title: Risk factors for development of diabetic nephropathy and retinopathy in Jewish IDDM patients.
abstract: Risk factors associated with diabetic microvascular complications, with special reference to ethnic origin, were looked for in 231 young Jewish insulin-dependent diabetes mellitus (IDDM) patients with duration of diabetes greater than or equal to 10 yr. Median age at diagnosis of diabetes was 9.2 yr (range 0.04-26.2 yr), and median duration of the disease was 15.3 yr (range 10.0-37.2 yr). Sixty-three percent of the patients were Ashkenazi Jews, and 37% were non-Ashkenazi Jews. HbA1 was evaluated every 3 mo in the last 10 yr of follow-up, and albumin excretion rate was tested in three 24-h urine collections. Direct and indirect ophthalmoscopy was performed every year since diagnosis of diabetes, and if retinal pathology was suspected, color photographs were taken. Microalbuminuria was detected in 31% and macroalbuminuria in 7% of the patients. Nonproliferative and proliferative retinopathy was found in 44 and 12% of the patients, respectively. On logistic regression analysis, two variables were significantly and independently associated with diabetic nephropathy--non-Ashkenazi origin and mean HbA1 values over the first 5 of 10 yr of follow-up. Variables significantly and independently related to diabetic retinopathy were non-Ashkenazi origin, mean HbA1 values over the last 10 yr of follow-up, and duration of diabetes. Because non-Ashkenazi Jews in Israel are of lower socioeconomic status than Ashkenazi Jews, we stratified our patients according to their socioeconomic parameters, median HbA1 values, and duration of diabetes. Non-Ashkenazi patients were at a higher risk to develop complications in all strata.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Medicine B, Beilinson Medical Center, Petah Tikva, Israel.
authors.forename: O
authors.initials: O
authors.lastname: Kalter-Leibovici
authors.forename: D J
authors.initials: DJ
authors.lastname: Van Dyk
authors.forename: L
authors.initials: L
authors.lastname: Leibovici
authors.forename: N
authors.initials: N
authors.lastname: Loya
authors.forename: A
authors.initials: A
authors.lastname: Erman
authors.forename: I
authors.initials: I
authors.lastname: Kremer
authors.forename: G
authors.initials: G
authors.lastname: Boner
authors.forename: J B
authors.initials: JB
authors.lastname: Rosenfeld
authors.forename: M
authors.initials: M
authors.lastname: Karp
authors.forename: Z
authors.initials: Z
authors.lastname: Laron
mesh_terms: D000293:Adolescent; D000328:Adult; D000419:Albuminuria / Q000150:complications / Q000453:epidemiology / Q000235:genetics; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000235:genetics / Q000401:mortality; D003929:Diabetic Neuropathies / Q000453:epidemiology / Q000209:etiology* / Q000235:genetics; D003930:Diabetic Retinopathy / Q000453:epidemiology / Q000209:etiology* / Q000235:genetics; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007585:Jews / Q000235:genetics*; D008297:Male; D015995:Prevalence; D011507:Proteinuria / Q000150:complications / Q000453:epidemiology / Q000235:genetics; D012044:Regression Analysis; D012307:Risk Factors; D012959:Socioeconomic Factors
chemical_list: D006442:Glycated Hemoglobin