Lipid screening in 100 pediatric patients with type 1DM in Tripoli children hospital (2008-2009)

Abstract

DM is a chronic metabolic disorder characterized by abnormalities in fuel metabolism including glucose, lipids and amino acids. Lipid disorders are common in diabetes mellitus, diabetic dyslipidemia is characterized by hypertriglyceridemia, increased levels of (VLDL), small dense LDL lipoprotein, and decreased levels of high density lipoproteins (HDL). Dyslipidemia will increase risk of cardiovascular disease in patients with diabetes mellitus. The study is designed to screen type1 diabetic patients for lipid abnormality and to know its relation to HbA1c, BMI and duration of DM. Case series study was done on 364 diabetic patients with type 1 DM of both sexes and aged between 1.5-18 yrs with different duration of DM, who attended endocrine clinic at Tripoli children hospital 2008- 2009. Those patients were investigated for fasting TC, TG, LDL, HDL, and HbA1C, only 100 patients. (Convenient sample) was included in the study according to complete investigations results which were done at national accredited laboratory, data were analyzed according to weight, height, BMI, HbA1c and duration of diabetes mellitus. Lipid profiles of our patients showed abnormality in TC, TG, LDL, and HDL with significant positive correlation between triglycerides level and HbA1c level. The age of the patients ranged between 1.5 to 18 years, with mean age 10.7±4.2 years. Female: Male ratio 1.4: 1, By using nonparametric chi-square; the difference between observed and expected count was insignificant (p=0.072). The duration of DM among our patients ranged between 1 month and 9.5 years, with mean 2.8±2.5 yrs.; the majority of our patients (92%) had normal weight. 3 % of them were overweight (z score >+2SD units). Only 1% were under weight. HbA1c was between 4.5% and 18.6 %, with mean HbA1c 9.3± 2.6%, so about 52% of the patients had accepted HbA1c and 45% had non accepted HbA1c. Total cholesterol, LDL, TG, and HDL were the parameters determined in this study; the mean value of each of them is within normal range. We found that 5% of the patients have high cholesterol level, and about 9% have high LDL cholesterol and 13% have low HDL cholesterol, 6% had high TG level. So the commonest lipid abnormality is low HDL cholesterol by using T student test for independent samples: HbA1c was significantly greater in patients with high triglyceride levels (mean HbA1c 11.9%) than in those with normal TG level (mean HbA1c 9.2%) P value = 0.024. There is an abnormality in lipid profile among patients with type1DM especially who have poor diabetic control. Further longitudinal study with large sized sample is needed to get more informative results.