Familial Hypercholesterolemia in Pediatric Patients With Type 1 Diabetes: Double Challenge for Diagnosis and Treatment
Authors' conclusion
The prevalence of probable FH was high (1 in 215 children) in pediatric T1D. We assume that the majority are affected by genetic FH, modified by HbA1c and BMI. Despite the very high risk for premature atherosclerosis in patients with FH and T1D, only one-third receive LLT.
Study context
- Population
- Children with T1D, Diabetes Prospective Follow-Up registry, 384 European centres, 2014–2023
- Participants
- 41,992 children
- Exposure
- Possible familial hypercholesterolemia (FH) and probable FH vs LDL-C <4.1 mmol/L
- Possible FHn = 416
- Probable FHn = 195
- LDL-C <4.1 mmol/Ln = 31,862reference
- Outcome
- Prevalence of probable FH and its lipid-lowering therapy (LLT)
Methodological detailsregistry-based, multicentre
- Registry-based
- Multicentre
Main finding
As reported in the abstract
- Prevalence of probable FH
- 1 in 215 children
Observational data: associations, not effects.
Further findings
Female sex — Possible FH and Probable FH vs LDL-C <4.1 mmol/L · more often female with FH groups
P < 0.00001
| Outcome | Possible FH | Probable FH | LDL-C <4.1 mmol/L | P value |
|---|---|---|---|---|
| BMI SD scorePossible FH and Probable FH vs LDL-C <4.1 mmol/L · higher with FH groups | 0.73 | 0.55 | 0.27 | P < 0.00001 |
| HbA1cPossible FH and Probable FH vs LDL-C <4.1 mmol/L · higher with FH groups | 8.2 % [66 mmol/mol] | 8.3 % [67 mmol/L] | 7.5 % [58 mmol/mol] | P < 0.00001 |
| Receiving LLT | 20% | 29% | — not stated in the abstract |
— not stated in the abstract
Factors associated with LDL-C 2× >4.9 mmol/L
- OR, HbA1c >9% (>75 mmol/mol)
- 3.85 (95% CI 2.6-5.7)
- OR, HbA1c 7.5-9% (58-75 mmol/mol)
- 2.12 (1.48-3.04)
- OR, female sex
- 2.10 (1.56-2.81)
- OR, BMI >70th percentile
- 1.47 (1.08-2.02)
Original publication
Familial Hypercholesterolemia in Pediatric Patients With Type 1 Diabetes: Double Challenge for Diagnosis and Treatment. Diabetes Care. Published 23 October 2025. doi:10.
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