患有1型188bet在线平台网址 且低密度脂蛋白胆固醇(LDL-C)水平较高的儿童，其患有心血管疾病的风险将增加，且这种风险可以从童年就可能发生。

　　《儿科188bet在线平台网址 》(Pediatr Diabetes)杂志在2015年3月发表了一项关于阿托伐他汀对患有1型188bet在线平台网址 且LDL-C水平较高的儿童的安全性和有效性的评估试验，该试验是一项随机，双盲，安慰剂对照试验。

　　研究选取了60名患有1型188bet在线平台网址 的儿童(平均年龄：15±0.3岁，平均病程6.8±0.5年，HbA1c： 8.8±0.2%，平均LDL-C 为124±4.0mg/dl)，3个月洗脱期后，42名受试者被随机分组接受阿托伐他汀或安慰剂治疗6个月。

　　研究发现，与安慰剂组比较，阿托伐他汀组总胆固醇、LDL-C、非高密度脂蛋白胆固醇和载脂蛋白B水平分别显著性降低21 %、32%、31 %和26 %(P<0.001)。各类脂蛋白在他汀类药物作用下均有下降(P < 0.03)。胰岛素敏感性在两组均保持恒定。

　　试验结果表明，阿托伐他汀能够降低患有1型188bet在线平台网址 且高LDL-C水平儿童的LDL-C和载脂蛋白B、脂蛋白亚型的水平，胰岛素抵抗没有恶化。阿托伐他汀耐受性和安全性良好。研究者指出，未来还需要进行长期研究这对188bet在线平台网址 儿童患者心血管疾病发展的影响是十分有意义的。

　　A randomized, double blind, placebo-controlled pilot trial of the safety and efficacy of atorvastatin in children with elevated low-density lipoprotein cholesterol (LDL-C) and type 1 diabetes.

BACKGROUND:

Children with type 1 diabetes (T1D) and elevated LDL-C have an increased risk for cardiovascular disease, a process that can begin in childhood.

OBJECTIVE:

To assess the safety and efficacy of atorvastatin improving lipid profiles in children with T1D and elevated LDL-C.

SUBJECTS:

Sixty children (31M/29F) with T1D, mean age: 15 ± 0.3 yr, mean diabetes duration: 6.8 ± 0.5 yr, HbA1c : 8.8 ± 0.2%, with mean LDL-C 124 ± 4.0mg/dl were recruited.

METHODS:

After a 3-month run-in period, subjects were randomized double-blindly to atorvastatin or placebo for 6 months. Lipoprotein subfractions were measured by ion mobility and glucose control by HbA1C; continuous glucose monitors were worn quarterly.

RESULTS:

After a run-in period, 42 subjects were randomized. There were decreases in total cholesterol (-21%), LDL-C (-32%), non-HDL-C (-31%) and apoB (-26%) in the atorvastatin group versus placebo (p < 0.001). Lipoprotein subparticles (LDL-large 1 and 2A, IDL-large and small, VLDL- medium and small) decreased with statins (p < 0.03 all). Insulin sensitivity scores remained constant in both groups and correlated inversely with apoB (r = -0.312 p = 0.039) and small LDL 3A (r = -0.404 p = 0.007). One subject had asymptomatic elevation of creatinine kinase which normalized after atorvastatin discontinuation.

CONCLUSIONS:

Atorvastatin lowered LDL-C, apoB, and atherogenic lipoprotein subparticles in children with T1D and elevated LDL-C without worsening insulin resistance. The drug was well tolerated and safe. Long-term studies would provide better insight on the impact of these interventions in the development of cardiovascular disease in children with diabetes..