Occurrence of microalbuminuria in young people with Type 1 diabetes: importance of age and diabetes duration
Occurrence of microalbuminuria in young people with Type 1 diabetes: importance of age and diabetes duration
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DOI：
10.1111/j.1464-5491.2010.02983.x
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发表时间：
2010-05-01
影响因子：
3.5
通讯作者：
Laffel, L. M. B.
中科院分区：
文献类型：
--
作者：
Alleyn, C. R.;Volkening, L. K.;Laffel, L. M. B.
目的确定1型糖尿病青年患者微量白蛋白尿的发生率，并将尿白蛋白排泄（UAE）持续升高与年龄、糖尿病病程、青春期及其他因素联系起来。年龄8-18岁（平均值+/- sd 12.9 +/- 2.3岁），1型糖尿病病程5.6 +/- 3.0年，作为常规临床护理的一部分。在1310份样本中测量尿白蛋白和肌酐浓度（中位数，每例患者3份样本），并计算白蛋白：肌酐比值（单位：微克白蛋白/毫克肌酐）。身高，体重，血压（BP），糖化血红蛋白（HbA（1C）），血糖监测频率和坦纳分期收集从患者的医疗records.Results23%的患者有一个或多个样本与升高的阿联酋（>= 20微克/毫克）和9.3%的持续升高（>= 2个样本>= 20微克/毫克）。有和没有持续性微量白蛋白尿的患者在年龄、糖尿病病程、体重指数z评分、青春期状态或血压百分位数方面没有显著差异。10%的< 13 years old and 9% of children >13岁以下儿童有持续性微量白蛋白尿。持续性微量白蛋白尿仅在年龄较大的儿童中与糖尿病病程显著相关（病程0.5-3年，4%; 4-6年，8%; ≥ 7年，14%; P = 0.02，趋势检验）。2年内的平均HbA（1c）为8.7 ± 1.2%。在Logistic回归模型中，平均HbA（1c）是唯一的持续性微量白蛋白尿（比值比1.3，95%置信区间1.0-1.6，P = 0.05）的显着预测。在年龄较小的儿童中，它可能反映功能性，可逆性肾脏变化。需要进行纵向分析以证实年轻1型糖尿病患者微量白蛋白尿可能具有短暂性。
P>AimsTo determine the occurrence of microalbuminuria in young people with Type 1 diabetes mellitus followed prospectively for 2 years and to relate the presence of persistent elevations in urinary albumin excretion (UAE) to age, diabetes duration, puberty and other factors.MethodsDuring a 2 year period, random urine samples were obtained from 471 patients, aged 8-18 years (mean +/- sd 12.9 +/- 2.3 years) with Type 1 diabetes duration 5.6 +/- 3.0 years, as part of routine clinical care. Urine albumin and creatinine concentrations were measured in 1310 samples (median, 3 samples per patient) and the albumin:creatinine ratio was calculated (in micrograms albumin per milligram creatinine). Height, weight, blood pressure (BP), glycated haemoglobin (HbA(1c)), blood glucose monitoring frequency and Tanner staging were collected from patients' medical records.ResultsTwenty-three per cent of patients had one or more sample with elevated UAE (>= 20 mu g/mg) and 9.3% had persistent elevations (>= 2 samples >= 20 mu g/mg). Those with and without persistent microalbuminuria did not differ significantly in age, diabetes duration, z-score for body mass index, pubertal status or BP percentile. Ten per cent of children < 13 years old and 9% of children >= 13 years old had persistent microalbuminuria. Persistent microalbuminuria was significantly associated with diabetes duration only in older children (duration 0.5-3 years, 4%; 4-6 years, 8%; >= 7 years, 14%; P = 0.02, trend test). Mean HbA(1c) over the 2 years was 8.7 +/- 1.2%. In a logistic regression model, mean HbA(1c) was the only significant predictor of persistent microalbuminuria (odds ratio 1.3, 95% confidence interval 1.0-1.6, P = 0.05).ConclusionsMicroalbuminuria in older children with Type 1 diabetes is likely to be clinically significant. In younger children, it may reflect functional, reversible renal changes. Longitudinal analysis is needed to confirm the probable transient nature of microalbuminuria in young patients with Type 1 diabetes.