data and warrants further investigation. J Clin Hypertens (Greenwich). 2011;13:351-356. Ó2010 Wiley Periodicals, Inc.Type 1 diabetes (T1D) is a common disease of childhood and is increasing in prevalence worldwide. 1 Cardiovascular (CV) disease occurs at a higher frequency and at a younger age in patients with T1D compared with the general population.2,3 Men and women with T1D have a cumulative mortality rate of 35% from coronary artery disease by the age of 55 years, compared with only 4% to 8% in nondiabetic persons.4 Since T1D is a disease mostly occurring in childhood, patients face a lifelong CV burden. Identifying risk factors for CV disease in childhood allows for earlier intervention and possible amelioration of risk.The Diabetes Control and Complications Trial (DCCT) examined the effect of an intensive insulin regimen compared with a conventional insulin regimen on subsequent microvascular and macrovascular complications associated with T1D. The trial demonstrated that tight control of diabetes with an intensive insulin regimen resulted in a decreased incidence of microvascular complications. 5 The use of intensive insulin resulted in better control of diabetes but had some deleterious side effects, notably increased risk of hypoglycemia and increased weight gain. The prevalence of overweight, defined by body mass index (BMI) of >27.8 kg ⁄ m 2 in men and >27.3 kg ⁄ m 2 in women, is almost 2-fold higher in intensively treated patients compared with patients on a conventional regimen. 6 However, it is still unclear whether macrovascular complications that occur with weig...

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“…Various apolipoprotein abnormalities have also been described in subjects with T1D including elevated apolipoprotein C and lipoprotein a levels[19, 20]. A 15-year follow-up study from Switzerland showed apolipoprotein B levels to be a strong predictor of cardiovascular mortality in T1D subjects[21]. However, all these studies have been done in adults with T1D.…”

Section: Discussionmentioning

confidence: 99%

Sex Differences in Cardiovascular Disease Risk in Adolescents With Type 1 Diabetes

et al. 2012

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Cardiovascular disease is seen at a younger age and at a higher prevalence in patients with type 1 diabetes (T1D) than in the general population. It is well described that women with T1D have a higher relative risk for cardiovascular disease than men with T1D, unlike that seen in the general population. The pathophysiology behind this is unknown. We did a cross-sectional study to examine gender differences in cardiovascular risk factors in adolescents with T1D between the ages of 13-20 years, compared to children of a similar age without T1D. All subjects underwent Dual Energy X-ray Absorptiometry (DXA scan) to measure body composition, and an HDI/Pulsewave CR-2000 test measure of arterial elasticity. Fasting serum lipids, apolipoprotein B and apolipoprotein C-III were measured in each subject. 29 children with T1D (10 F, 19 M) and 37 healthy children (18F, 19 M) participated. Although no gender differences for body mass index (p = 0.91) and A1C (p =0.69) were seen, females with T1D had a significantly higher trunk % fat compared to males (p=0.004). No gender differences were found (p > 0.05) for trunk % fat in adolescents without diabetes. There was no gender difference among any other cardiovascular risk factors in both children with and without diabetes. Thus we conclude that female adolescents with T1D have more centrally distributed fat which may contribute to their relatively higher cardiovascular risk. Attenuation of the central distribution of fat through exercise and dietary modifications may help ameliorate their subsequent cardiovascular disease burden.

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Apolipoprotein B as a long‐term predictor of mortality in type 1 diabetes mellitus: a 15‐year follow up

Cited by 19 publications

References 51 publications

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

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

Impact of Type 1 Diabetes and Body Weight Status on Cardiovascular Risk Factors in Adolescent Children

Sex Differences in Cardiovascular Disease Risk in Adolescents With Type 1 Diabetes

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