[Evaluation of selected risk factors of atherosclerosis in children with type 1 diabetes mellitus and hypercholesterolemia].

Background: Increased risk of atherosclerosis in individuals with diabetes mellitus is not fully explained by the conventional risk factors. Therefore, new independent risk factors are taken under consideration. AIM OF THE STUDY was to evaluate selected risk factors of atherosclerosis in children with type 1 diabetes mellitus and hypercholesterolemia.

Material and methods: The study comprised 30 diabetic children, aged 5-18 years with plasma cholesterol concentration exceeding 170 mg/dl. In children, their parents and siblings plasma concentration of total cholesterol, HDL and LDL-cholesterol, triglicerides, homocysteine, apolipoprotein A-I, apolipoprotein B was measured and electrophoretic distribution of lipids was performed. Anthropometric measurements with BMI estimation were performed in diabetic children. Data were analyzed with respect to BMI, metabolic control and physical activity in children and with respect to family history of atherosclerosis.

Results: No significant differences in measured parameters were found between diabetic children and their healthy siblings besides significantly lower homocysteine concentration (p=0.037). Concentration of triglicerides was significantly higher in children with low than with high physical activity (101.6+/-64.6 mg/dl vs. 60.2+/-27.4 mg/dl respectively, p<0.05), HDL cholesterol was significantly lower in children with poor than with a satisfactory metabolic control (58.3+/-10.0 mg/dl vs. 69.1+/-12 mg/dl, p<0.05) and lipoprotein apoB concentration was significantly higher in children with positive (0.77+/-0.15 g/l) compared to children with a negative family history of atherosclerosis (0.66+/-0.09 g/l, p<0.05). Overweight did not influence the measured parameters significantly. Statistically significant positive correlations were found for apoB between affected children and their mothers (r=0.62), for LDL-cholesterol between affected children and their fathers (r=0.35), and for total cholesterol (r=0.47) and homocysteine (r=0.44) between affected children and their siblings.

Conclusions: 1. Lipid disorders in children with type 1 diabetes mellitus may be present regardless their metabolic control, but they are more pronounced in children with poor control 2. Higher triglicerides concentrations were found in children with low physical activity and higher apolipoprotein B concentration in children with a positive family history for atherosclerosis. 3. Parental lipoprotein concentration may significantly influence the lipid profile in their diabetic offspring.