“A Cross-sectional study of dyslipidemia among underweight, normal weight and overweight type 1 diabetic paediatric & adolescent patients coming to a tertiary care referral hospital, Mysuru, Karnataka”.
DOI:
https://doi.org/10.51168/sjhrafrica.v6i9.2045Keywords:
Dyslipidemia, Diabetes Mellitus, Body Mass Index, Cardiovascular diseaseAbstract
Introduction
The prevalence and impact of dyslipidemia in relation to body mass index (BMI) categories in T1DM patients remains a critical area of research. This study aims to evaluate the prevalence of dyslipidemia among underweight, normal weight, and overweight pediatric and adolescent T1DM patients and explore the effect of BMI on the prevalence of dyslipidemia.
Materials and Methods
This cross-sectional observational study included 58 pediatric and adolescent patients diagnosed with T1DM. The patients were classified into three BMI categories: underweight, normal weight, and overweight. Data were analyzed to assess the association between BMI categories and the prevalence of dyslipidemia.
Results
Dyslipidemia was observed in 82.76% of the participants, with the majority being classified as overweight (68.75%). A smaller proportion had a normal BMI (27.08%), while 4.17% were underweight. No significant association was found between BMI categories and dyslipidemia (p = 0.4735). The study also noted that the mean age of participants was 10.19 ± 4.96 years.
Conclusion
The study highlights the high prevalence of dyslipidemia among pediatric and adolescent T1DM patients, particularly those who are overweight. While no significant association between BMI categories and dyslipidemia was found, these findings suggest the importance of monitoring lipid profiles in T1DM patients, especially those with higher BMI, to mitigate the risk of cardiovascular complications.
Recommendations
Given the rising prevalence of overweight and obesity among pediatric and adolescent T1DM patients, understanding the impact of BMI on dyslipidemia is of critical importance. Identifying BMI-related lipid abnormalities can facilitate early intervention strategies, including lifestyle modifications, dietary interventions, and tailored insulin regimens to mitigate cardiovascular risk. Furthermore, the findings of this study could contribute to the development of targeted screening guidelines for dyslipidemia in pediatric T1DM populations, optimizing long-term metabolic health outcomes.
References
Amutha A, Thai K, Vishwanathan M. Childhood and adolescent onset type 1 diabetes in India. J Med Sci. 2013;1(1):46-53. https://doi.org/10.5005/jp-journals-10036-1013
Li J, Motsko SP, Goehring Jr EL, Tave A, Pezzullo JC, Jones JK. Prevalence of pediatric dyslipidemia: comparison of a population‐based claims database to national surveys. pharmacoepidemiology and drug safety. 2010;19(10):1031-40. https://doi.org/10.1002/pds.1982
Ciężki S, Kurpiewska E, Bossowski A, Głowińska-Olszewska B. Multi-Faceted Influence of Obesity on Type 1 Diabetes in Children-From Disease Pathogenesis to Complications. Frontiers in Endocrinology. 2022;13:890833. https://doi.org/10.3389/fendo.2022.890833
Colom C, Rull A, Sanchez-Quesada JL, Perez A. Cardiovascular disease in type 1 diabetes mellitus: epidemiology and management of cardiovascular risk. Journal of Clinical Medicine. 2021;10(8):1798. https://doi.org/10.3390/jcm10081798
Mona HM, Sahar SA, Hend SM, Nanees AW. Dyslipidemia in type 1 diabetes mellitus: relation to diabetes duration, glycemic control, body habitus, dietary intake, and other epidemiological risk factors. Egyptian Pediatric Association Gazette. 2015;63(2):63-8. https://doi.org/10.1016/j.epag.2015.03.001
Leopold S, Zachariah JP. Pediatric lipid disorders. Pediatric Annals. 2021 Mar 1;50(3):e105-12. https://doi.org/10.3928/19382359-20210218-01
Elmaoğulları S, Tepe D, Uçaktürk SA, Kara FK, Demirel F. Prevalence of dyslipidemia and associated factors in obese children and adolescents. Journal of clinical research in pediatric endocrinology. 2015 Aug 31;7(3):228. https://doi.org/10.4274/jcrpe.1867
Shah N, Khadilkar A, Gondhalekar K, Khadilkar V. Prevalence of dyslipidemia in Indian children with poorly controlled type 1 diabetes mellitus. Pediatric Diabetes. 2020 Sep;21(6):987-94. https://doi.org/10.1111/pedi.13063
Gujral J, Gupta J. Pediatric Dyslipidemia. [Updated 2024 Dec 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK585106/
Centers for Disease Control and Prevention (CDC. Prevalence of abnormal lipid levels among youths--United States, 1999-2006. MMWR: Morbidity & Mortality Weekly Report. 2010;59(2).
Constantin AT, Delia C, Tudor LM, Rosca I, Irimie AD, Năstase L, Gherghina I. Dyslipidemia in pediatric patients: a cross-sectional study. Medicina. 2023;59(8):1434. https://doi.org/10.3390/medicina59081434
Otfried Schwab K, Doerfer J, Marg W, Schober E, Holl RW. Characterization of 33,488 children and adolescents with type 1 diabetes based on the gender-specific increase of cardiovascular risk factors. Pediatr Diabetes. 2010;11(5):357-63. https://doi.org/10.1111/j.1399-5448.2010.00665.x
Qannia FM, Rimbun R, Faizi M, Purba AKR. Management of Dyslipidemia in Type 1 Diabetes Mellitus: Literature Review. International Journal of Scientific Advances. 2024;5(6): 1617-1622. https://doi.org/10.51542/ijscia.v5i6.94
Vergès B. Lipid disorders in type 1 diabetes. Diabetes Metab. 2009;35:353-60. https://doi.org/10.1016/j.diabet.2009.04.004
Maahs DM, Wadwa RP, Bishop F, Daniels SR, Rewers M, Klingensmith GJ. Dyslipidemia in Youth with Diabetes: To Treat or Not to Treat? J Pediatr. 2008;153(4). https://doi.org/10.1016/j.jpeds.2008.05.062
Noras K, Rusak E, Jarosz-Chobot P. The Problem of Abnormal Body Weight and Dyslipidemia as Risk Factors for Cardiovascular Diseases in Children and Adolescents with Type 1 Diabetes. J Diabetes Res. 2021. https://doi.org/10.1155/2021/5555149
Ashour D, AlSubaihin A, Lim YY, Legault L. Overweight and obese youth with type 1 or type 2 diabetes share similar elevation in triglycerides during middle and late adolescence. Obes Res Clin Pract. 2022;16(2):138-43. https://doi.org/10.1016/j.orcp.2022.03.003
Ramachandran A, Snehalatha C, Krishnaswamy CV, Moses A, Mariappan C, Chinnaian P, et al. Incidence of IDDM in children in the urban population in Southern India. Diabetes Res Clin Pract. 1996;34(2):79-82. https://doi.org/10.1016/S0168-8227(96)01338-1
Kalra S, Kalra B, Sharma A. Prevalence of type 1 diabetes mellitus in Karnal district, Haryana state, India. Diabetol Metab Syndr. 2010;2(1):14. https://doi.org/10.1186/1758-5996-2-14
Buchmann M, Tuncer O, Auzanneau M, Eckert AJ, Rosenbauer J, Reitzle L, Heidemann C, Holl RW, Thamm R. Incidence, prevalence and care of type 1 diabetes in children and adolescents in Germany: Time trends and regional socioeconomic situation. Journal of Health Monitoring. 2023 Jun 14;8(2):57.
Ogle GD, James S, Dabelea D, Pihoker C, Svennson J, Maniam J, et al. Global estimates of incidence of type 1 diabetes in children and adolescents: Results from the International Diabetes Federation Atlas, 10th edition. Diabetes Res Clin Pract. 2022;183. https://doi.org/10.1016/j.diabres.2021.109083
Das AK. Type 1 diabetes in India: Overall insights. Indian J Endocrinol Metab. 2015;19(7):S31-3. https://doi.org/10.4103/2230-8210.155372
Gong B, Yang W, Xing Y, Lai Y, Shan Z. Global, regional, and national burden of type 1 diabetes in adolescents and young adults. Pediatric Research. 2024 Mar 5:1-9. https://doi.org/10.1038/s41390-024-03107-5
Kandemir N, Vuralli D, Ozon A, Gonc N, Ardicli D, Jalilova L, et al. Epidemiology of type 1 diabetes mellitus in children and adolescents: A 50-year, single-center experience. J Diabetes. 2024;16(5). https://doi.org/10.1111/1753-0407.13562
Fagundes Melo R, Laurindo LF, Sloan KP, Sloan LA, Cressoni Araújo A, Bitelli P, et al. Investigating the Incidence of Dyslipidemia among Brazilian Children and Adolescents Diagnosed with Type 1 Diabetes Mellitus: A Cross-Sectional Study. Diseases. 2024;12(3):45. https://doi.org/10.3390/diseases12030045
Kim G, DeSalvo D, Guffey D, Minard CG, Cephus C, Moodie D, et al. Dyslipidemia in adolescents and young adults with type 1 and type 2 diabetes: a retrospective analysis. Int J Pediatr Endocrinol. 2020;2020(1):1-8. https://doi.org/10.1186/s13633-020-00081-7
Maffeis C, Birkebaek NH, Konstantinova M, Schwandt A, Vazeou A, Casteels K, et al. Prevalence of underweight, overweight, and obesity in children and adolescents with type 1 diabetes: Data from the international SWEET registry. Pediatr Diabetes. 2018;19(7):1211-20. https://doi.org/10.1111/pedi.12730
Punthakee Z, Goldenberg R, Katz P. Definition, Classification, and Diagnosis of Diabetes, Prediabetes, and Metabolic Syndrome. Can J Diabetes. 2018;42:S10-5. https://doi.org/10.1016/j.jcjd.2017.10.003
Popoviciu MS, Kaka N, Sethi Y, Patel N, Chopra H, Cavalu S. Type 1 Diabetes Mellitus and Autoimmune Diseases: A Critical Review of the Association and the Application of Personalized Medicine. J Pers Med. 2023;13. https://doi.org/10.3390/jpm13030422
Bodis G, Toth V, Schwarting A. Role of human leukocyte antigens (HLA) in autoimmune diseases. Rheumatology and therapy. 2018 Jun;5:5-20. https://doi.org/10.1007/s40744-018-0100-z
Aly TA, Eller E, Ide A, Gowan K, Babu SR, Erlich HA, et al. Multi-SNP analysis of MHC region: Remarkable conservation of HLA-A1-B8-DR3 haplotype. Diabetes. 2006;55(5):1265-9. https://doi.org/10.2337/db05-1276
Feingold KR, Grunfeld C. Effect of inflammation on HDL structure and function. Curr Opin Lipidol. 2016;27:521-30. https://doi.org/10.1097/MOL.0000000000000333
Homma TK, Endo CM, Saruhashi T, Mori API, de Noronha RM, Monte O, et al. Dyslipidemia in young patients with type 1 diabetes mellitus. Arch Endocrinol Metab. 2015;59(3):215-9. https://doi.org/10.1590/2359-3997000000040
Sowers JR. Insulin Resistance, Hyperinsulinemia, Dyslipidemia, Hypertension, and Accelerated Atherosclerosis. J Clin Pharmacol. 1992;32(6):529-35. https://doi.org/10.1177/009127009203200607
Zabeen B, Balsa AM, Islam N, Parveen M, Nahar J, Azad K. Lipid profile in relation to glycemic control in Type 1 diabetes children and adolescents in Bangladesh. Indian J Endocrinol Metab. 2018;22(1):89-92. https://doi.org/10.4103/ijem.IJEM_217_17
Corpeleijn WE, de Waal WJ, Schipper HS, Wiegman A. Dyslipidemia as a target for atherosclerotic cardiovascular disease prevention in children with type 1 diabetes: lessons learned from familial hypercholesterolemia. Diabetologia. 2024;67:19-26. https://doi.org/10.1007/s00125-023-06041-z
Jones S, Khanolkar AR, Gevers E, Stephenson T, Amin R. Cardiovascular risk factors from diagnosis in children with type 1 diabetes mellitus: A longitudinal cohort study. BMJ Open Diabetes Res Care. 2019;7(1). https://doi.org/10.1136/bmjdrc-2018-000625
Silva LC de SE, Silva SLBE, Oliveira ÁMS de, Araujo JR de, Arruda IKG de, Maio R, et al. Hypertriglyceridemic waist and associated factors in children and adolescents with type 1 diabetes mellitus. Rev Paul Pediatr. 2020;38:e2019073. https://doi.org/10.1590/1984-0462/2020/38/2019073
Wysocka-Mincewicz M, Kołodziejczyk H, Wierzbicka E, Szalecki M. Overweight, obesity and lipid abnormalities in adolescents with type 1 diabetes. Pediatr Endocrinol Diabetes Metab. 2015;21(2):70-81. https://doi.org/10.18544/PEDM-21.02.0027
Kosteria I, Schwandt A, Davis E, Jali S, Prieto M, Rottembourg D. Lipid profile is associated with treatment regimen in a large cohort of children and adolescents with type 1 diabetes mellitus: A study from the international SWEET database. Diabet Med. 2019;36(10):1294-303. https://doi.org/10.1111/dme.13963
Urbina EM, Isom S, Bell RA, Bowlby DA, D'Agostino Jr R, Daniels SR, Dolan LM, Imperatore G, Marcovina SM, Merchant AT, Reynolds K. Burden of cardiovascular risk factors over time and arterial stiffness in youth with type 1 diabetes mellitus: the SEARCH for diabetes in youth study. Journal of the American Heart Association. 2019 Jul 2;8(13):e010150. https://doi.org/10.1161/JAHA.118.010150
Bamba V. Update on screening, etiology, and treatment of dyslipidemia in children. J Clin Endocrinol Metab. 2014;99:3093-102. https://doi.org/10.1210/jc.2013-3860
Management of dyslipidemia in children and adolescents with diabetes. Diabetes Care. 2003;26(7):2194-7. https://doi.org/10.2337/diacare.26.7.2194
Grundy SM, Stone NJ, Bailey AL, Beam C, Birtcher KK, Blumenthal RS, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: Executive summary. J Am Coll Cardiol. 2019;73(24):3168-209. https://doi.org/10.1016/j.jacc.2018.11.003 https://doi.org/10.1016/j.jacc.2018.11.002
Lauer RM, Obarzanek E, Hunsberger SA, Van Horn L, Hartmuller VW, Barton BA, et al. Efficacy and safety of lowering dietary intake of total fat, saturated fat, and cholesterol in children with elevated LDL cholesterol: The Dietary Intervention Study in Children. Am J Clin Nutr. 2000;72(5 Suppl). https://doi.org/10.1093/ajcn/72.5.1332s
Obarzanek E, Kimm SYS, Barton BA, Van Horn L, Kwiterovich PO, Simons-Morton DG, et al. Long-term safety and efficacy of a cholesterol-lowering diet in children with elevated low-density lipoprotein cholesterol: Seven-year results of the Dietary Intervention Study in Children (DISC). Pediatrics. 2001;107(2):256-64. https://doi.org/10.1542/peds.107.2.256
Mayer-Davis EJ, Nichols M, Liese AD, Bell RA, Dabelea DM, Johansen JM, et al. Dietary intake among youth with diabetes: The SEARCH for Diabetes in Youth Study. J Am Diet Assoc. 2006;106(5):689-97. https://doi.org/10.1016/j.jada.2006.02.002
Kalra S, Gandhi A, Kalra B, Agrawal N. Management of dyslipidemia in children. Diabetol Metab Syndr. 2009;1(1):26. https://doi.org/10.1186/1758-5996-1-26
Sunil B, Foster C, Wilson DP, Ashraf AP. Novel therapeutic targets and agents for pediatric dyslipidemia. Ther Adv Endocrinol Metab. 2021;12. https://doi.org/10.1177/20420188211058323
Selvaraj M, Prasad HK, White S, Prasanna B, Sangaralingam T. Prevalence and determinants of occurrence of dyslipidemia in subjects with type 1 diabetes mellitus. Indian J Pediatr. 2023;90(2):118-23. https://doi.org/10.1007/s12098-022-04130-2
Oza C, Khadilkar A, Mondkar SA, Gondhalekar K, Khadilkar V. Longitudinal trends in lipid profile in Indian children and youth with type-1 diabetes: A 5-year follow-up from a single centre. Endocrine. 2023;79(2):313-22. https://doi.org/10.1007/s12020-022-03259-6
Soliman H, Ibrahim A. Prevalence and pattern of dyslipidemia in Egyptian children and adolescents with type 1 diabetes. Egypt Pediatr Assoc Gaz. 2021;69(1):1-7. https://doi.org/10.1186/s43054-021-00067-x
Jaja TC, Yarhere IE. Dyslipidemia in Nigerian children and adolescents with diabetes mellitus: Prevalence and associated risk factors. Dubai Diabetes Endocrinol J. 2019;25(1-2):45-51. https://doi.org/10.1159/000499713
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(4):327-34. https://doi.org/10.1515/jpem-2018-0383
El Bakry M, Mansour A, Ahmed M, Sptan H. Dyslipidemia in Egyptian children and adolescents with type 1 diabetes mellitus. Benha Med J. 2017;34(2):104. https://doi.org/10.21608/bmfj.2017.69207
Bulut T, Demirel F, Metin A. The prevalence of dyslipidemia and associated factors in children and adolescents with type 1 diabetes. J Pediatr Endocrinol Metab. 2017;30(2):181-7. https://doi.org/10.1515/jpem-2016-0111
Khadilkar VV, Khadilkar AV. Revised Indian Academy of Pediatrics 2015 growth charts for height, weight, and body mass index for 5- 18-year-old Indian children. Indian J Endocrinol Metab 2015;19: 470-6. https://doi.org/10.4103/2230-8210.159028
Warnick GR, Knopp RH, Fitzpatrick V, Branson L. Estimating low-density lipoprotein cholesterol by the Friedewald equation is adequate for classifying patients based on nationally recommended cutpoints. Clin Chem 1990;36:15-9. https://doi.org/10.1093/clinchem/36.1.15
Donaghue KC, Marcovecchio ML, Wadwa RP, Chew EY, Wong TY, Calliari LE, et al. ISPAD clinical practice consensus guidelines 2018: microvascular and macrovascular complications in children and adolescents. Pediatr Diabetes 2018;19(Suppl 27):262-74. https://doi.org/10.1111/pedi.12742
Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents, National Heart, Lung, and Blood Institute. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics 2011;128(Suppl 5):S213-256. https://doi.org/10.1542/peds.2009-2107C
Chiang JL, Maahs DM, Garvey KC, Hood KK, Laffel LM, Weinzimer SA, et al. Type 1 diabetes in children and adolescents: a position statement by the American Diabetes Association. Diabetes Care 2018;41:2026-44. https://doi.org/10.2337/dci18-0023
American Diabetes Association Professional Practice Committee. 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes-2024. Diabetes Care. 2024;47(Suppl 1):S20-S42. https://doi.org/10.2337/dc24-S002
American Diabetes Association Professional Practice Committee. Summary of revisions: Standards of Care in Diabetes-2025. Diabetes Care. 2025;48(Suppl 1):S6-S13.
World Health Organization. Obesity and overweight [Internet]. Geneva: World Health Organization; 2021 [cited 2025 Jul 3]. Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
Khadilkar V, Yadav S, Agrawal KK, Tamboli S, Banerjee M, Cherian A, et al. Revised IAP growth charts for height, weight, and body mass index for 5- to 18-year-old Indian children. Indian Pediatr. 2015 Jan;52(1):47-55. https://doi.org/10.1007/s13312-015-0566-5
Jaja T, Yarhere I. Dyslipidaemia in Nigerian children and adolescents with diabetes mellitus: Prevalence and associated risk factors. International Journal of Diabetes and Metabolism. 2019;25(1-2):45-51. https://doi.org/10.1159/000499713
Akhter S, Khoso Z, Rai V, Laghari T, Parveen R, Mahar S, Ibrahim M. Association of dyslipidemia and type-I diabetes mellitus among children up to 16 years of age. Pakistan Journal of Medical & Health Sciences. 2022;16(02):704. https://doi.org/10.53350/pjmhs22162704
Dange NS, Oza C, Khadilkar V, Gondhalekar K, Yewale S, Khadilkar A. Patterns and determinants of serum amylase, lipase concentrations in Indian adolescents and youth with type 1 diabetes. Journal of Pediatric Endocrinology and Metabolism. 2025;38(2):146-54. https://doi.org/10.1515/jpem-2024-0314
PA J., N. N, P. H. Clinical profile of diabetes in young adults aged 15 to 30 years. International Journal of Advances in Medicine. 2019;6(5):1466. https://doi.org/10.18203/2349-3933.ijam20193670
Carneiro LBV, Lacerda EMDA, Medeiros da Costa V, Luiz Luescher J, Fontes de Lima GC, Berardo Szundy R, et al. Perfil lipídico de crianças e adolescentes com diabetes mellitus tipo 1. Nutrición Clínica y Dietética Hospitalaria. 2017;37(4):23-8. https://doi.org/10.12873/374carneiro
Da Costa VM, de Carvalho Padilha P, de Lima GC, Ferreira AA, Luescher JL, Porto L, Peres WA. Overweight among children and adolescents with type 1 diabetes mellitus: prevalence and associated factors. Diabetology & Metabolic Syndrome. 2016;8:1-6. https://doi.org/10.1186/s13098-016-0154-4
Kaminski BM, Klingensmith GJ, Beck RW, Tamborlane WV, Lee J, Hassan K, Schatz D, Kollman C, Redondo MJ, Pediatric Diabetes Consortium. Body mass index at the time of diagnosis of autoimmune type 1 diabetes in children. The Journal of Pediatrics. 2013;162(4):736-40. https://doi.org/10.1016/j.jpeds.2012.09.017
El Bakry MM, Mansour AI, Ahmed ME, Sptan HE. Dyslipidemia in Egyptian children and adolescents with type 1 diabetes mellitus. Benha Med J. 2017S;34:104-7. https://doi.org/10.21608/bmfj.2017.69207
Flokas ME, Zeymo A, Mete M, Anhalt H, Rother KI, Gourgari E. Overweight and obese children with optimal control in the T1D Exchange Registry: How are they different from lean children with optimal control?. Journal of Diabetes and Its Complications. 2020 Apr 1;34(4):107513. https://doi.org/10.1016/j.jdiacomp.2019.107513
Stankute I, Dobrovolskiene R, Danyte E, Razanskaite-Virbickiene D, Jasinskiene E, Mockeviciene G, Marciulionyte D, Schwitzgebel VM, Verkauskiene R. Factors affecting cardiovascular risk in children, adolescents, and young adults with type 1 diabetes. Journal of diabetes research. 2019;2019(1):9134280. https://doi.org/10.1155/2019/9134280
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Dr. Santhosh Kumar M, Dr .Devika Premnath

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.