Diabetes & its Complications

Abstract

Microalbuminuria in Children and Adolescents with Type 1 Diabetes Mellitus: Prevalence and Predictive Factors

Joana Menezes Nunes, Ricardo Monteiro, Daniela Amaral, Rosa Pina, Lurdes Lopes, Catarina Limbert.

Background: Microalbuminuria is usually the first microvascular complication of T1DM and several variables are believed to play a major role in its determination.

Objective: We aimed to identify microalbuminuria frequency, time after diagnosis and related risk factors.

Methods: Clinical reports and biochemical results of 201 children with T1DM, followed in our institution, were retrospectively analyzed.

Results: Seventeen patients (8.5%) presented microalbuminuria in a mean diabetes duration of 5.5 ± 3.8 years. Five children (29.4%) presented before 2 years of diabetes duration; 3 children between 2 to 5 years after the onset and 9 children (52.9%) 5 or more years afterwards. Logistic regression analysis revealed that longer diabetes duration (6.3 ± 3.7 years vs 3.5 ± 3.5 years), higher BMI (23.1 ± 4.9 vs 20.3 ± 4.1 Kg/m2), total cholesterol (TC) (180.6 ± 57.5 mg/dL vs 159.1 ± 31.0 mg/dL), LDL (125.5 ± 36.3 mg/dL vs 110.9 ± 24.7 mg/dL), TG (133.3 ± 39.3 mg/dL vs 78.6 ± 38.4 mg/dL) and HbA1c (9.6 ± 1.9 vs 8.9 ± 1.7%) were significantly associated with microalbuminuria. There were no statistical significant differences regarding gender, puberty and HDL-C. 

Conclusions: In children, nephropathy can occur soon after T1DM onset. Besides poor metabolic control and longer diabetes duration, obesity and dyslipidemia seem to play a significant role. Our results indicate that yearly screening of microalbuminuria from T1DM onset and early treatment of dyslipidemia and obesity might be recommended / advisable.