Authors: Schwab, K Otfried; Doerfer, Jürgen¹; Naeke, Andrea²; Rohrer, Tilman³; Wiemann, Dagobert⁴; Marg, Wolfgang⁵; Hofer, Sabine E⁶; Holl, Reinhard W⁷

Source: Pediatric Diabetes, Volume 10, Number 3, May 2009 , pp. 184-192(9)

Publisher: Wiley-Blackwell

Abstract:

Schwab KO, Doerfer J, Naeke A, Rohrer T, Wiemann D, Marg W, Hofer SE, Holl RW, on behalf of the German/Austrian Pediatric DPV Initative. Influence of food intake, age, gender, HbA1c, and BMI levels on plasma cholesterol in 29 979 children and adolescents with type 1 diabetes - reference data from the German diabetes documentation and quality management system (DPV).

Pediatric Diabetes 2009: 10: 184-192. Objective: 

We investigated influences of a 12-h fast, age, gender, body mass index (BMI), hemoglobin A1c (HbA1c) on total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) to provide reference percentiles for TC, LDL-C, and HDL-C of patients with good diabetes control (HbA1c < 7.5%) and normal weight (BMI < 90th percentile). Method: 

A cross-sectional analysis of the diabetes documentation and quality management system using the diabetes data acquisition system for prospective surveillance (DPV) software included 29 979 patients with type 1 diabetes mellitus (T1DM) aged 1-20 yr (52.4% male) from 253 diabetes centers in Germany and Austria. Results: 

Fasting had no relevant influence on TC, LDL-C, and HDL-C. Multivariate regression analysis revealed strongest dependences of cholesterol on gender and HbA1c followed by BMI and age. Reference cholesterol percentiles of well-controlled and normal weight patients showed TC ≥4.40 mmol/L (170 mg/dL) corresponding to the 50th percentile in females and the 75th percentile in males. LDL-C ≥2.59 mmol/L (100 mg/dL) corresponded to the 50th-75th percentile in females and the 75th percentile in males. Conclusions: 

(i) Fasting is no precondition for the determination of TC, LDL-C, and HDL-C; (ii) TC, LDL-C, and HDL-C are strongest associated with gender and HbA1c followed by BMI and age; (iii) Gender- and age-adjusted cholesterol percentiles of well-controlled and normal weight patients with T1DM may serve as reference values and are similar to healthy German children; and (iv) Single target values for TC, LDL-C, and HDL-C based on healthy individuals' data do not sufficiently characterize abnormal cholesterol levels in young patients with T1DM.

Keywords: childhood/adolescence; cholesterol percentiles; T1DM

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1399-5448.2008.00469.x

Affiliations: 1: Department of Pediatrics and Adolescence Medicine, Freiburg University Hospital, Freiburg, Germany 2: Department of Pediatrics, Dresden University Hospital, Dresden, Germany 3: Department of Pediatrics and Adolescence Medicine, Homburg University Hospital, Homburg/Saar, Germany 4: Department of Pediatrics, Magdeburg University Hospital, Magdeburg, Germany 5: Professor-Hess-Children's Hospital, Bremen, Germany 6: Department of Pediatrics and Adolescence Medicine, Innsbruck University Hospital, Innsbruck, Austria 7: Institute of Epidemiology, Ulm University, Ulm, Germany

Publication date: 2009-05-01

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• By this author: Schwab, K Otfried ;  Doerfer, Jürgen ;  Naeke, Andrea ;  Rohrer, Tilman ;  Wiemann, Dagobert ;  Marg, Wolfgang ;  Hofer, Sabine E ;  Holl, Reinhard W

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