Factors associated with microalbuminuria in 7,549 children and adolescents with type 1 diabetes in the T1D Exchange clinic registry

Mark Daniels; Stephanie N DuBose; David M Maahs; Roy W Beck; Larry A Fox; Rose Gubitosi-Klug; Lori M Laffel; Kellee M Miller; Heather Speer; William V Tamborlane; Michael J Tansey; T1D Exchange Clinic Network

doi:10.2337/dc12-2192

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Factors associated with microalbuminuria in 7,549 children and adolescents with type 1 diabetes in the T1D Exchange clinic registry

Journal article

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Peer reviewed

Factors associated with microalbuminuria in 7,549 children and adolescents with type 1 diabetes in the T1D Exchange clinic registry

Mark Daniels, Stephanie N DuBose, David M Maahs, Roy W Beck, Larry A Fox, Rose Gubitosi-Klug, Lori M Laffel, Kellee M Miller, Heather Speer, William V Tamborlane, …

Diabetes care, Vol.36(9), pp.2639-2645

09/2013

DOI: 10.2337/dc12-2192

PMCID: PMC3747908

PMID: 23610082

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Abstract

To examine factors associated with clinical microalbuminuria (MA) diagnosis in children and adolescents in the T1D Exchange clinic registry. T1D Exchange participants <20 years of age with type 1 diabetes ≥ 1 year and urinary albumin-to-creatinine ratio (ACR) measured within the prior 2 years were included in the analysis. MA diagnosis required all of the following: 1) a clinical diagnosis of sustained MA or macroalbuminuria, 2) confirmation of MA diagnosis by either the most recent ACR being ≥ 30 mg/g or current treatment with an ACE inhibitor (ACEI) or angiotensin receptor blocker (ARB), and 3) no known cause for nephropathy other than diabetes. Logistic regression was used to assess factors associated with MA. MA was present in 329 of 7,549 (4.4%) participants, with a higher frequency associated with longer diabetes duration, higher mean glycosylated hemoglobin (HbA1c) level, older age, female sex, higher diastolic blood pressure (BP), and lower BMI (P ≤ 0.01 for each in multivariate analysis). Older age was most strongly associated with MA among participants with HbA1c ≥ 9.5% (≥ 80 mmol/mol). MA was uncommon (<2%) among participants with HbA1c <7.5% (<58 mmol/mol). Of those with MA, only 36% were receiving ACEI/ARB treatment. Our results emphasize the importance of good glycemic and BP control, particularly as diabetes duration increases, in order to reduce the risk of nephropathy. Since age and diabetes duration are important nonmodifiable factors associated with MA, the importance of routine screening is underscored to ensure early diagnosis and timely treatment of MA.

Glycated Hemoglobin A - metabolism

Humans

Risk Factors

Child, Preschool

Diabetes Mellitus, Type 1 - metabolism

Male

Young Adult

Albuminuria - diagnosis

Adolescent

Adult

Female

Albuminuria - metabolism

Blood Pressure - physiology

Blood Glucose - metabolism

Child

Details

Title: Subtitle: Factors associated with microalbuminuria in 7,549 children and adolescents with type 1 diabetes in the T1D Exchange clinic registry
Creators: Mark Daniels - Children’s Hospital of Orange County, Orange, California, USA
Stephanie N DuBose
David M Maahs
Roy W Beck
Larry A Fox
Rose Gubitosi-Klug
Lori M Laffel
Kellee M Miller
Heather Speer
William V Tamborlane
Michael J Tansey
T1D Exchange Clinic Network
Resource Type: Journal article
Publication Details: Diabetes care, Vol.36(9), pp.2639-2645
DOI: 10.2337/dc12-2192
PMID: 23610082
PMCID: PMC3747908
NLM abbreviation: Diabetes Care
ISSN: 0149-5992
eISSN: 1935-5548
Grant note: UL1 TR000439 / NCATS NIH HHS
Language: English
Date published: 09/2013
Academic Unit: Endocrinology and Diabetes; Stead Family Department of Pediatrics; Fraternal Order of Eagles Diabetes Research Center
Record Identifier: 9984093503802771

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