Show simple item record

dc.contributor.authorNwosu, Benjamin U.
dc.contributor.authorZhang, Bo
dc.contributor.authorAyyoub, Sanaa S.
dc.contributor.authorChoi, Stephanie
dc.contributor.authorVillalobos-Ortiz, Tony R.
dc.contributor.authorAlonso, Laura C.
dc.contributor.authorBarton, Bruce A.
dc.date2022-08-11T08:10:13.000
dc.date.accessioned2022-08-23T16:59:42Z
dc.date.available2022-08-23T16:59:42Z
dc.date.issued2018-05-16
dc.date.submitted2018-06-27
dc.identifier.citation<p>PLoS One. 2018 May 16;13(5):e0196912. doi: 10.1371/journal.pone.0196912. eCollection 2018. <a href="https://doi.org/10.1371/journal.pone.0196912">Link to article on publisher's site</a></p>
dc.identifier.issn1932-6203 (Linking)
dc.identifier.doi10.1371/journal.pone.0196912
dc.identifier.pmid29768449
dc.identifier.urihttp://hdl.handle.net/20.500.14038/43648
dc.description.abstractIMPORTANCE: Landmark studies showed that partial clinical remission in new-onset type 1 diabetes is associated with reduced prevalence of long-term complications, but early clinical indicators of this favorable outcome are poorly characterized. AIM: To determine if there were any differences in lipid parameters, especially LDL-cholesterol, between remitters and non-remitters 4 to 5 years after the diagnosis of type 1 diabetes after controlling for hemoglobin A1c, body mass index, and pubertal status. SUBJECTS AND METHODS: A longitudinal retrospective cohort study of 123 subjects of mean age 11.9 +/- 2.9 years, [male 11.7 +/- 2.9 years, (n = 55); female 12.0 +/- 2.9 years, (n = 68), p = 0.60] with type 1 diabetes of 4-5 years duration. Anthropometric and biochemical data were collected at the 4th or 5th year after diagnosis in line with the American Diabetes Association recommendation to initiate screening for complications in children either at the beginning of puberty or 4-5 years after diagnosis. Puberty was defined by Tanner stages II-V. Partial clinical remission was defined by the gold-standard insulin-dose adjusted hemoglobin A1c (IDAA1c) of < /=9. RESULTS: There were 44 (35.8%) remitters (age 13.0 +/- 2.5y; male 52.3%). Both the total cholesterol and LDL-cholesterol were significantly lower in remitters compared to non-remitters: LDL-C: 78.8 +/- 28.7 mg/dL vs. 91.6 +/- 26.5 mg/dL, p = 0.023; and total cholesterol: 151.5 +/- 32.6 mg/dL vs. 167.0 +/- 29.6 mg/dL, p = 0.015. Other lipid fractions were similar between the groups. There were no differences between the groups for glycemic control, body mass index z score, thyroid function, celiac disease occurrence, or vitamin D status. A greater number of remitters were in puberty compared to non-remitters (86.4% vs. 60.8%, p = 0.006). LDL-C concentration was similar in prepubertal remitters vs. non-remitters (p = 0.93), but was significantly lower in remitters in puberty compared to non-remitters in puberty (p = 0.018) after adjusting for age and duration of diabetes. CONCLUSIONS: Children with type 1 diabetes who underwent a honeymoon phase had significantly lower LDL cholesterol 5 years after diagnosis. This early divergence in lipidemia may explain the dichotomy in the prevalence of long-term complication in type 1 diabetes between remitters and non-remitters. It also offers a pathway for targeted lipid monitoring in type 1 diabetes, by establishing non-remission as a non-modifiable risk factor for vascular complication in type 1 diabetes.
dc.language.isoen_US
dc.relation<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=29768449&dopt=Abstract">Link to Article in PubMed</a>. <strong>Data Availability: </strong>Data are available from the University of Massachusetts Medical School’s institutional repository, eScholarship@UMMS at <a href="https://escholarship.umassmed.edu/pediatrics_data/6/">https://escholarship.umassmed.edu/pediatrics_data/6/</a> or <a href="https://doi.org/10.13028/M2FT3K">https://doi.org/10.13028/M2FT3K</a>.</p>
dc.rightsCopyright: © 2018 Nwosu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectType 1 diabetes
dc.subjectlipids
dc.subjectcholesterol
dc.subjectchildren
dc.subjectpuberty
dc.subjectEndocrine System Diseases
dc.subjectEndocrinology, Diabetes, and Metabolism
dc.subjectLipids
dc.subjectNutritional and Metabolic Diseases
dc.subjectPediatrics
dc.titleChildren with type 1 diabetes who experienced a honeymoon phase had significantly lower LDL cholesterol 5 years after diagnosis
dc.typeJournal Article
dc.source.journaltitlePloS one
dc.source.volume13
dc.source.issue5
dc.identifier.legacyfulltexthttps://escholarship.umassmed.edu/cgi/viewcontent.cgi?article=1220&amp;context=peds_pp&amp;unstamped=1
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/peds_pp/221
dc.identifier.contextkey12400436
refterms.dateFOA2022-08-23T16:59:42Z
html.description.abstract<p>IMPORTANCE: Landmark studies showed that partial clinical remission in new-onset type 1 diabetes is associated with reduced prevalence of long-term complications, but early clinical indicators of this favorable outcome are poorly characterized.</p> <p>AIM: To determine if there were any differences in lipid parameters, especially LDL-cholesterol, between remitters and non-remitters 4 to 5 years after the diagnosis of type 1 diabetes after controlling for hemoglobin A1c, body mass index, and pubertal status.</p> <p>SUBJECTS AND METHODS: A longitudinal retrospective cohort study of 123 subjects of mean age 11.9 +/- 2.9 years, [male 11.7 +/- 2.9 years, (n = 55); female 12.0 +/- 2.9 years, (n = 68), p = 0.60] with type 1 diabetes of 4-5 years duration. Anthropometric and biochemical data were collected at the 4th or 5th year after diagnosis in line with the American Diabetes Association recommendation to initiate screening for complications in children either at the beginning of puberty or 4-5 years after diagnosis. Puberty was defined by Tanner stages II-V. Partial clinical remission was defined by the gold-standard insulin-dose adjusted hemoglobin A1c (IDAA1c) of < /=9.</p> <p>RESULTS: There were 44 (35.8%) remitters (age 13.0 +/- 2.5y; male 52.3%). Both the total cholesterol and LDL-cholesterol were significantly lower in remitters compared to non-remitters: LDL-C: 78.8 +/- 28.7 mg/dL vs. 91.6 +/- 26.5 mg/dL, p = 0.023; and total cholesterol: 151.5 +/- 32.6 mg/dL vs. 167.0 +/- 29.6 mg/dL, p = 0.015. Other lipid fractions were similar between the groups. There were no differences between the groups for glycemic control, body mass index z score, thyroid function, celiac disease occurrence, or vitamin D status. A greater number of remitters were in puberty compared to non-remitters (86.4% vs. 60.8%, p = 0.006). LDL-C concentration was similar in prepubertal remitters vs. non-remitters (p = 0.93), but was significantly lower in remitters in puberty compared to non-remitters in puberty (p = 0.018) after adjusting for age and duration of diabetes.</p> <p>CONCLUSIONS: Children with type 1 diabetes who underwent a honeymoon phase had significantly lower LDL cholesterol 5 years after diagnosis. This early divergence in lipidemia may explain the dichotomy in the prevalence of long-term complication in type 1 diabetes between remitters and non-remitters. It also offers a pathway for targeted lipid monitoring in type 1 diabetes, by establishing non-remission as a non-modifiable risk factor for vascular complication in type 1 diabetes.</p>
dc.identifier.submissionpathpeds_pp/221
dc.contributor.departmentUMass Metabolic Network
dc.contributor.departmentDiabetes Division, Department of Medicine
dc.contributor.departmentDepartment of Quantitative Health Sciences
dc.contributor.departmentDivision of Endocrinology, Department of Pediatrics
dc.source.pagese0196912


Files in this item

Thumbnail
Name:
journal.pone.0196912.pdf
Size:
953.5Kb
Format:
PDF

This item appears in the following Collection(s)

Show simple item record

Copyright: © 2018 Nwosu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Except where otherwise noted, this item's license is described as Copyright: © 2018 Nwosu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.