Which lipid pattern is most characteristic of secondary hyperlipidemia due to diabetes in a child?

Which lipid pattern is most characteristic of secondary hyperlipidemia due to diabetes in a child?

• A. High triglycerides and low HDL
• B. High HDL and high triglycerides
• C. Low triglycerides
• D. Normal triglycerides

Answer: (A)

Elevated triglycerides with reduced HDL reflect how diabetes disrupts lipid metabolism. In diabetes, especially with poor glycemic control, insulin deficiency or resistance leads the liver to dump more triglyceride-rich VLDL into the blood, while lipoprotein lipase activity is diminished, so triglyceride-rich particles aren’t cleared efficiently. At the same time, exchange of triglycerides into HDL via CETP makes HDL triglyceride-rich and more rapidly cleared, lowering HDL levels. The net result is a pattern of high triglycerides and low HDL, which is typical of diabetes-related (secondary) dyslipidemia in children. Patterns with normal triglycerides or with high HDL don’t match this diabetes-driven disturbance, and a high HDL with high triglycerides isn’t characteristic of this scenario.

Elevated triglycerides with reduced HDL reflect how diabetes disrupts lipid metabolism. In diabetes, especially with poor glycemic control, insulin deficiency or resistance leads the liver to dump more triglyceride-rich VLDL into the blood, while lipoprotein lipase activity is diminished, so triglyceride-rich particles aren’t cleared efficiently. At the same time, exchange of triglycerides into HDL via CETP makes HDL triglyceride-rich and more rapidly cleared, lowering HDL levels. The net result is a pattern of high triglycerides and low HDL, which is typical of diabetes-related (secondary) dyslipidemia in children. Patterns with normal triglycerides or with high HDL don’t match this diabetes-driven disturbance, and a high HDL with high triglycerides isn’t characteristic of this scenario.