Characterization of 33 488 children and adolescents with type 1 diabetes based on the gender-specific increase of cardiovascular risk factors

Objectives: Characterization of children with type 1 diabetes (T1DM) regarding number and gender distribution of cardiovascular risk factors (cvRF) and of total cholesterol/high-density lipoprotein cholesterol ratio (TC/HDL-C ratio) for risk assessment. Methods: 33488 patients < 18 years were included in this cross-sectional analysis and placed into 5 categories by their number of cvRF. Dyslipidemia (TC > 200 mg/dL, > 5.17 mmol/L; and/or HDL-C < 35 mg/dL, < 0.91 mmol/L; and/or LDL-C > 130 mg/dL, > 3.36 mmol/L), elevated systolic and/or diastolic blood pressure (BP) >= 90th percentile, obesity > 97th percentile, active smoking, and HbA1c >= 7.5% were considered as cvRF. Results: 65% had no or 1 cvRF. HbA1c >= 7.5% was the most frequently occurring cvRF followed by BP >= 90th percentile, dyslipidemia, smoking, and BMI > 97th percentile. Age at diabetic onset ranged from 7.7 to 9.2 years and diabetes duration from 4.1 to 6.6 years. CvRF showed differences in disfavour of females except smoking and HDL-C < 35 mg/dL (0.91 mmol/L). Rate of females was 45% with 0 cvRF and 60% with 4 to 5 cvRF. TC/HDL-C ratio showed no clear association to the number of cvRF. Conclusions: 35% of a pediatric T1DM population develops 2 or more cvRF thus increasing their cv risk in adulthood. With increasing numbers of cvRF, the percentage of girls is rising from 45% to 60% which might contribute to an assimilation of survival rates in female and male adults. TC/HDL ratio does not predict the extent of cardiovascular risk in pediatric T1DM.