Total cholesterol changes in type 1 diabetes and the diagnostic value of glycated hemoglobin

Abstract

Persons with type 1 diabetes (T1D) are classified as individuals with high risk of cardiovascular disease (CVD).
Dyslipidemia in patients with type 1 diabetes, especially young children, is largely undiagnosed and, therefore, inadequately
treated. The aim of the study was to evaluate the prognostic characteristics of glycated hemoglobin as a diagnostic test for total
cholesterol. Material and methods: The study was based on biochemical data from 230 children and adolescents with type 1
diabetes aged 9 to 18 years (13+2.82) from the Megalab clinic contingent. Serum total cholesterol (TC) was determined after a
12-hour overnight fast, by the oxidase-peroxidase method, using the Atellica® CH analyzer (Siemens Healthcare Diagnostics
Inc.). Total cholesterol level was considered elevated when (TC) ≥ 200 mg/dL. The diagnostic value of HbA1c was determined
by ROC analysis, estimating the area under the curve - AUC: 0.5 - no significance, 0.6–0.7 - weak; 0.7–0.8 - moderate, 0.8–0.9 –
good. Results: The HbA1c test for the prediction of total cholesterol with a threshold of 8.45% is characterized by moderate
sensitivity (59.65%) and high specificity (87.28%), indicating that this indicator is more effective for confirming an increase in
total cholesterol (TC) than for its screening. The predictive value of a positive result is moderate - 60.71%, the predictive value
of a negative result is high - 86.78%, and the diagnostic accuracy is 80.43%. Conclusions: HbA1c ≥8.45% can be used as a specific
indicator for the probable presence of an increase in total cholesterol. Due to the relatively low sensitivity of HbA1c, it is not
suitable as the only screening method.