European Journal of Endocrinology
Volume 166, Issue 3, 2012, Pages 493-501

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 (Article) (Open Access)

Galler A.* , Haberland H. , Näke A. , Hofer S. , Holder M. , Raile K. , Holl R.W.
  • a Paediatric Endocrinology and Diabetology, University Hospital for Children and Adolescents, Campus Virchow Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany
  • b Sana Hospital Berlin Lindenhof, Hospital for Children and Adolescents, Gotlindestraße 2-20, 10365 Berlin, Germany
  • c University Carl Gustav Carus Dresden, University Hospital for Children and Adolescents, Fetscherstr. 4, 01307 Dresden, Germany
  • d Department of Paediatrics, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria
  • e Klinikum Stuttgart, Olgahospital, Paediatric Endocrinology and Diabetology, Bismarckstraße 8, 70176 Stuttgart, Germany
  • f Paediatric Endocrinology and Diabetology, University Hospital for Children and Adolescents, Campus Virchow Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany
  • g Department of Epidemiology, University Ulm, Helmholtzstr. 22, 89081 Ulm, Germany

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 criteriawere 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 inhibitorswere 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. © 2012 European Society of Endocrinology.

Author Keywords

[No Keywords available]

Index Keywords

Germany longitudinal study insulin dependent diabetes mellitus low density lipoprotein cholesterol Follow-Up Studies follow up clinical feature human immigration Prospective Studies Longitudinal Studies sex difference risk assessment Cohort Studies controlled study priority journal Time Factors microalbuminuria Health Surveys Austria hemoglobin A1c albuminuria disease duration school child Diabetes Mellitus, Type 1 Humans Adolescent male Emigrants and Immigrants female risk factor Risk Factors Article major clinical study Age Factors high density lipoprotein cholesterol child health care Urinalysis body mass disease association systolic blood pressure diastolic blood pressure onset age Child health survey
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84857982948&doi=10.1530%2fEJE-11-0695&partnerID=40&md5=3e7ecc0310d319bf61b1c19a76271b26
DOI: 10.1530/EJE-11-0695
ISSN: 08044643
Cited by: 11
Original Language: English