AIMS: We aimed to identify long-term HbA1c trajectories and examine associated characteristics in an observational, childhood-onset (<17 years) type 1 diabetes cohort. METHODS: Data are from the Epidemiology of Diabetes Complications study, comprising 405 participants with ≥2 of seven possible HbA1c measurements over follow-up (1988-2013) and available DNA (baseline mean diabetes duration 21 years, 53% men). HbA1c trajectories were estimated using latent class growth models. Baseline and change in participant characteristics were compared across trajectories. RESULTS: Five HbA1c trajectories were identified: low (51%), intermediate stable (22%), improved (19%), high stable (6%), and worsened (2%; not included in analyses). Age, diabetes duration, diabetes onset age, and sex did not differ across trajectories. Characteristics did not differ significantly between intermediate stable and low trajectories at baseline, though albumin excretion rate (AER, p = 0.0002) and estimated glomerular filtration rate (eGFR, p = 0.001) worsened slightly more in intermediate stable over time. Improved and high stable trajectories had higher baseline LDL-c (p = 0.002 and 0.003, respectively). Improved trajectory increased median self-monitoring of blood glucose from <1 to 3.5 times/day (p < 0.0001) and had larger LDL-c improvement (p = 0.004) but greater worsening of AER (p < 0.0001) and eGFR (p < 0.0001) than low. The A allele of rs12970134 (near MC4R) was associated with improved (p = 0.0003) or high stable (p = 0.001) HbA1c trajectory, both patterns with high baseline HbA1c. CONCLUSIONS: Long-term HbA1c trajectories were primarily associated with modifiable factors in this type 1 diabetes cohort. The intermediate stable pattern had a risk factor profile that suggests some protection against adverse metabolic effects of chronic hyperglycaemia, warranting further study.
AIMS: We aimed to identify long-term HbA1c trajectories and examine associated characteristics in an observational, childhood-onset (<17 years) type 1 diabetes cohort. METHODS: Data are from the Epidemiology of Diabetes Complications study, comprising 405 participants with ≥2 of seven possible HbA1c measurements over follow-up (1988-2013) and available DNA (baseline mean diabetes duration 21 years, 53% men). HbA1c trajectories were estimated using latent class growth models. Baseline and change in participant characteristics were compared across trajectories. RESULTS: Five HbA1c trajectories were identified: low (51%), intermediate stable (22%), improved (19%), high stable (6%), and worsened (2%; not included in analyses). Age, diabetes duration, diabetes onset age, and sex did not differ across trajectories. Characteristics did not differ significantly between intermediate stable and low trajectories at baseline, though albumin excretion rate (AER, p = 0.0002) and estimated glomerular filtration rate (eGFR, p = 0.001) worsened slightly more in intermediate stable over time. Improved and high stable trajectories had higher baseline LDL-c (p = 0.002 and 0.003, respectively). Improved trajectory increased median self-monitoring of blood glucose from <1 to 3.5 times/day (p < 0.0001) and had larger LDL-c improvement (p = 0.004) but greater worsening of AER (p < 0.0001) and eGFR (p < 0.0001) than low. The A allele of rs12970134 (near MC4R) was associated with improved (p = 0.0003) or high stable (p = 0.001) HbA1c trajectory, both patterns with high baseline HbA1c. CONCLUSIONS: Long-term HbA1c trajectories were primarily associated with modifiable factors in this type 1 diabetes cohort. The intermediate stable pattern had a risk factor profile that suggests some protection against adverse metabolic effects of chronic hyperglycaemia, warranting further study.
Authors: Mark A Clements; Anke Schwandt; Kim C Donaghue; Kellee Miller; Ursula Lück; Jennifer J Couper; Nicole Foster; Carmen Schröder; Helen Phelan; David Maahs; Nicole Prinz; Maria E Craig Journal: Pediatr Diabetes Date: 2019-08-28 Impact factor: 4.866
Authors: Andrew S Levey; Lesley A Stevens; Christopher H Schmid; Yaping Lucy Zhang; Alejandro F Castro; Harold I Feldman; John W Kusek; Paul Eggers; Frederick Van Lente; Tom Greene; Josef Coresh Journal: Ann Intern Med Date: 2009-05-05 Impact factor: 25.391
Authors: Jennifer M Rohan; Joseph R Rausch; Jennifer Shroff Pendley; Alan M Delamater; Lawrence Dolan; Grafton Reeves; Dennis Drotar Journal: Health Psychol Date: 2013-11-25 Impact factor: 4.267
Authors: Nicole Soranzo; Serena Sanna; Eleanor Wheeler; Christian Gieger; Dörte Radke; Josée Dupuis; Nabila Bouatia-Naji; Claudia Langenberg; Inga Prokopenko; Elliot Stolerman; Manjinder S Sandhu; Matthew M Heeney; Joseph M Devaney; Muredach P Reilly; Sally L Ricketts; Alexandre F R Stewart; Benjamin F Voight; Christina Willenborg; Benjamin Wright; David Altshuler; Dan Arking; Beverley Balkau; Daniel Barnes; Eric Boerwinkle; Bernhard Böhm; Amélie Bonnefond; Lori L Bonnycastle; Dorret I Boomsma; Stefan R Bornstein; Yvonne Böttcher; Suzannah Bumpstead; Mary Susan Burnett-Miller; Harry Campbell; Antonio Cao; John Chambers; Robert Clark; Francis S Collins; Josef Coresh; Eco J C de Geus; Mariano Dei; Panos Deloukas; Angela Döring; Josephine M Egan; Roberto Elosua; Luigi Ferrucci; Nita Forouhi; Caroline S Fox; Christopher Franklin; Maria Grazia Franzosi; Sophie Gallina; Anuj Goel; Jürgen Graessler; Harald Grallert; Andreas Greinacher; David Hadley; Alistair Hall; Anders Hamsten; Caroline Hayward; Simon Heath; Christian Herder; Georg Homuth; Jouke-Jan Hottenga; Rachel Hunter-Merrill; Thomas Illig; Anne U Jackson; Antti Jula; Marcus Kleber; Christopher W Knouff; Augustine Kong; Jaspal Kooner; Anna Köttgen; Peter Kovacs; Knut Krohn; Brigitte Kühnel; Johanna Kuusisto; Markku Laakso; Mark Lathrop; Cécile Lecoeur; Man Li; Mingyao Li; Ruth J F Loos; Jian'an Luan; Valeriya Lyssenko; Reedik Mägi; Patrik K E Magnusson; Anders Mälarstig; Massimo Mangino; María Teresa Martínez-Larrad; Winfried März; Wendy L McArdle; Ruth McPherson; Christa Meisinger; Thomas Meitinger; Olle Melander; Karen L Mohlke; Vincent E Mooser; Mario A Morken; Narisu Narisu; David M Nathan; Matthias Nauck; Chris O'Donnell; Konrad Oexle; Nazario Olla; James S Pankow; Felicity Payne; John F Peden; Nancy L Pedersen; Leena Peltonen; Markus Perola; Ozren Polasek; Eleonora Porcu; Daniel J Rader; Wolfgang Rathmann; Samuli Ripatti; Ghislain Rocheleau; Michael Roden; Igor Rudan; Veikko Salomaa; Richa Saxena; David Schlessinger; Heribert Schunkert; Peter Schwarz; Udo Seedorf; Elizabeth Selvin; Manuel Serrano-Ríos; Peter Shrader; Angela Silveira; David Siscovick; Kjioung Song; Timothy D Spector; Kari Stefansson; Valgerdur Steinthorsdottir; David P Strachan; Rona Strawbridge; Michael Stumvoll; Ida Surakka; Amy J Swift; Toshiko Tanaka; Alexander Teumer; Gudmar Thorleifsson; Unnur Thorsteinsdottir; Anke Tönjes; Gianluca Usala; Veronique Vitart; Henry Völzke; Henri Wallaschofski; Dawn M Waterworth; Hugh Watkins; H-Erich Wichmann; Sarah H Wild; Gonneke Willemsen; Gordon H Williams; James F Wilson; Juliane Winkelmann; Alan F Wright; Carina Zabena; Jing Hua Zhao; Stephen E Epstein; Jeanette Erdmann; Hakon H Hakonarson; Sekar Kathiresan; Kay-Tee Khaw; Robert Roberts; Nilesh J Samani; Mark D Fleming; Robert Sladek; Gonçalo Abecasis; Michael Boehnke; Philippe Froguel; Leif Groop; Mark I McCarthy; W H Linda Kao; Jose C Florez; Manuela Uda; Nicholas J Wareham; Inês Barroso; James B Meigs Journal: Diabetes Date: 2010-09-21 Impact factor: 9.461