Risk factors for microalbuminuria in children and adolescents with type 1 diabetes.

Abstract

The aim of this study was to investigate the influence of sex, age, diabetes duration, puberty, blood pressure, glycemic control and parental blood pressure on microalbuminuria in children with type 1 diabetes. The study was a multicenter cross-sectional survey including 702 children and adolescents (age = 14.3+/-2.9 yr) with type 1 diabetes duration of 7.6+/-3.1 yr. One third of the population had not undergone pubertal development. Blood pressure was measured in children and their parents using a Dinamap instrument. Microalbuminuria was defined as a urinary albumin excretion rate > or = 15 microg/min measured on at least two out of three urine collections. HbA1c centrally measured by HPLC, was 8.7+/-1.5%. The proportion of permanent microalbuminuria was 5.1+/-1.6%. The prevalence was significantly enhanced after 10 yr of diabetes duration (11.6+/-5.2%) and complete puberty (8.2+/-3.1%). Independent risk factors for microalbuminuria tested in a logistic regression model were diabetes duration (OR/1 yr = 1.04-1.32), complete puberty (OR = 5.02-8.0), and maternal hypertension (OR = 1.94-4.28). HbA1c had a borderline independent and significant effect (OR/1% = 0.96-1.62; p = 0.07). Our results indicate that pubertal adolescents with a long duration of the disease and maternal history of hypertension are candidates for targeted interventions with the objective of reducing the rate of developing nephropathy in these individuals.