Inflammatory Atherosclerosis Risk and Lipid Ratios Markers in Type 1 Diabetic Patients: The Role of Ketosis as a Metabolic State
Background and aim: Epidemiological inquiries on subclinical atherosclerotic inflammatory disease in ketosis-onset type 1 diabetes (T1D) are scarce. Our objective was to evaluate the risk of developing atherosclerosis via lipid ratios by comparing two groups of patients according to their ketosis status. Subjects and methods: We performed a comparative retrospective study including 351 patients (13-74 years) with confirmed T1D divided into the following groups; patients with inaugural diabetic ketosis (IDK) vs. patients with diabetic ketosis (DK). Clinical, biological and pathophysiological patients' data were compared. Main lipid ratios have been assessed according to the patients’ ketosis status and gender. The multivariate logistic regression test was applied to evaluate the association of lipid ratios quartiles with the diabetic ketosis status. Results: Our study showed a slight predominance of males (50.43%), with an average age of 25.77 years. Comparing to IDK, DK patients had a higher body mass index. No significant differences were observed between fasting plasma glucose and HbA1C and lipid levels. The results showed that the 3rd (OR= 2.14 [0.81-5.61]; p=0.12) and the 4th quartiles (OR= 0.9 [0.35-2.33]; p=0.83) of TC/HDL ratio were higher in both groups. We noticed higher concordant values on the last two quartiles (3rd and 4th) of LDL/HDL ratio with p values of 0.07 and 0.39, respectively. In both groups, TC/HDL and TG/HDL were slightly higher in males comparing to females T1D patients except for LDL/HDL ratio which showed a slight ascendant median in females compared to males with IDK. Conclusions: The prevalence and risk of atherosclerosis inflammatory disease were higher in newly and formerly diagnosed patients with ketosis-onset T1D. Thus, medical awareness initiatives and a routine thorough endothelial function are needed to reduce the prevalence of the risk of atherosclerotic inflammatory disease.