Paper
Thursday, July 22, 2004
Cardiovascular Risks in Youth With Diabetes: Homocysteine, Lipids, and Diet
Melissa Spezia Faulkner, BSN, MSN, DSN1, Wei-Hsun Chao, MS2, Laurie Quinn, PhD3, Cynthia Fritschi, MS, CDE1, and Robert D. Reynolds, PhD2. (1) Maternal-Child Nursing, University of Illinois at Chicago, Chicago, IL, USA, (2) Human Nutrition and Dietetics, University of Illinois at Chicago, Chicago, IL, USA, (3) Medical-Surgical Nursing, University of Illinois at Chicago, Chicago, IL, USA
| Learning Objective #1: Describe the associations of homocysteine and lipids with heart disease in persons with diabetes
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| Learning Objective #2: Identify the influences of gender and age on homocysteine levels in adolescents |
Objective: The purposes of this study were to compare total homocysteine (tHcy), lipids, and dietary intake of macronutrients, folate, and vitamins B6 and B12 in adolescents with type 1 and type 2 diabetes (DM) and healthy controls. The influences of age, gender, and body mass index on tHcy were explored. Design: A cross-sectional, descriptive design was used. Population, Sample, Setting, Years: Subjects included adolescents: 50 with type 1 DM, 14 with type 2 DM, and 53 controls. The mean ages for those with type 1 vs. type 2 DM were 15.2 ± 1.9 years vs. 16.1 ± 1.9 years. The mean age for the controls was 16.5 ± 1.0 years. Youth with DM were recruited from the pediatric diabetes clinic of a major Midwestern medical center. Controls were recruited from a suburban high school in the same metropolitan area. Variables Studied Together: Variables included fasting tHcy and lipids, and 24-hour dietary recalls for macronutrients and micronutrients. Hemoglobin A1c was obtained for those with DM. Methods: Dietary data were analyzed using Nutritionist V (First Data Bank, San Bruno, CA). Lab assays were performed at university-based facilities. Statistical analyses included one-way analyses of variance, Pearson correlations, and stepwise regression. Findings: Adolescents with type 1 DM had the lowest tHcy values (P < 0.05). Age was the strongest predictor for higher tHcy (P < 0.001). Hemoglobin A1c was related to total cholesterol and triglycerides in those with type 1 DM. Conclusions: Lower tHcy in those with type 1 DM were consistent with the limited extant research with this population. Age variation in tHcy was similar to recent NHANES data. Implications: Further research is needed to determine the efficacy of using tHcy as a predictor of CV risks in youth with DM. Better metabolic control is suggested to lower lipids in youth with DM.
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Sigma Theta Tau International
July 22-24, 2004