Microalbuminuria predictive factors in pediatric patients with type 1 diabetes mellitus (type 1 DM)

Abstract

Nephropathy constitutes the most serious type 1 diabetes mellitus (type 1 DM) complication and microalbuminuria is the initial manifestation. Objectives: To determine the role of epidemiological, clinical and biochemical factors in the development of microalbuminuria in type 1 DM patients. Design: Case and control study. Setting: Endocrinology Unit, National Institute of Child Health, Lima, Peru. Patients: Subjects less than 18 year-old with type 1 DM. Interventions: Sixty-four type 1 DM patients were studied, 22 patients with microalbuminuria (cases) and 42 patients without it (controls). Epidemiological factors studied were age at diagnosis, time from onset, gender, family history of diabetes, nephropathy, dyslipidemia, and/or hypertension; clinical factors studied were nutritional status, pubertal stage (Tanner method) and blood pressure; biochemical factors were glycated hemoglobin (HbA1c), microalbuminuria and lipid profile. Both cases and controls were followed for one year. Statistical analysis used chi square, odds ratio and multiple logistic regression calculations to determine main risk factors. Main outcome measures: Pubertal stage, lipid profile and HbA1c. Results: Risk factors determined were high diastolic blood pressure (p=0.037), puberty (p=0.008), high HbA1C (p<0.0001), hypertriglyceridemia (p=0.007), and hypercholesterolemia (p<0.0001). Conclusions: Elevated HbA1c, hypercholesterolemia and puberty were the more important risk factors for development of microalbuminuria. Main measures to prevent development of microalbuminuria were good metabolic control and good management of dyslipidemia, especially in pubertal patients.