Glycemic control is associated with dyslipidemia over time in youth with type 2 diabetes: The SEARCH for diabetes in youth study

Abstract

Background Dyslipidemia has been documented in youth with type 2 diabetes. There is a paucity of studies examining dyslipidemia over time in youth with type 2 diabetes and associated risk factors. Objective To evaluate lipids at baseline and follow‐up and associated risk factors in youth with type 2 diabetes. Methods We studied 212 youth with type 2 diabetes at baseline and after an average of 7 years of follow‐up in the SEARCH for Diabetes in Youth Study. Abnormal lipids were defined as high‐density lipoprotein cholesterol (HDL‐C) < 35, low‐density lipoprotein cholesterol (LDL‐C) > 100, or triglycerides >150 (all mg/dl). We evaluated participants for progression to abnormal lipids (normal lipids at baseline and abnormal at follow‐up), regression (abnormal lipids at baseline and normal at follow‐up), stable normal, and stable abnormal lipids over time for HDL‐C, LDL‐C, and triglycerides. Associations between hemoglobin A1c (HbA1c) and adiposity over time (area under the curve [AUC]) with progression and stable abnormal lipids were evaluated. Results HDL‐C progressed, regressed, was stable normal, and stable abnormal in 12.3%, 11.3%, 62.3%, and 14.2% of participants, respectively. Corresponding LDL‐C percentages were 15.6%, 12.7%, 42.9%, and 28.8% and triglycerides were 17.5%, 10.8%, 55.7%, and 16.0%. Each 1% increase in HbA1c AUC was associated with a 13% higher risk of progression and stable abnormal triglycerides and a 20% higher risk of progression and stable abnormal LDL‐C. Higher adiposity AUC was marginally (p = 0.049) associated with abnormal HDL‐C. Conclusions Progression and stable abnormal LDL‐C and triglycerides occur in youth with type 2 diabetes and are associated with higher HbA1c.

Expression analysis of ABCA1 in type 2 diabetic Pakistani patients with and without dyslipidemia and correlation with glycemic index and lipid profile

“…Baig et al reported that dyslipidemia is an early transition in type 2 DM rather than a later stage complication 40 . In another study increased TGs and LDL levels have been reported to be associated with high levels of HbA1c in young type 2 diabetics 41 .…”

ISPAD Clinical Practice Consensus Guidelines 2022: Type 2 diabetes in children and adolescents

“…Elevated LDL‐C and elevated TG were present in 8.6% and 50.0% of Canadian youth with T2D at a mean diabetes duration of 2.3 years compared to 3.5% and 7.5% of youth with T1D who had diabetes for 7.2 years 163 . The SEARCH study also found a greater prevalence of high TG, apoB and small dense LDL particles in youth with T2D compared to youth with T1D with continued worsening overtime in youth with T2D 175–178 . Higher rates of dyslipidemia and diabetes related complications by young adulthood 164 are the primary reason LDL‐C treatment thresholds in youth with T2D are more aggressive compared to T1D.…”

“…163 The SEARCH study also found a greater prevalence of high TG, apoB and small dense LDL particles in youth with T2D compared to youth with T1D with continued worsening overtime in youth with T2D. [175][176][177][178] Higher rates of dyslipidemia and diabetes related complications by young adulthood 164 Liraglutide and placebo, 0.82; 95% CI 0.72-0.94 and 0.83; 95% CI 0.72-0.95, respectively), but no differences at week 52. 126 Metabolic weight loss surgery in youth with T2D is associated with near normalization of lipids soon after surgery with sustained improvements observed beyond 5 years.…”

Risk Analysis and Assessment of Lipid Abnormalities as the Earliest Complication in Newly Diagnosed Diabetic and Non-Diabetic Individuals of a Local Population

“…Insulin resistance has an impact on lipid metabolism modification. Generally, clinicians consider dyslipidemia as a late-onset complication of diabetes [ 14 , 15 , 16 , 17 ]. A local study showed the presence of disturbed lipid profiles in newly diagnosed as well as known diabetics [ 18 ].…”