Heterogeneous behavior of lipids according to HbA1(c) levels undermines the plausibility of metabolic syndrome in type 1 diabetes: data from a nationwide multicenter survey
dc.contributor.author | Giuffrida, Fernando de Mello Almada [UNIFESP] | |
dc.contributor.author | Guedes, Alexis D. | |
dc.contributor.author | Rocco, Eloa Roberta [UNIFESP] | |
dc.contributor.author | Mory, Denise Barreto [UNIFESP] | |
dc.contributor.author | Dualib, Patricia [UNIFESP] | |
dc.contributor.author | Matos, Odelisa S. | |
dc.contributor.author | Chaves-Fonseca, Reine M. | |
dc.contributor.author | Cobas, Roberta A. | |
dc.contributor.author | Negrato, Carlos Antonio | |
dc.contributor.author | Gomes, Marilia B. | |
dc.contributor.author | Dib, Sergio Atala [UNIFESP] | |
dc.contributor.author | Brazilian Type 1 Diabet Study Group | |
dc.contributor.institution | CEDEBA Ctr Endocrinol Estado Bahia | |
dc.contributor.institution | Universidade Federal de São Paulo (UNIFESP) | |
dc.contributor.institution | Universidade do Estado do Rio de Janeiro (UERJ) | |
dc.contributor.institution | Assoc Diabet Bauru | |
dc.date.accessioned | 2016-01-24T14:28:10Z | |
dc.date.available | 2016-01-24T14:28:10Z | |
dc.date.issued | 2012-12-27 | |
dc.description.abstract | Background: Cardiovascular risk factors (CVRF) may cluster in type 1 diabetes, analogously to the metabolic syndrome described in type 2 diabetes. the threshold of HbA1(c) above which lipid variables start changing behavior is unclear. This study aims to 1) assess the behavior of dyslipidemia according to HbA1(c) values; 2) detect a threshold of HbA1(c) beyond which lipids start to change and 3) compare the clustering of lipids and other non-lipid CVRF among strata of HbA1(c) individuals with type 1 diabetes.Methods: Effects of HbA1(c) quintiles (1st: <= 7.4%; 2nd: 7.5-8.5%; 3rd: 8.6-9.6%; 4th: 9.7-11.3%; and 5th: > 11.5%) and covariates (gender, BMI, blood pressure, insulin daily dose, lipids, statin use, diabetes duration) on dyslipidemia were studied in 1275 individuals from the Brazilian multi-centre type 1 diabetes study and 171 normal controls.Results: Body size and blood pressure were not correlated to lipids and glycemic control. OR (99% CI) for high-LDL were 2.07 (1.21-3.54) and 2.51 (1.46-4.31), in the 4th and 5th HbA1(c) quintiles, respectively. Hypertriglyceridemia increased in the 5th quintile of HbA1(c), OR 2.76 (1.20-6.37). OR of low-HDL-cholesterol were 0.48 (0.24-0.98) and 0.41 (0.19-0.85) in the 3rd and 4th HbA1(c) quintiles, respectively. HDL-cholesterol correlated positively (0.437) with HbA1(c) in the 3rd quintile. HDL-cholesterol and insulin dose correlated inversely in all levels of glycemic control.Conclusions: Correlation of serum lipids with HbA1(c) is heterogeneous across the spectrum of glycemic control in type 1 diabetes individuals. LDL-cholesterol and triglycerides worsened alongside HbA1(c) with distinct thresholds. Association of lower HDL-cholesterol with higher daily insulin dose is consistent and it points out to a role of exogenous hyperinsulinemia in the pathophysiology of the CVRF clustering. These data suggest diverse pathophysiological processes depending on HbA1(c), refuting a unified explanation for cardiovascular risk in type 1 diabetes. | en |
dc.description.affiliation | CEDEBA Ctr Endocrinol Estado Bahia, Salvador, BA, Brazil | |
dc.description.affiliation | Universidade Federal de São Paulo, Ctr Diabet, São Paulo, Brazil | |
dc.description.affiliation | Univ Estado Rio de Janeiro, Rio de Janeiro, Brazil | |
dc.description.affiliation | Assoc Diabet Bauru, Bauru, Brazil | |
dc.description.affiliationUnifesp | Universidade Federal de São Paulo, Ctr Diabet, São Paulo, Brazil | |
dc.description.source | Web of Science | |
dc.format.extent | 8 | |
dc.identifier | http://dx.doi.org/10.1186/1475-2840-11-156 | |
dc.identifier.citation | Cardiovascular Diabetology. London: Biomed Central Ltd, v. 11, 8 p., 2012. | |
dc.identifier.doi | 10.1186/1475-2840-11-156 | |
dc.identifier.file | WOS000313940900001.pdf | |
dc.identifier.issn | 1475-2840 | |
dc.identifier.uri | http://repositorio.unifesp.br/handle/11600/35626 | |
dc.identifier.wos | WOS:000313940900001 | |
dc.language.iso | eng | |
dc.publisher | Biomed Central Ltd | |
dc.relation.ispartof | Cardiovascular Diabetology | |
dc.rights | Acesso aberto | |
dc.subject | Type 1 diabetes | en |
dc.subject | Metabolic syndrome | en |
dc.subject | Dyslipidemia | en |
dc.subject | Cardiovascular risk factor | en |
dc.title | Heterogeneous behavior of lipids according to HbA1(c) levels undermines the plausibility of metabolic syndrome in type 1 diabetes: data from a nationwide multicenter survey | en |
dc.type | Artigo |
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