Samy Hadjadj1,2,3,4,5, Bertrand Cariou6,7, Frederic Fumeron8,9,10, Elise Gand11, Guillaume Charpentier12,13, Ronan Roussel8,9,10, Ahmed-Amine Kasmi14,15,16, Jean-François Gautier8,9,17, Kammel Mohammedi8,9,10, Pierre Gourdy18,19,20, Pierre-Jean Saulnier14,21,15,16, Eva Feigerlova14,21,15,16, Michel Marre8,9,10. 1. Université de Poitiers, UFR Médecine Pharmacie, Centre d'Investigation clinique, Poitiers, France. samy.hadjadj@gmail.com. 2. CHU de Poitiers, Service d'Endocrinologie-Diabetologie, Rue de la milétrie, 86000, Poitiers, France. samy.hadjadj@gmail.com. 3. CHU de Poitiers, Centre d'Investigation Clinique, Poitiers, France. samy.hadjadj@gmail.com. 4. Inserm, CIC1402 and U1082, Poitiers, France. samy.hadjadj@gmail.com. 5. CHU de Poitiers, Service d'Endocrinologie-Diabetologie and Centre d'Investigation Clinique, Rue de la Milétrie, 86000, Poitiers, France. samy.hadjadj@gmail.com. 6. Department of Endocrinology, University Hospital of Nantes, Nantes, France. 7. Inserm, UMR1087-CNRS UMR6291, Institut du Thorax, Nantes, France. 8. Université Paris Diderot, Sorbonne Paris Cité, Paris, France. 9. Inserm, UMRS1138, Centre de Recherche des Cordeliers, Paris, France. 10. Diabetologie, Endocrinologie Nutrition, DHU FIRE, Hopital Bichat, AP-HP, Paris, France. 11. CHU de Poitiers, Pôle Dune, Poitiers, France. 12. Centre Hospitalier Sud Francilien, Corbeil-Essonnes, France. 13. CERITD, Evry, France. 14. Université de Poitiers, UFR Médecine Pharmacie, Centre d'Investigation clinique, Poitiers, France. 15. CHU de Poitiers, Centre d'Investigation Clinique, Poitiers, France. 16. Inserm, CIC1402 and U1082, Poitiers, France. 17. Department of Diabetes and Endocrinology, Assistance Publique - Hôpitaux de Paris, Lariboisière Hospital, Paris, France. 18. CHU de Toulouse, Service de Diabétologie, Maladies Métaboliques et Nutrition, Toulouse, France. 19. Inserm, UMR1048/I2MC, Toulouse, France. 20. Université Paul Sabatier, UMR1048/I2MC, Toulouse, France. 21. CHU de Poitiers, Service d'Endocrinologie-Diabetologie, Rue de la milétrie, 86000, Poitiers, France.
Abstract
AIMS/HYPOTHESIS: Microvascular complications are a common feature of diabetes but additional research is needed regarding diabetic nephropathy endpoints in type 1 and type 2 diabetes. METHODS: We compared 277 type 1 diabetes patients with 942 type 2 diabetes patients, with clinical proteinuria and no endstage renal disease (ESRD) at baseline, prospectively followed for death, ESRD and decline in estimated glomerular filtration rate (eGFR, all available measures). RESULTS: The incidence rate of death was 67.0 (95% CI 59.2, 74.8) vs. 24.6 (95% CI, 19.0, 30.2) per 1,000 patient-years, in type 2 diabetes and type 1 diabetes, respectively. Unadjusted risk for death was greater for type 2 diabetes patients (HR 3.423; 95% CI, 2.501, 4.683; p<0.0001), but the difference did not persist after adjustment for age (HRage-adj 0.859; 95% CI 0.581, 1.269; p=0.445). The incidence rate of ESRD was 18.4 (95% CI 14.2, 22.5) vs. 47.1 (95%CI 38.4, 55.9) per 1,000 patient-years, in type 2 diabetes and type 1 diabetes, respectively. Unadjusted risk for ESRD was lower in type 2 diabetes (HR 0.399; 95% CI 0.287, 0.554; p<0.0001), but the difference did not persist after adjustment for sex, age and baseline serum creatinine (HRadj 0.989; 95% CI 0.597, 1.639; p=0.965). In a mixed linear model, eGFR decline was not significantly different in type 2 vs. type 1 diabetes (difference in slope −0.19 [0.28] ml min(−1) 1.73 m(−2) year(−1); p=0.512). CONCLUSIONS/ INTERPRETATION: In diabetic nephropathy, once baseline risk factors were taken into account the risk for death, ESRD and renal function decline did not significantly differ between type 1 diabetes and type 2 diabetes.
AIMS/HYPOTHESIS: Microvascular complications are a common feature of diabetes but additional research is needed regarding diabetic nephropathy endpoints in type 1 and type 2 diabetes. METHODS: We compared 277 type 1 diabetespatients with 942 type 2 diabetespatients, with clinical proteinuria and no endstage renal disease (ESRD) at baseline, prospectively followed for death, ESRD and decline in estimated glomerular filtration rate (eGFR, all available measures). RESULTS: The incidence rate of death was 67.0 (95% CI 59.2, 74.8) vs. 24.6 (95% CI, 19.0, 30.2) per 1,000 patient-years, in type 2 diabetes and type 1 diabetes, respectively. Unadjusted risk for death was greater for type 2 diabetespatients (HR 3.423; 95% CI, 2.501, 4.683; p<0.0001), but the difference did not persist after adjustment for age (HRage-adj 0.859; 95% CI 0.581, 1.269; p=0.445). The incidence rate of ESRD was 18.4 (95% CI 14.2, 22.5) vs. 47.1 (95%CI 38.4, 55.9) per 1,000 patient-years, in type 2 diabetes and type 1 diabetes, respectively. Unadjusted risk for ESRD was lower in type 2 diabetes (HR 0.399; 95% CI 0.287, 0.554; p<0.0001), but the difference did not persist after adjustment for sex, age and baseline serum creatinine (HRadj 0.989; 95% CI 0.597, 1.639; p=0.965). In a mixed linear model, eGFR decline was not significantly different in type 2 vs. type 1 diabetes (difference in slope −0.19 [0.28] ml min(−1) 1.73 m(−2) year(−1); p=0.512). CONCLUSIONS/ INTERPRETATION: In diabetic nephropathy, once baseline risk factors were taken into account the risk for death, ESRD and renal function decline did not significantly differ between type 1 diabetes and type 2 diabetes.
Authors: Amanda I Adler; Richard J Stevens; Sue E Manley; Rudy W Bilous; Carole A Cull; Rury R Holman Journal: Kidney Int Date: 2003-01 Impact factor: 10.612
Authors: Samy Hadjadj; Franck Péan; Yves Gallois; Philippe Passa; Robert Aubert; Laurent Weekers; Vincent Rigalleau; Bernard Bauduceau; Amine Bekherraz; Ronan Roussel; Bernard Dussol; Michel Rodier; Richard Marechaud; Pierre J Lefebvre; Michel Marre Journal: Diabetes Care Date: 2004-11 Impact factor: 19.112
Authors: Carol Forsblom; Valma Harjutsalo; Lena M Thorn; Johan Wadén; Nina Tolonen; Markku Saraheimo; Daniel Gordin; John L Moran; Merlin C Thomas; Per-Henrik Groop Journal: J Am Soc Nephrol Date: 2011-02-18 Impact factor: 10.121
Authors: M Marre; X Jeunemaitre; Y Gallois; M Rodier; G Chatellier; C Sert; L Dusselier; Z Kahal; L Chaillous; S Halimi; A Muller; H Sackmann; B Bauduceau; F Bled; P Passa; F Alhenc-Gelas Journal: J Clin Invest Date: 1997-04-01 Impact factor: 14.808
Authors: Maryam Afkarian; Michael C Sachs; Bryan Kestenbaum; Irl B Hirsch; Katherine R Tuttle; Jonathan Himmelfarb; Ian H de Boer Journal: J Am Soc Nephrol Date: 2013-01-29 Impact factor: 10.121