OBJECTIVE: Baseline data from the Adolescent Type 1 Diabetes Cardio-Renal Intervention Trial (AdDIT) indicated that tertiles of urinary albumin-to-creatinine ratios (ACRs) in the normal range at age 10-16 years are associated with risk markers for diabetic nephropathy (DN) and cardiovascular disease (CVD). We aimed to determine whether the top ACR tertile remained associated with DN and CVD risk over the 2-4-year AdDIT study. RESEARCH DESIGN AND METHODS: One hundred fifty adolescents (mean age 14.1 years [SD 1.6]) with baseline ACR in the upper tertile (high-ACR group) recruited to the AdDIT trial, who remained untreated, and 396 (age 14.3 years [1.6]) with ACR in the middle and lower tertiles (low-ACR group), who completed the parallel AdDIT observational study, were evaluated prospectively with assessments of ACR and renal and CVD markers, combined with carotid intima-media thickness (cIMT) at baseline and end of study. RESULTS: After a median follow-up of 3.9 years, the cumulative incidence of microalbuminuria was 16.3% in the high-ACR versus 5.5% in the low-ACR group (log-rank P < 0.001). Cox models showed independent contributions of the high-ACR group (hazard ratio 4.29 [95% CI 2.08-8.85]) and HbA1c (1.37 [1.10-1.72]) to microalbuminuria risk. cIMT change from baseline was significantly greater in the high- versus low-ACR group (mean difference 0.010 mm [0.079], P = 0.006). Changes in estimated glomerular filtration rate, systolic blood pressure, and hs-CRP were also significantly greater in the high-ACR group (P < 0.05). CONCLUSIONS: ACR at the higher end of the normal range at the age of 10-16 years is associated with an increased risk of progression to microalbuminuria and future CVD risk, independently of HbA1c.
OBJECTIVE: Baseline data from the Adolescent Type 1 Diabetes Cardio-Renal Intervention Trial (AdDIT) indicated that tertiles of urinary albumin-to-creatinine ratios (ACRs) in the normal range at age 10-16 years are associated with risk markers for diabetic nephropathy (DN) and cardiovascular disease (CVD). We aimed to determine whether the top ACR tertile remained associated with DN and CVD risk over the 2-4-year AdDIT study. RESEARCH DESIGN AND METHODS: One hundred fifty adolescents (mean age 14.1 years [SD 1.6]) with baseline ACR in the upper tertile (high-ACR group) recruited to the AdDIT trial, who remained untreated, and 396 (age 14.3 years [1.6]) with ACR in the middle and lower tertiles (low-ACR group), who completed the parallel AdDIT observational study, were evaluated prospectively with assessments of ACR and renal and CVD markers, combined with carotid intima-media thickness (cIMT) at baseline and end of study. RESULTS: After a median follow-up of 3.9 years, the cumulative incidence of microalbuminuria was 16.3% in the high-ACR versus 5.5% in the low-ACR group (log-rank P < 0.001). Cox models showed independent contributions of the high-ACR group (hazard ratio 4.29 [95% CI 2.08-8.85]) and HbA1c (1.37 [1.10-1.72]) to microalbuminuria risk. cIMT change from baseline was significantly greater in the high- versus low-ACR group (mean difference 0.010 mm [0.079], P = 0.006). Changes in estimated glomerular filtration rate, systolic blood pressure, and hs-CRP were also significantly greater in the high-ACR group (P < 0.05). CONCLUSIONS:ACR at the higher end of the normal range at the age of 10-16 years is associated with an increased risk of progression to microalbuminuria and future CVD risk, independently of HbA1c.
Authors: Josephine M Forbes; Selena Le Bagge; Samuel Righi; Amelia K Fotheringham; Linda A Gallo; Domenica A McCarthy; Sherman Leung; Tracey Baskerville; Janelle Nisbett; Adam Morton; Stephanie Teasdale; Neisha D'Silva; Helen Barrett; Timothy Jones; Jennifer Couper; Kim Donaghue; Nicole Isbel; David W Johnson; Leigh Donnellan; Permal Deo; Lisa K Akison; Karen M Moritz; Trisha O'Moore-Sullivan Journal: Sci Rep Date: 2021-05-03 Impact factor: 4.379
Authors: Viral N Shah; Ryan Bailey; Mengdi Wu; Nicole C Foster; Rodica Pop-Busui; Michelle Katz; Jill Crandall; Fida Bacha; Kristen Nadeau; Ingrid Libman; Paul Hiers; Kara Mizokami-Stout; Linda A DiMeglio; Jennifer Sherr; Richard Pratley; Shivani Agarwal; Janet Snell-Bergeon; Eda Cengiz; Sarit Polsky; Sanjeev N Mehta Journal: J Clin Endocrinol Metab Date: 2020-05-01 Impact factor: 5.958
Authors: Moon Bae Ahn; Kyoung Soon Cho; Seul Ki Kim; Shin Hee Kim; Won Kyoung Cho; Min Ho Jung; Jin-Soon Suh; Byung-Kyu Suh Journal: Children (Basel) Date: 2021-05-19
Authors: Josephine M Forbes; Domenica A McCarthy; Andrew J Kassianos; Tracey Baskerville; Amelia K Fotheringham; Kurt T K Giuliani; Anca Grivei; Andrew J Murphy; Michelle C Flynn; Mitchell A Sullivan; Preeti Chandrashekar; Rani Whiddett; Kristen J Radford; Nicole Flemming; Sam S Beard; Neisha D'Silva; Janelle Nisbet; Adam Morton; Stephanie Teasdale; Anthony Russell; Nicole Isbel; Timothy Jones; Jennifer Couper; Helen Healy; Mark Harris; Kim Donaghue; David W Johnson; Andrew Cotterill; Helen L Barrett; Trisha O'Moore-Sullivan Journal: Diabetes Date: 2021-03-18 Impact factor: 9.337