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Natural course of untreated microalbuminuria in children and adolescents with type 1 diabetes and the importance of diabetes duration and immigrant status: longitudinal analysis from the prospective nationwide German and Austrian diabetes survey DPV

Item Type:Article
Title:Natural course of untreated microalbuminuria in children and adolescents with type 1 diabetes and the importance of diabetes duration and immigrant status: longitudinal analysis from the prospective nationwide German and Austrian diabetes survey DPV
Creators Name:Galler, A. and Haberland, H. and Naeke, A. and Hofer, S. and Holder, M. and Raile, K. and Holl, R.W.
Abstract:OBJECTIVE: To identify risk factors for the development and progression of untreated persistent microalbuminuria in children and adolescents with type 1 diabetes. DESIGN AND METHODS: A total number of 683 children and adolescents with type 1 diabetes recruited from the prospective nationwide German and Austrian diabetes survey (DPV) were included in the analysis. Inclusion criteria were onset of type 1 diabetes under the age of 11 years, diabetes duration of more than 1 year and continuous follow-up over 5 years with at least two documented urine analyses per year. Subjects treated with angiotensin-converting enzyme inhibitors were excluded. Risk factors such as sex, body mass index SDS, diabetes duration, HbA1c, total cholesterol, HDL-cholesterol, LDL-cholesterol, systolic and diastolic blood pressure, and immigrant status were analysed by logistic regression. RESULTS: At baseline (age 10.5 +/- 0.1 years, diabetes duration 4.6 +/- 2.4 years and HbA1c 7.4 +/- 1.1%), 75.6% of children had normoalbuminuria, 15.7% had intermittent microalbuminuria, 8.6% had persistent microalbuminuria and 0.1% had macroalbuminuria. After a follow-up of 5 years, 59.4% of adolescents continued to have normoalbuminuria, 18.4% had progression, 15.2% had regression of microalbuminuria, and in 6.9% of the subjects, microalbuminuria remained unchanged. We found significant associations between persistent microalbuminuria at baseline and during each year of follow-up (P < 0.0001). Logistic regression analysis identified diabetes duration and immigrant status as significant factors for microalbuminuria (P = 0.009 and P = 0.009). CONCLUSIONS: The survey in a real-world setting shows that diabetes duration and immigrant status are risk factors for the development and progression of untreated microalbuminuria in children and adolescents with type 1 diabetes.
Keywords:Age Factors, Albuminuria, Austria, Cohort Studies, Diabetes Mellitus Type 1, Emigrants and Immigrants, Follow-Up Studies, Germany, Health Surveys, Longitudinal Studies, Prospective Studies, Risk Factors, Time Factors
Source:European Journal of Endocrinology
ISSN:0804-4643
Publisher:BioScientifica (U.K.)
Volume:166
Number:3
Page Range:493-501
Date:March 2012
Official Publication:https://doi.org/10.1530/EJE-11-0695
PubMed:View item in PubMed

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