Cardiovascular (CV) Risk Profile. CV risk factors track from childhood to
adulthood
(89, 90)
and risk factors measured in youth predict adult target organ damage
(91 - 93)
. Thus, an adverse risk profile among youth with diabetes may magnify the
already three-fold excess risk for CV mortality associated with diabetes in adulthood
(94)
. In SEARCH, we found that T1 youth had a prevalence of overweight (22%) that
was significantly higher than that of non-diabetic counterparts, and ~ 90% of youth
with T2D were overweight or obese
(95)
. The prevalence of metabolic syndrome
among SEARCH youth with T1D was 14%, and 92% for youth with T2D
(96)
.
Further, among youth with T1D, 11% had elevated apoB, 8% had dense LDL, and
12% had elevated LDL-cholesterol. In contrast, among youth with T2D, 36% had
elevated apoB, 36% had dense LDL, but only 23% had elevated LDL-cholesterol.
Moreover, the prevalence of elevated blood pressure in youth with type 1 was 5.9%;
minority ethnic groups, obese adolescents and youth with poor glycemic control were
disproportionately affected. In contrast, 23.7% of adolescents with type 2 diabetes
had elevated BP (p<0.0001)
(97)
.