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Type: Journal article
Title: Determinants of cardiovascular risk in 7,000 youth with type 1 diabetes in the Australasian Diabetes Data Network
Author: Couper, J.J.
Jones, T.W.
Chee, M.
Barrett, H.L.
Bergman, P.
Cameron, F.
Craig, M.E.
Colman, P.
Davis, E.E.
Donaghue, K.C.
Fegan, P.G.
Hamblin, P.S.
Holmes-Walker, D.J.
Jefferies, C.
Johnson, S.
Mok, M.T.
King, B.R.
Sinnott, R.
Ward, G.
Wheeler, B.J.
et al.
Citation: The Journal of Clinical Endocrinology and Metabolism, 2020; 106(1):133-142
Publisher: The Endocrine Society
Issue Date: 2020
ISSN: 0021-972X
Statement of
Jenny J Couper, Timothy W Jones, Melissa Chee, Helen L Barrett, Philip Bergman, Fergus Cameron ... et al.
Abstract: CONTEXT:Cardiovascular disease occurs prematurely in type 1 diabetes. The additional risk of overweight is not well characterised. OBJECTIVE:Primary aim was to measure the impact of BMI in youth with type 1 diabetes on cardiovascular risk factors. Secondary aim was to identify other determinants of cardiovascular risk. DESIGN:Observational longitudinal study of 7061 youth with type 1 diabetes followed for median 7.3 (IQR 4-11) years over 41 (IQR 29-56) visits until March 2019. SETTING:15 tertiary care diabetes centres in the Australasian Diabetes Data Network. PARTICIPANTS:aged 2 - 25 years at baseline, with at least two measures of BMI and blood pressure. MAIN OUTCOME MEASURE:Standardised systolic and diastolic blood pressure scores and non-HDL cholesterol were co-primary outcomes. Urinary albumin/creatinine ratio was the secondary outcome. RESULTS:BMI z-score related independently to standardised blood pressure z- scores and non-HDL cholesterol. An increase in 1 BMI z-score related to an average increase in systolic/diastolic blood pressure of 3.8/1.4mmHg and an increase in non -HDL cholesterol (coefficient + 0.16mmol/L, 95%CI 0.13-0.18; p<0.001) and in LDL cholesterol. Females had higher blood pressure z-scores, higher non-HDL and LDL cholesterol, and higher urinary albumin/creatinine than males. Indigenous youth had markedly higher urinary albumin/creatinine (coefficient +2.15 mg/mmol, 95% CI 1.27-3.03; p<0.001) and higher non-HDL cholesterol than non-indigenous youth. Continuous subcutaneous insulin infusion was associated independently with lower non-HDL cholesterol and lower urinary albumin/creatinine. CONCLUSIONS:BMI had a modest independent effect on cardiovascular risk. Females and indigenous Australians in particular had a more adverse risk profile.
Keywords: Children; adolescents; type 1 diabetes; cardiovascular risk
Rights: © The Author(s) 2020. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved.
RMID: 1000029317
DOI: 10.1210/clinem/dgaa727
Appears in Collections:Paediatrics publications

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