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Urinary albumin/creatinine ratio tertiles predict risk of diabetic retinopathy progression: a natural history study from the Adolescent Cardio-Renal Intervention Trial (AdDIT) observational cohort.
Benitez-Aguirre, Paul Z; Marcovecchio, M Loredana; Chiesa, Scott T; Craig, Maria E; Wong, Tien Y; Davis, Elizabeth A; Cotterill, Andrew; Couper, Jenny J; Cameron, Fergus J; Mahmud, Farid H; Neil, H Andrew W; Jones, Timothy W; Hodgson, Lauren A B; Dalton, R Neil; Marshall, Sally M; Deanfield, John; Dunger, David B; Donaghue, Kim C.
Afiliación
  • Benitez-Aguirre PZ; Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia.
  • Marcovecchio ML; Discipline of Child and Adolescent Health, University of Sydney, Sydney, NSW, Australia.
  • Chiesa ST; Department of Paediatrics, University of Cambridge, Cambridge, UK. mlm45@medschl.cam.ac.uk.
  • Craig ME; Institute of Cardiovascular Science, University College London, London, UK.
  • Wong TY; Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia.
  • Davis EA; Discipline of Child and Adolescent Health, University of Sydney, Sydney, NSW, Australia.
  • Cotterill A; School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia.
  • Couper JJ; Centre for Eye Research Australia, Melbourne, VIC, Australia.
  • Cameron FJ; Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.
  • Mahmud FH; Duke-NUS Medical School, National University of Singapore, Singapore, Singapore.
  • Neil HAW; Department of Endocrinology and Diabetes, Princess Margaret Hospital for Children, Perth, WA, Australia.
  • Jones TW; Telethon Kids Institute, University of Western Australia, Perth, WA, Australia.
  • Hodgson LAB; University of Queensland, Brisbane, QLD, Australia.
  • Dalton RN; Endocrinology and Diabetes Centre, Women's and Children's Hospital, and Robinson Institute, University of Adelaide, Adelaide, SA, Australia.
  • Marshall SM; Department of Endocrinology and Diabetes, Royal Children's Hospital, Melbourne, VIC, Australia.
  • Deanfield J; Murdoch Children's Research Institute, Melbourne, VIC, Australia.
  • Dunger DB; The University of Melbourne, Melbourne, VIC, Australia.
  • Donaghue KC; Division of Endocrinology, Hospital for Sick Children, Toronto, ON, Canada.
Diabetologia ; 65(5): 872-878, 2022 05.
Article en En | MEDLINE | ID: mdl-35182158
AIMS/HYPOTHESIS: We hypothesised that adolescents with type 1 diabetes with a urinary albumin/creatinine ratio (ACR) in the upper tertile of the normal range (high ACR) are at greater risk of three-step diabetic retinopathy progression (3DR) independent of glycaemic control. METHODS: This was a prospective observational study in 710 normoalbuminuric adolescents with type 1 diabetes from the non-intervention cohorts of the Adolescent Cardio-Renal Intervention Trial (AdDIT). Participants were classified as 'high ACR' or 'low ACR' (lowest and middle ACR tertiles) using baseline standardised log10 ACR. The primary outcome, 3DR, was determined from centrally graded, standardised two-field retinal photographs. 3DR risk was determined using multivariable Cox regression for the effect of high ACR, with HbA1c, BP, LDL-cholesterol and BMI as covariates; diabetes duration was the time-dependent variable. RESULTS: At baseline mean ± SD age was 14.3 ± 1.6 years and mean ± SD diabetes duration was 7.2 ± 3.3 years. After a median of 3.2 years, 83/710 (12%) had developed 3DR. In multivariable analysis, high ACR (HR 2.1 [1.3, 3.3], p=0.001), higher mean IFCC HbA1c (HR 1.03 [1.01, 1.04], p=0.001) and higher baseline diastolic BP SD score (HR 1.43 [1.08, 1.89], p=0.01) were independently associated with 3DR risk. CONCLUSIONS/INTERPRETATION: High ACR is associated with greater risk of 3DR in adolescents, providing a target for future intervention studies. TRIAL REGISTRATION: isrctn.org ISRCTN91419926.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Diabetes Mellitus Tipo 1 / Nefropatías Diabéticas / Retinopatía Diabética Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Child / Humans Idioma: En Revista: Diabetologia Año: 2022 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Diabetes Mellitus Tipo 1 / Nefropatías Diabéticas / Retinopatía Diabética Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Child / Humans Idioma: En Revista: Diabetologia Año: 2022 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Alemania