PP.19.11

Abstract

Objective: To identify risk factors for its association with any diabetic nephropathy. Design and method: Retrospectively we studied 82 diabetic patients charts (20 with microalbuminuria, 23 with macroalbuminuria and 39 controls – with normoalbuminuria) in whom type 1 diabetes (T1DM) was diagnosed before the age of 15 years and duration of diabetes more than 20 years in Moscow district. All patients were matched by age (mean age of 35, 2 years), age at onset of diabetes (mean age 13,4 years) sex and duration of diabetes (mean 24,2 years). The relation between possible risk factors and development of micro- and macroalbuminuria was analysed with the use of multivariable regression models. Variables included in the model were: age, sex, age at onset of diabetes, duration of diabetes, glycosylated hemoglobin (HbA1c) level, lipids and blood pressure. Results: In comparison with normoalbuminuric subjects, both micro- and macroalbuminuric diabetic subject had significantly higher levels of systolic and diastolic blood pressure, lipid values and HbA1c. However, when all possible risk factors were tested in a multivariable model, only HbA1c odds ratio [OR] (95% CI) 3,1 (1,1 -9,5) (p < 0,05) and triglycerides [OR] (95% CI) 3,0 (1,7 – 5,4) (p < 0,01) showed a significant correlation to microalbuminuria. In logistic regression, variables independently related to macroalbuminuria were systolic blood pressure[OR] (95% CI) 3,4 (1,5 – 7,8) (p < 0,01) and HbA1c [OR] (95% CI) 4,4 (1,1 – 4,7) (p < 0,05) Conclusions: In childhood-onset (T1DM) after 20 years of diabetes, the only poor glycemic control and hypertension are main risk factors of macroalbuminuria, whereas inadequate glycemic control and dyslipidemia are main risk factors of microalbuminuria.