# Trends in CVD Risk Factors for Youth with Incident Diabetes: SEARCH for Diabetes in Youth

## TL;DR

This study examines how cardiovascular risk factors have changed over time in young people with type 1 and type 2 diabetes, finding improvements in type 1 but worsening trends in type 2.

## Contribution

The study provides new insights into diverging trends of cardiovascular risk factors in youth with type 1 versus type 2 diabetes over a 15-year period.

## Key findings

- Youth with type 1 diabetes showed significant improvements in most cardiovascular risk factors over time.
- Youth with type 2 diabetes experienced worsening trends in BMI z-score, CRP, and kidney function.
- Differential trends were observed for TC, HDL-c, BMI z-score, BP z-scores, WC, and CRP between diabetes types.

## Abstract

Cardiovascular disease (CVD) is the leading cause of death and disability among persons with diabetes. Early intervention on cardiovascular risk factors (CRFs) is important in reducing CVD burden. The SEARCH for Diabetes in Youth study assessed CRFs in incident cohorts of youth aged <20 years established from 2002 to 2016. Research Design and Methods. Regression models assessed trends over each incident year for lipids (total cholesterol (TC), HDL-c, LDL-c, triglycerides (TG), VLDL-c, and non-HDL-c), kidney function (albumin/creatinine ratio (ACR) ≥30 and ≥300, cystatin C, serum creatinine and estimated glomerular filtration rate (eGFR)), systolic and diastolic blood pressure (BP) z-scores, BMI z-score, waist circumference (WC), and an inflammatory marker (C-reactive protein (CRP)). Models were stratified by diabetes type (type 1 diabetes (T1D), N = 4,600; type 2 diabetes (T2D), N = 932) and adjusted for age at diagnosis, sex, race/ethnicity, and diabetes duration. An interaction analysis assessed differential time trends by type.

For youth with T1D, all CRFs significantly improved over time, with the exception of ACR > 300, cystatin C, serum creatinine, eGFR, and CRP. For youth with T2D, TC, LDL-c, and non-HDL-c significantly improved, while eGFR, BMI z-score, and CRP significantly worsened. Significant differences in trends over time by type were seen for TC, HDL-c, BMI z-score, BP z-scores, WC, and CRP.

Overall, improvements in CRFs were more often observed in youth with T1D. Youth with T2D had worsening trends over time in BMI z-score, CRP, and kidney function. Further research is needed to better understand these trends and their implications for long-term CVD risk.