{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T15:21:46Z","timestamp":1788708106151,"version":"build-2803163510"},"reference-count":34,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,12,27]],"date-time":"2020-12-27T00:00:00Z","timestamp":1609027200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003793","name":"Hj\u00e4rt-Lungfonden","doi-asserted-by":"publisher","award":["20190298"],"award-info":[{"award-number":["20190298"]}],"id":[{"id":"10.13039\/501100003793","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003793","name":"Hj\u00e4rt-Lungfonden","doi-asserted-by":"publisher","award":["20170120"],"award-info":[{"award-number":["20170120"]}],"id":[{"id":"10.13039\/501100003793","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004348","name":"Stockholms L\u00e4ns Landsting","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004348","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004348","name":"Stockholms L\u00e4ns Landsting","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004348","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008550","name":"Diabetesfonden","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008550","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Intern Med"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Microvascular complications are common in people with diabetes, where poor glycaemic control is the major contributor. The aim of this study was to explore the association between elevated LDL cholesterol levels and the risk of retinopathy or nephropathy in young individuals with type 1 diabetes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a nationwide observational population\u2010based cohort study, including all children and adults with a duration of type 1 diabetes of\u00a0\u2264\u00a010\u00a0years, identified in the Swedish National Diabetes Register between 1998 and 2017. We calculated the crude incidence rates with 95% confidence intervals (CIs) and used multivariable Cox regression to estimate crude and adjusted hazard ratios (HRs) of retinopathy or nephropathy in four LDL cholesterol categories: &lt;2.6 (Reference), 2.6\u20133.4, 3.4\u20134.1 and\u00a0&gt;\u00a04.1\u00a0mmol\u00a0L<jats:sup>\u22121<\/jats:sup>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 11\u00a0024\/12\u00a0350 (retinopathy\/nephropathy, both cohorts, respectively) children and adults (median age 21\u00a0years, female 42%) were followed up to 28\u00a0years from diagnosis until end of study. Median duration of diabetes when entering the study was 6 and 7\u00a0years in the retinopathy and nephropathy cohort, respectively. Median LDL cholesterol was 2.4\u00a0mmol\u00a0L<jats:sup>\u22121<\/jats:sup>, and median HbA1c level was 61\u00a0mmol\u00a0mol<jats:sup>\u22121<\/jats:sup> (7.7 %). After multivariable adjustment, the HRs (95% CI) for retinopathy in individuals with LDL cholesterol levels of 2.6\u20133.4, 3.4\u20134.1 or\u00a0&gt;\u00a04.1\u00a0mmol\u00a0L<jats:sup>\u22121<\/jats:sup> were as follows: 1.13 (1.03\u20131.23), 1.16 (1.02\u20131.32) and 1.18 (0.99\u20131.41), compared with the reference. The corresponding numbers for nephropathy were as follows: 1.15 (0.96\u20131.32), 1.30 (1.03\u20131.65) and 1.41 (1.06\u20131.89).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Young individuals with type 1 diabetes exposed to high LDL cholesterol levels have an increased risk of retinopathy and nephropathy independent of glycaemia and other identified risk factors for vascular complications.<\/jats:p><\/jats:sec>","DOI":"10.1111\/joim.13212","type":"journal-article","created":{"date-parts":[[2020,11,30]],"date-time":"2020-11-30T03:20:40Z","timestamp":1606706440000},"page":"873-886","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["LDL cholesterol level as a risk factor for retinopathy and nephropathy in children and adults with type 1 diabetes mellitus: A nationwide cohort study"],"prefix":"10.1111","volume":"289","author":[{"given":"B.","family":"Rathsman","sequence":"first","affiliation":[{"name":"From the Department of Clinical Science and Education Karolinska Institutet Stockholm Sweden"},{"name":"Sachs\u2019 Children and Youth Hospital Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Haas","sequence":"additional","affiliation":[{"name":"From the Department of Clinical Science and Education Karolinska Institutet Stockholm Sweden"},{"name":"Sachs\u2019 Children and Youth Hospital Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Persson","sequence":"additional","affiliation":[{"name":"From the Department of Clinical Science and Education Karolinska Institutet Stockholm Sweden"},{"name":"Sachs\u2019 Children and Youth Hospital Stockholm Sweden"},{"name":"Department of Medicine Clinical Epidemiological Unit Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Ludvigsson","sequence":"additional","affiliation":[{"name":"Division of Paediatrics Department of Biomedical and Clinical Sciences Link\u00f6ping University Link\u00f6ping Sweden"},{"name":"Crown Princess Victoria Children\u2019s Hospital Link\u00f6ping Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.\u2010M.","family":"Svensson","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine Institute of Medicine University of Gothenburg Gothenburg Sweden"},{"name":"Centre of Registers in Region V\u00e4stra G\u00f6taland Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Lind","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine Institute of Medicine University of Gothenburg Gothenburg Sweden"},{"name":"Department of Medicine NU Hospital Group Uddevalla Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Andersson Franko","sequence":"additional","affiliation":[{"name":"From the Department of Clinical Science and Education Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3462-7990","authenticated-orcid":false,"given":"T.","family":"Nystr\u00f6m","sequence":"additional","affiliation":[{"name":"From the Department of Clinical Science and Education Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,12,27]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199309303291401"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa052187"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2011.06.029"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000034"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz455"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz486"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/pedi.12742"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc10-0398"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/pedi.12467"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/18.6.499"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2003.024802"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc11-0943"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1198\/000313005X70371"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.320.7244.1240"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc15-0939"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(99)00165-5"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.2003.00164.x"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.02-0648"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(97)30327-3"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4894"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-005-0082-6"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.16425"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.2337\/db10-0862"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31506-X"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.29.02.06.dc05-0724"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2006.04.065"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.161.2.159"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.160.18.2756"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9394(99)00222-6"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000012283"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.24.6.1053"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1909637"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/joim.12111"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1703518"}],"container-title":["Journal of Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/joim.13212","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/joim.13212","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/joim.13212","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T09:16:39Z","timestamp":1693386999000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/joim.13212"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,27]]},"references-count":34,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021,6]]}},"alternative-id":["10.1111\/joim.13212"],"URL":"https:\/\/doi.org\/10.1111\/joim.13212","archive":["Portico"],"relation":{},"ISSN":["0954-6820","1365-2796"],"issn-type":[{"value":"0954-6820","type":"print"},{"value":"1365-2796","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,27]]},"assertion":[{"value":"2020-08-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-11-10","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-12-27","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}