Abstract
Aim To assess 1) the prevalence of children and adolescents with type 1 diabetes (T1D)
changing from low-risk into borderline-high-risk lipid levels or from borderline-high-risk
into high-risk lipid levels (‘lose track of lipids’) and 2) the power of a risk score
including the determinants HbA1c, body mass index (BMI), gender, age, diabetes duration
and ethnicity in predicting which patients lose track of lipids.
Methods 651 children and adolescents with T1D were included in this longitudinal retrospective
cohort study. Lipid dynamics and the impact of the risk score on losing track of lipids
were evaluated. Kaplan-Meier analysis was used to estimate screening intervals.
Results 31–43% percent of the patients had lost track of one or more lipids at the next lipid
measurement. This happened more frequently in patients with a low-risk lipid level
at start. Depending on the lipid parameter, 5% of patients with low-risk lipid levels
lost track of lipids after 13–23 months. The risk score based on concomitant information
on the determinants was moderately able to predict which patients would lose track
of lipids on the short term.
Conclusions A considerable number of children and adolescents with T1D loses track of lipids
and does so within a 2-year screening interval. The predictive power of a risk score
including age, BMI, gender, HbA1c, diabetes duration and ethnicity is only moderate.
Future research should focus on another approach to the determinants used in this
study or other determinants predictive of losing track of lipids on the short term.
Key words
type 1 diabetes - children - dyslipidemia - HbA1c - longitudinal
