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Su X, Luo M, Tang X, Luo Y, Zheng X, Peng D. Goals of non-high density lipoprotein cholesterol need to be adjusted in Chinese acute coronary syndrome patients: Findings from the CCC-ACS project. Clin Chim Acta 2019; 496:48-54. [PMID: 31255567 DOI: 10.1016/j.cca.2019.06.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 06/19/2019] [Accepted: 06/26/2019] [Indexed: 01/17/2023]
Abstract
BACKGROUND Guidelines recommended non-high density lipoprotein cholesterol (non-HDL-C) as a co-primary target, and set non-HDL-C goals as 30 mg/dl higher than low-density lipoprotein cholesterol (LDL-C) goals. However, the value is largely uncertain in Chinese patients. METHODS We assigned non-HDL-C values at the same percentiles correspondent to LDL-C goals for patients from the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome (CCC-ACS) Project. We calculated the differences between non-HDL-C and LDL-C and proposed appropriate adding values according to LDL-C and TG concentrations. RESULTS Among 73,495 patients, 17.7% used lipid-lowering agents before admission. Of these, 27.2% achieved LDL-C <70 mg/dl while 39.4% achieved non-HDL-C <100 mg/dl. The mean difference between non-HDL-C and LDL-C was 23.2 mg/dl, which could be affected by LDL-C and TG concentrations. Importantly, of patients with LDL-C concentrations ≤100 mg/dl, the mean differences were 19.1 mg/dl in patients with TG ≤150 mg/dl and 24.6 mg/dl in patients with TG >150 mg/dl. CONCLUSIONS There are significant differences between LDL-C and non-HDL-C in Chinese ACS patients. For secondary prevention, on average, the adding values should be 20 mg/dl for patients with TG ≤150 mg/dl and 25 mg/dl for patients with TG >150 mg/dl when LDL-C goals of 70 mg/dl is achieved.
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Affiliation(s)
- Xin Su
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Mengdie Luo
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xiaoyu Tang
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yonghong Luo
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xiaoyan Zheng
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Daoquan Peng
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
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- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
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2
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Abed E, LaBarbera B, Dvorak J, Zhang Y, Beck J, Talsania M. Prevalence of dyslipidemia and factors affecting dyslipidemia in young adults with type 1 diabetes: evaluation of statin prescribing. J Pediatr Endocrinol Metab 2019; 32:327-334. [PMID: 30860978 DOI: 10.1515/jpem-2018-0383] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 01/30/2019] [Indexed: 11/15/2022]
Abstract
Background There is limited information about cardiovascular complications among young adults (YA) with type 1 diabetes mellitus (T1DM) who are transitioning from pediatric to adult care. We aimed to study the prevalence and associated factors of dyslipidemia (DLD) and statin treatment in these patients. Methods We recruited 129 YA with T1DM aged 15-25 years. In a cross-sectional analysis, the prevalence of DLD (low-density lipoprotein cholesterol [LDL-C] ≥ 100 mg/dL, high-density lipoprotein cholesterol [HDL-C] <40 mg/dL [males] or <50 mg/dL [females], total cholesterol [TC] ≥200 mg/dL or triglycerides [TG] ≥150 mg/dL) was reported. Socioeconomic and clinical characteristics were compared between YA with and without DLD. We also assessed statin use among YA with DLD. Results DLD was found in 64% of YA, predominantly increased LDL-C (34.9%). Higher mean glycated hemoglobin (HbA1c) was associated with DLD (p < 0.043). Of all YA who met the criteria for statin therapy, only 42% had one prescribed. Conclusions The prevalence of DLD is high in YA with T1DM and is associated with poor glycemic control, and use of statin therapy in this high-risk population is low.
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Affiliation(s)
- Elie Abed
- Department of Adult Endocrinology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.,Harold Hamm Diabetes Center, Oklahoma City, OK, USA
| | - Brenton LaBarbera
- Harold Hamm Diabetes Center, Oklahoma City, OK, USA.,Department of Pediatric Diabetes and Endocrinology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Justin Dvorak
- Harold Hamm Diabetes Center, Oklahoma City, OK, USA.,Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Ying Zhang
- Harold Hamm Diabetes Center, Oklahoma City, OK, USA.,Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Joni Beck
- Harold Hamm Diabetes Center, Oklahoma City, OK, USA.,Department of Pediatric Diabetes and Endocrinology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Mitali Talsania
- Department of Adult Endocrinology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.,Harold Hamm Diabetes Center, Oklahoma City, OK, USA
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3
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Jacobo-Cejudo MG, Valdés-Ramos R, Guadarrama-López AL, Pardo-Morales RV, Martínez-Carrillo BE, Harbige LS. Effect of n-3 Polyunsaturated Fatty Acid Supplementation on Metabolic and Inflammatory Biomarkers in Type 2 Diabetes Mellitus Patients. Nutrients 2017; 9:nu9060573. [PMID: 28587203 PMCID: PMC5490552 DOI: 10.3390/nu9060573] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 05/28/2017] [Accepted: 06/01/2017] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is accompanied by chronic low-grade inflammation, with an imbalance in the secretion of adipokines and, worsening insulin resistance. Supplementation with n-3 PUFA in T2DM decreases inflammatory markers, the purpose of the study was to investigate the effect of n-3 PUFA supplementation on adipokines, metabolic control, and lipid profile in T2DM Mexican adults. METHODS In a randomized, single-blind, placebo-controlled pilot study, 54 patients with T2DM received 520 mg of DHA + EPA-enriched fish-oil (FOG) or a placebo (PG) daily. Baseline and 24-week anthropometric and biochemical measurements included glucose, insulin, glycosylated hemoglobin (Hb1Ac), leptin, adiponectin, resistin, and lipid profile; n-3 PUFA intake was calculated in g/day. RESULTS Waist circumference and blood glucose showed significant reductions in the FOG group (p = 0.001 and p = 0.011, respectively). Hb1Ac (p = 0.009 and p = 0.004), leptin (p < 0.000 and p < 0.000), and leptin/adiponectin ratio (p < 0.000 and p < 0.000) decreased significantly in both groups after 24 weeks (FOG and PG respectively). Serum resistin (FOG p < 0.000 and PG p = 0.001), insulin (FOG p < 0.000 and PG p < 0.000), and HOMA-IR (FOG p = 0.000 and PG p < 0.000) increased significantly in both groups. FOG had an overall improvement in the lipid profile with a significant decrease in triacylgycerols (p = 0.002) and atherogenic index (p = 0.031); in contrast, the PG group had increased total cholesterol (p < 0.000), non-HDL cholesterol (p < 0.000), and atherogenic index (p = 0.017). CONCLUSIONS We found a beneficial effect of n-3 PUFA supplementation on waist circumference, glucose, Hb1Ac, leptin, leptin/adiponectin ratio, and lipid profile, without significant changes in adiponectin, and increases in resistin, insulin, and HOMA-IR in both groups.
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Affiliation(s)
- M Gorety Jacobo-Cejudo
- Faculty of Medicine, Universidad Autónoma del Estado de México, Paseo Tollocan esq. Jesús Carranza, Col. Moderna de la Cruz, Toluca 50180, Mexico.
| | - Roxana Valdés-Ramos
- Faculty of Medicine, Universidad Autónoma del Estado de México, Paseo Tollocan esq. Jesús Carranza, Col. Moderna de la Cruz, Toluca 50180, Mexico.
| | - Ana L Guadarrama-López
- Faculty of Medicine, Universidad Autónoma del Estado de México, Paseo Tollocan esq. Jesús Carranza, Col. Moderna de la Cruz, Toluca 50180, Mexico.
| | - Rosa-Virgen Pardo-Morales
- Instlituto Materno-Infantil del Estado de México, Paseo Colón s/n, Col. Villa Hogar, Toluca 50170, Mexico.
| | - Beatriz E Martínez-Carrillo
- Faculty of Medicine, Universidad Autónoma del Estado de México, Paseo Tollocan esq. Jesús Carranza, Col. Moderna de la Cruz, Toluca 50180, Mexico.
| | - Laurence S Harbige
- Faculty of Life Sciences and Computing, London Metropolitan University, 166-220 Holloway Road, London N7 8DB, UK.
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Shah AS, Maahs DM, Stafford JM, Dolan LM, Lang W, Imperatore G, Bell RA, Liese AD, Reynolds K, Pihoker C, Marcovina S, D'Agostino RB, Dabelea D. Predictors of Dyslipidemia Over Time in Youth With Type 1 Diabetes: For the SEARCH for Diabetes in Youth Study. Diabetes Care 2017; 40:607-613. [PMID: 28126715 PMCID: PMC5360282 DOI: 10.2337/dc16-2193] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 01/11/2017] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Understanding the risk factors associated with progression and regression of dyslipidemia in youth with type 1 diabetes may guide treatments. RESEARCH DESIGN AND METHODS We studied 1,478 youth with type 1 diabetes (age 10.8 ± 3.9 years, 50% male, 77% non-Hispanic white, not on lipid-lowering medications) at baseline and at a mean follow-up of 7.1 ± 1.9 years in the SEARCH for Diabetes in Youth (SEARCH) study. Progression to dyslipidemia was defined as normal lipid concentrations at baseline and abnormal at follow-up (non-HDL-cholesterol [C] >130 mg/dL or HDL-C <35 mg/dL). Regression was defined as abnormal lipids at baseline and normal at follow-up. Multivariable logistic regression was used to evaluate factors associated with progression and regression compared with stable normal and stable abnormal, respectively. An area under the curve (AUC) variable was used for the time-varying covariates A1C and waist-to-height ratio (WHtR). RESULTS Non-HDL-C progressed, regressed, was stable normal, and stable abnormal in 19%, 5%, 69%, and 7% of youth with type 1 diabetes, respectively. Corresponding percentages for HDL-C were 3%, 3%, 94%, and 1%, respectively. Factors associated with non-HDL-C progression were higher A1C AUC and higher WHtR AUC in males. Non-HDL-C regression was associated with lower WHtR AUC, and HDL-C progression was associated with male sex and higher WHtR AUC. HDL-C regression was not modeled due to small numbers. CONCLUSIONS A1C and WHtR are modifiable risk factors associated with change in dyslipidemia over time in youth with type 1 diabetes.
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Affiliation(s)
- Amy S Shah
- Department of Pediatrics, Cincinnati Children's Hospital and University of Cincinnati, Cincinnati, OH
| | - David M Maahs
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO
| | - Jeanette M Stafford
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC
| | - Lawrence M Dolan
- Department of Pediatrics, Cincinnati Children's Hospital and University of Cincinnati, Cincinnati, OH
| | - Wei Lang
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC
| | - Giuseppina Imperatore
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA
| | - Ronny A Bell
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC
| | - Angela D Liese
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC
| | - Kristi Reynolds
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | | | - Santica Marcovina
- Northwest Lipid Metabolism and Diabetes Research Laboratories, University of Washington, Seattle, WA
| | - Ralph B D'Agostino
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC
| | - Dana Dabelea
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Aurora, CO
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5
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Katz ML, Kollman CR, Dougher CE, Mubasher M, Laffel LMB. Influence of HbA1c and BMI on Lipid Trajectories in Youths and Young Adults With Type 1 Diabetes. Diabetes Care 2017; 40:30-37. [PMID: 27797924 PMCID: PMC5180464 DOI: 10.2337/dc16-0430] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 09/28/2016] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To assess the influence of HbA1c and BMI (measured as BMI z score [zBMI]) on LDL, HDL, and non-HDL trajectories as youths with type 1 diabetes age into early adulthood. RESEARCH DESIGN AND METHODS Dynamic, retrospective cohort study examining changes in lipid values in 572 youths with type 1 diabetes followed longitudinally for a median of 9.3 years. Through longitudinal modeling, we describe the relationship of HbA1c and zBMI on lipid values as subjects age after adjusting for other relevant factors, including lipid-lowering medication use. RESULTS The median number of lipid assessments was 7 (range 2-39). Every 1% increase in HbA1c was associated with an ∼2-6 mg/dL increase in LDL levels, with a greater increase in LDL levels as subjects progressed from prepubertal to postpubertal age ranges. A 1-SD increase in BMI was associated with a mean LDL increase of 2.1 mg/dL when subjects were 10 years old and increased to a mean of 8.2 mg/dL when subjects were 19 years old. The association between changes in HbA1c level and zBMI and changes in non-HDL levels as youths aged were similar to the associations found with LDL. The influence of HbA1c and zBMI on HDL levels was small and not dependent on age. CONCLUSIONS Changes in HbA1c level and zBMI modestly impact LDL and non-HDL cholesterol and have greater impacts as children age. Addressing elevations in HbA1c and zBMI as children enter into adolescence and beyond may lead to improvements in lipid levels.
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Affiliation(s)
- Michelle L Katz
- Section on Genetics and Epidemiology, Joslin Diabetes Center, Boston, MA
| | | | - Carly E Dougher
- Section on Genetics and Epidemiology, Joslin Diabetes Center, Boston, MA
| | | | - Lori M B Laffel
- Section on Genetics and Epidemiology, Joslin Diabetes Center, Boston, MA
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6
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Cree-Green M, Maahs DM, Ferland A, Hokanson JE, Wang H, Pyle L, Kinney GL, King M, Eckel RH, Nadeau KJ. Lipoprotein subfraction cholesterol distribution is more atherogenic in insulin resistant adolescents with type 1 diabetes. Pediatr Diabetes 2016; 17:257-65. [PMID: 26080650 PMCID: PMC4887262 DOI: 10.1111/pedi.12277] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 03/15/2015] [Accepted: 03/16/2015] [Indexed: 02/06/2023] Open
Abstract
AIMS/HYPOTHESIS Adolescents with type 1 diabetes (T1D) often have a less atherogenic-appearing fasting lipid profile than controls, despite increased rates of cardiovascular disease (CVD) as adults. We previously reported an atherogenic lipoprotein subfraction cholesterol distribution associated with insulin resistance (IR) in T1D adults. We sought to determine if T1D youth have more atherogenic profile than controls via a cross-sectional study. METHODS Following 3 days of controlled diet and restricted exercise, fasting plasma samples were drawn from 28 T1D youth [50% female, age 15.3 ± 2 yr, body mass index (BMI) 48%ile; diabetes duration 73 ± 52 months, hemoglobin A1c (HbA1c) 8.3 ± 1.4%] and 17 non-diabetic controls (47% female, age: 15.0 ± 2 yr, BMI 49%ile) prior to a hyperinsulinemic euglycemic clamp. Lipoproteins were fractionated by fast protein liquid chromatography (FPLC) and lipoprotein cholesterol distribution determined. Outcome measures were IR assessed by glucose infusion rate (GIR) and FPLC lipoprotein subfraction cholesterol distribution. RESULTS T1D youth were more IR (GIR 9.1 ± 3.6 vs. 14.7 ± 3.9 mg/kg/min, p < 0.0001) and had more cholesterol distributed as small dense low density lipoprotein-cholesterol (LDL-C) and less as large buoyant high density lipoprotein-cholesterol (HDL-C) than controls (p < 0.05), despite no differences in the fasting lipid panel. T1D girls lacked the typical female less-atherogenic profile, whereas control girls tended to have a shift toward less dense LDL-C and HDL-C vs. control boys. Among T1D, IR but not HbA1c was associated with a more atherogenic lipoprotein profile. CONCLUSIONS/INTERPRETATIONS Normal weight T1D youth, especially females, had more atherogenic LDL-C and HDL-C distributions which correlated with lower insulin sensitivity. IR may contribute to the increased CVD burden in T1D.
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Affiliation(s)
- Melanie Cree-Green
- Barbara Davis Center for Childhood Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO
- Department of Pediatrics, Division of Pediatric Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, CO
- Center for Women’s Health Research, Aurora, CO
| | - David M. Maahs
- Barbara Davis Center for Childhood Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Annie Ferland
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - John E. Hokanson
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Hong Wang
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Laura Pyle
- Department of Pediatrics, Division of Pediatric Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Gregory L. Kinney
- Department of Pediatrics, Division of Pediatric Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, CO
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Martina King
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Robert H. Eckel
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Kristen J. Nadeau
- Barbara Davis Center for Childhood Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO
- Department of Pediatrics, Division of Pediatric Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, CO
- Center for Women’s Health Research, Aurora, CO
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7
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Abstract
In this article, the author reviews the long-term outcomes and their precursors of type 1 diabetes starting in youth. The author also contrasts the changing incidence of these long-term complications as we have moved from the pre-Diabetes Control and Complications Trial (DCCT) to the post-DCCT standard of care and reviews the emerging data related to complications in youths with type 2 diabetes. Finally, the author reviews the recent understanding related to the effects of diabetes on the brain and cognition.
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Affiliation(s)
- Neil H White
- Department of Pediatrics, Washington University School of Medicine, 660 South Euclid Avenue, Box 8116, St Louis, MO 63110, USA.
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8
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Al-Daghri NM, Aljohani NJ, Al-Attas OS, Al-Saleh Y, Wani K, Alnaami AM, Alfawaz H, Al-Ajlan ASM, Kumar S, Chrousos GP, Alokail MS. Non-high-density lipoprotein cholesterol and other lipid indices vs elevated glucose risk in Arab adolescents. J Clin Lipidol 2014; 9:35-41. [PMID: 25670358 DOI: 10.1016/j.jacl.2014.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 11/02/2014] [Accepted: 11/06/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Non-high-density lipoprotein cholesterol (non-HDL-C) has been identified as a significant predictor of various cardiovascular events in adults. Limited studies have been conducted in the pediatric population with diverse results, depending on ethnic origin. None has been conducted in the Arabic adolescent population so far; this study aims to fill this gap. METHODS In this cross-sectional study, 1690 Saudi school adolescents (968 boys [mean age 14.8 ± 1.7] and 722 girls [mean age 14.6 ± 1.7]) were recruited. Anthropometrics were obtained. Fasting blood glucose and lipid profiles were quantified routinely. Non-HDL-C was calculated and screening was done for dyslipidemia using cutoffs obtained from the cohort and elevated fasting glucose. RESULTS Using the 90th percentile cutoff obtained, the overall prevalence of high non-HDL-C (≥4.26 mmol/L) was 10.1%. Prevalence was slightly higher in girls (10.5%) than boys (9.9%). Non-HDL-C was similar to other lipids in terms of significant associations with anthropometric measures and glucose in both boys and girls. Elevated triglycerides was most predictive of elevated glucose in both girls (odds ratio 2.41; confidence interval 1.43-4.08; P = .001) and boys (odds ratio 2.61; confidence interval 1.70-4.0); P < .001). CONCLUSION Non-HDL-C appears to be gender-specific and is cardiometabolically more associated with Saudi boys, despite higher levels in girls. It is inferior compared with triglycerides in assessing elevated glucose risk. Further investigations may provide a more definite value for non-HDL-C use as a biomarker in assessing cardiometabolic risk in the Arab adolescent population.
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Affiliation(s)
- Nasser M Al-Daghri
- Biomarkers Research Program Biochemistry Department, College of Science, King Saud University, King Saud University, Riyadh, Saudi Arabia; Biochemistry Department, Prince Mutaib Chair for Biomarkers of Osteoporosis, King Saud University, Riyadh, Saudi Arabia.
| | - Naji J Aljohani
- Biochemistry Department, Prince Mutaib Chair for Biomarkers of Osteoporosis, King Saud University, Riyadh, Saudi Arabia; Specialized Diabetes and Endocrine Center, College of Medicine, King Fahad Medical City and King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Omar S Al-Attas
- Biomarkers Research Program Biochemistry Department, College of Science, King Saud University, King Saud University, Riyadh, Saudi Arabia; Biochemistry Department, Prince Mutaib Chair for Biomarkers of Osteoporosis, King Saud University, Riyadh, Saudi Arabia
| | - Yousef Al-Saleh
- Biochemistry Department, Prince Mutaib Chair for Biomarkers of Osteoporosis, King Saud University, Riyadh, Saudi Arabia; Medicine Department, Faculty of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Kaiser Wani
- Biomarkers Research Program Biochemistry Department, College of Science, King Saud University, King Saud University, Riyadh, Saudi Arabia; Biochemistry Department, Prince Mutaib Chair for Biomarkers of Osteoporosis, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah M Alnaami
- Biomarkers Research Program Biochemistry Department, College of Science, King Saud University, King Saud University, Riyadh, Saudi Arabia; Biochemistry Department, Prince Mutaib Chair for Biomarkers of Osteoporosis, King Saud University, Riyadh, Saudi Arabia
| | - Hanan Alfawaz
- Department of Food Science and Nutrition, College of Food Science and Agriculture, King Saud University, Riyadh, Saudi Arabia
| | - Abdulrahman S M Al-Ajlan
- Clinical Laboratory Department, Riyadh College of Health Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Sudhesh Kumar
- Division of Metabolic and Vascular Health, Clinical Sciences Research Institute, University Hospitals Coventry and Warwickshire Trust, Walsgrave, Coventry, United Kingdom
| | - George P Chrousos
- Biomarkers Research Program Biochemistry Department, College of Science, King Saud University, King Saud University, Riyadh, Saudi Arabia; First Department of Pediatrics, Athens University Medical School, Athens, Greece
| | - Majed S Alokail
- Biomarkers Research Program Biochemistry Department, College of Science, King Saud University, King Saud University, Riyadh, Saudi Arabia; Biochemistry Department, Prince Mutaib Chair for Biomarkers of Osteoporosis, King Saud University, Riyadh, Saudi Arabia
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