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Document Type:	Artigo
Title:	Heterogeneous behavior of lipids according to HbA1c levels undermines the plausibility of metabolic syndrome in type 1 diabetes: data from a nationwide multicenter survey
Authors:	Giuffrida, Fernando de Mello Almada Guedes, Alexis Dourado Rocco, Eloá Roberta Mory, Denise Barretto Dualib, Patricia Matos, Odelisa S. Chaves Fonseca, Reine Marie Cobas, Roberta Arnoldi Negrato, Carlos Antonio Gomes, Marilia B.
Issue Date:	2012
Resumo :	Background: Cardiovascular risk factors (CVRF) may cluster in type 1 diabetes, analogously to the metabolic syndrome described in type 2 diabetes. The threshold of HbA1c above which lipid variables start changing behavior is unclear. This study aims to 1) assess the behavior of dyslipidemia according to HbA1c values; 2) detect a threshold of HbA1c beyond which lipids start to change and 3) compare the clustering of lipids and other non-lipid CVRF among strata of HbA1c individuals with type 1 diabetes. Methods: Effects of HbA1c 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 HbA1c quintiles, respectively. Hypertriglyceridemia increased in the 5th quintile of HbA1c, 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 HbA1c quintiles, respectively. HDL-cholesterol correlated positively (0.437) with HbA1c in the 3rd quintile. HDL-cholesterol and insulin dose correlated inversely in all levels of glycemic control. Conclusions: Correlation of serum lipids with HbA1c is heterogeneous across the spectrum of glycemic control in type 1 diabetes individuals. LDL-cholesterol and triglycerides worsened alongside HbA1c 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 HbA1c, refuting a unified explanation for cardiovascular risk in type 1 diabetes.
Keywords:	Type 1 diabetes Metabolic syndrome Dyslipidemia Cardiovascular risk factor
ISSN:	1475-2840
Is part of:	Cardiovascular Diabetology
Language:	eng
Publisher / Institution :	BioMed Central
Citation:	GIUFFRIDA, F. M. A. et al. Heterogeneous behavior of lipids according to HbA1c levels undermines the plausibility of metabolic syndrome in type 1 diabetes: data from a nationwide multicenter survey. Cardiovascular Diabetology, London, v. 11, n. 156, 2012. Disponível em: https://cardiab.biomedcentral.com/articles/10.1186/1475-2840-11-156. Acesso em: 7 out. 2025.
License:	Creative Commons Atribuição 2.0 Genérica (CC BY 2.0)
URI:	https://ri.ufs.br/jspui/handle/riufs/23370
Appears in Collections:	DME - Artigos de periódicos

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