Cardiovascular Risk Factors in Adolescents with Type 1 Diabetes: Prevalence and Gender Differences

Evaluation of Arrhythmia Risk in Children with Type 1 Diabetes Mellitus

Objective

Children with type 1 diabetes mellitus (T1DM) are susceptible to cardiac arrhythmias and even sudden cardiac death. The aim of this study was to explore the risk of arrhythmia among children with T1DM by assessing electrocardiographic (ECG) parameters.

Methods

Children diagnosed with T1DM, aged 10-18 years, and healthy children matched for age and gender were included. The ECG ventricular depolarization-repolarization parameters of both groups and the correlation of these parameters with length of time since diagnosis of T1DM, markers of metabolic control, and the presence of additional complications were evaluated.

Results

There were 165 children with type 1 diabetes and 154 controls in the groups, which were similar in for age, gender, weight, height, and body mass index. The median length of time since diagnosis of diabetes was 5 years. QT (maximum), QTc (minimum and maximum), QT and QTc dispersion, Tp-e (minimum and maximum), Tp-e dispersion, and Tp-e/QTc-maximum values were significantly higher in the diabetic group compared with controls, although QTc intervals were within normal ranges. No significant correlation was observed between ECG findings and length of time since diagnosis of T1DM, HbA1c levels, or complications.

Conclusion

As children with T1DM are at high risk of impaired ventricular depolarization and repolarization, they should undergo cardiac assessment and regular annual ECG monitoring.

Triglycerides/high-density lipoprotein-cholesterol ratio outperforms traditional lipid indicators in predicting metabolic dysfunction-associated steatotic liver disease among U.S. adults

Objective

Triglycerides (TG), high-density lipoprotein cholesterol (HDL-c), and their ratio (TG/HDL-c) are key lipid markers associated with metabolic dysfunction. This study aims to investigate the association of TG, HDL-c, and TG/HDL-c ratio with metabolic dysfunction-associated steatotic liver disease (MASLD) and to assess whether TG/HDL-c ratio provides superior predictive ability for MASLD compared to TG or HDL-c alone.

Importance

Although previous research has explored the relationship between TG/HDL-c and MASLD, the applicability of these findings across different ethnicities and populations remains uncertain. Additionally, this study is based on NHANES data, which relies on self-reported measures and lacks longitudinal follow-up, limiting the ability to establish causal relationships. While we adjusted for multiple covariates, residual confounding cannot be ruled out. Therefore, further large-scale, prospective studies are needed to validate these associations and assess the long-term predictive value of TG/HDL-c ratio for MASLD.

Methods

A cross-sectional study utilizing the NHANES 2017-2020 database was conducted. We performed univariate and multivariate logistic regression analyses to examine the associations between TG, HDL-c, and the TG/HDL-c ratio with MASLD. Receiver Operating Characteristic (ROC) curve analysis was used to evaluate the predictive effectiveness. Sensitivity analysis was carried out using multiple imputation for missing data and subgroup stratification to validate the findings.

Results

TG, HDL-c, and TG/HDL-c ratio were significantly associated with MASLD (p < 0.05 for all). The TG/HDL-c ratio demonstrated the highest predictive value (AUC = 0.732, 95% CI: 0.683-0.781), compared to TG (AUC = 0.713, 95% CI: 0.664-0.762) and HDL-c (AUC = 0.313, 95% CI: 0.264-0.362). The weak predictive power of HDL-c alone may be attributed to its complex role in lipid metabolism and potential confounding by other metabolic factors.

Conclusion

Maintaining favorable levels of TG, HDL-c and TG/HDL-c ratio may lower MASLD risk. Using TG/HDL-c ratio could improve prediction models compared to individual TG or HDL-c markers.

Glycemic control and study of lipid and bone metabolism in type 1 diabetic children

Introduction. Type 1 diabetes mellitus is considered one of the most common chronic diseases of childhood. It is a high-risk factor for developing early cardiovascular disease and it also affects bone health. Objective. To describe demographic characteristics and biochemical parameters of a population of children with type 1 diabetes, evaluated in the pediatric diabetes unit of a tertiary Spanish hospital. Materials and methods. In this retrospective study, we determined metabolic, lipid, and bone parameters in 124 children with type 1 diabetes who were monitored in the pediatric diabetes unit of the Hospital Universitario Miguel Servet in Zaragoza (Spain) from May 2020 to July 2021. Results. Children with type 1 diabetes have worse metabolic control of the disease at puberty, but their lipid control is considered acceptable. We found an inverse correlation between bone formation markers and disease duration, as well as with metabolic control. Conclusion. Bone formation markers are inversely correlated with the percentage of glycated hemoglobin and diabetes evolution time. Patients’ lipid and bone profiles are more favorable when metabolic control of the disease is achieved.