LDL cholesterol level as a risk factor for retinopathy and nephropathy in children and adults with type 1 diabetes mellitus: A nationwide cohort study

Autor: Marcus Lind, Thomas Nyström, Josephine Haas, M. Andersson Franko, Johnny Ludvigsson, Mats A. A. Persson, Björn Rathsman, Ann-Marie Svensson
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Journal of Internal Medicine
ISSN: 2019-0298
Popis: Background Microvascular complications are common in people with diabetes, where poor glycaemic control is the major contributor. The aim of this study was to explore the association between elevated LDL cholesterol levels and the risk of retinopathy or nephropathy in young individuals with type 1 diabetes. Methods This was a nationwide observational population-based cohort study, including all children and adults with a duration of type 1 diabetes of 4.1 mmol L-1. Results In total, 11 024/12 350 (retinopathy/nephropathy, both cohorts, respectively) children and adults (median age 21 years, female 42%) were followed up to 28 years from diagnosis until end of study. Median duration of diabetes when entering the study was 6 and 7 years in the retinopathy and nephropathy cohort, respectively. Median LDL cholesterol was 2.4 mmol L-1, and median HbA1c level was 61 mmol mol(-1) (7.7 %). After multivariable adjustment, the HRs (95% CI) for retinopathy in individuals with LDL cholesterol levels of 2.6-3.4, 3.4-4.1 or > 4.1 mmol L-1 were as follows: 1.13 (1.03-1.23), 1.16 (1.02-1.32) and 1.18 (0.99-1.41), compared with the reference. The corresponding numbers for nephropathy were as follows: 1.15 (0.96-1.32), 1.30 (1.03-1.65) and 1.41 (1.06-1.89). Conclusions Young individuals with type 1 diabetes exposed to high LDL cholesterol levels have an increased risk of retinopathy and nephropathy independent of glycaemia and other identified risk factors for vascular complications. Funding Agencies|Swedish Heart-Lung FoundationSwedish Heart-Lung Foundation [20190298]; Stockholm County CouncilStockholm County Council [20170120]; Karolinska InstituteKarolinska Institutet [20170120]; Stockholm City Council; Barndiabetesfonden; Diabetesfonden
Databáze: OpenAIRE