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  • Title: Risk factors for microalbuminuria in children and adolescents with type 1 diabetes.
    Author: Lévy-Marchal C, Sahler C, Cahané M, Czernichow P, GECER Study Group.
    Journal: J Pediatr Endocrinol Metab; 2000 Jun; 13(6):613-20. PubMed ID: 10905385.
    Abstract:
    OBJECTIVES: The aim of this study was to investigate the influence of sex, age, diabetes duration, puberty, blood pressure, glycemic control and parental blood pressure on microalbuminuria in children with type 1 diabetes. STUDY DESIGN: The study was a multicenter cross-sectional survey including 702 children and adolescents (age = 14.3+/-2.9 yr) with type 1 diabetes duration of 7.6+/-3.1 yr. One third of the population had not undergone pubertal development. Blood pressure was measured in children and their parents using a Dinamap instrument. Microalbuminuria was defined as a urinary albumin excretion rate > or = 15 microg/min measured on at least two out of three urine collections. HbA1c centrally measured by HPLC, was 8.7+/-1.5%. RESULTS: The proportion of permanent microalbuminuria was 5.1+/-1.6%. The prevalence was significantly enhanced after 10 yr of diabetes duration (11.6+/-5.2%) and complete puberty (8.2+/-3.1%). Independent risk factors for microalbuminuria tested in a logistic regression model were diabetes duration (OR/1 yr = 1.04-1.32), complete puberty (OR = 5.02-8.0), and maternal hypertension (OR = 1.94-4.28). HbA1c had a borderline independent and significant effect (OR/1% = 0.96-1.62; p = 0.07). CONCLUSIONS: Our results indicate that pubertal adolescents with a long duration of the disease and maternal history of hypertension are candidates for targeted interventions with the objective of reducing the rate of developing nephropathy in these individuals.
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