Evaluating Temporal Trends for CVD Risk Factors in Youth With Diabetes

Female doctor measuring waist of overweight woman with measuring tape in clinic
Metabolic syndrome has traditionally been described as having 3 or more cardiovascular risk factors such as altered glucose metabolism, hypertension, abdominal obesity, and dyslipidemia.

Young adults with type 2 diabetes (T2D) have a higher prevalence of cardiovascular disease (CVD) risk factors than young adults with type 1 diabetes (T1D), with no change when stratified by diagnosis year, according to study results published in Pediatric Diabetes.

In order to examine temporal trends in CVD risk factors, researchers identified children and young adults age 3 to 19 years with recently diagnosed T1D (n = 3954) and T2D (n = 706) whose diabetes was not secondary to another condition. Study participants self-identified as non-Hispanic white, non-Hispanic black, Hispanic, Asian or Pacific Islander, and Native American.

CVD risk factors were defined as having a high-density lipoprotein cholesterol (HDL-C) level ≤40 mg/dL; waist circumference ≥90th percentile for age and sex; systolic or diastolic blood pressure ≥90th percentile for age, sex, and height or taking medication for hypertension; and triglyceride levels ≥110 mg/dL.

In the group with T1D, 7.0% of participants had ≥2 CVD risk factors and 1.7% had ≥3 CVD risk factors. The 2 most common CVD risk factors in participants with T1D were high waist circumference and low HDL-C. Researchers also found that the prevalence of most CVD risk factors did not change over the incident years in the group with T1D. However, risk factors increased with each age category and there were significant relationships between race/ethnicity and having ≥2 CVD risk factors (P =.02) and between body mass index and CVD risk factors relative to normal weight individuals with T1D (odds ratio [OR] of having ≥2 CVD risk factors with obesity, 22.6; 95% CI, 16.5-30.9; OR of having ≥2 CVD risk factors with overweight, 4.5; 95% CI, 3.2-6.5).

Of the study participants with T2D, 31.7% had ≥3 CVD risk factors, with the 2 most prevalent being high waist circumference and low HDL-C. Further, participants with T2D were more likely to have ≥2 CVD risk factors relative to participants with T1D (OR, 5.1; 95% CI, 4.8-5.4; P <.0001). In youth with T2D, the only CVD risk factor for which prevalence changed over time was high waist circumference, increasing from 71.0% to 88.4% at an average annual rate of 12.8% (P <.0001).

Like the group with T1D, the participants with T2D showed a significant relationship between race/ethnicity and having ≥2 CVD risk factors. Moreover, the prevalence of having ≥2 CVD risk factors was higher in older compared with younger participants with T2D. After adjustment for age, sex, and race/ethnicity, the number of CVD risk factors increased in participants with T2D at an annual rate of 1.56% (95% CI, 0.28%-2.85%; P =.02), which likely was related to increasing waist circumference.

“Given the importance of adiposity on prevalence of CVD risk factors, achieving healthy weight status is an essential goal in diabetes management for youth with T1D and T2D,” noted the researchers.


Kim G, Divers J, Fino NF, et al. Trends in prevalence of cardiovascular risk factors from 2002-2012 among youth early in the course of type 1 and type 2 diabetes. The SEARCH for Diabetes in Youth Study [published online March 23, 2019]. Pediatr Diabetes. doi:10.1111/pedi.12846

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This article originally appeared on Endocrinology Advisor