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Statins May Work in Children and Adolescents with Type 1 Diabetes

A small randomized trial showed that statins may be an effective and safe way to treat high LDL cholesterol in children and adolescents….

After participants were given atorvastatin for 6 months, non-HDL cholesterol went from 250 to 180mg/L compared to a slight increase in the control group, said Jose Atilio Canas, MD, of Nemours Children’s Clinic, Jacksonville, Florida.

"Long-term prospective follow-up may better characterize the impact of these changes on future cardiovascular diseases. More studies in this patient population regarding glycation, atheromatous plaque formation, inflammatory markers, and vascular stiffness are still required," said Canas.

The study examined the effects of statins in children and teens who had had type 1 diabetes for more than one year before the study, had an HbA1c less than 10 percent, were only on insulin therapy, had an LDL cholesterol level greater than 100mg/dL and had a body mass index below the 95th percentile.

The researchers enrolled 89 patients, all of whom received a nutritional intervention for 3 months aimed at lowering the consumption of cholesterol and saturated fat.

After 3 months, the 42 patients who still had LDL cholesterol levels greater than 100 mg/dL were randomized to atorvastatin or placebo. Although most characteristics were well matched at baseline, patients in the placebo group had a significantly higher HbA1c (9.1% versus 7.9%, P<0.05) and a lower insulin sensitivity score (7.2 versus 8.8, P<0.05).

Within the first 3 months of treatment, there was an increase in HbA1c in the atorvastatin group, but by 6 months, there was no difference between the two groups.

Atorvastatin significantly decreased levels of various lipoproteins measured using an ion mobility assay, including small and medium very low density lipoprotein, LDL-L1, and apolipoprotein B (P<0.05 for all).

Canas J, et al "Atorvastatin safely reduces non-HDL cholesterol in children with type 1 diabetes (T1DM) and high LDL-C: preliminary results" ENDO 2013; Abstract OR11-2.