Microalbuminuria development in short-term IDDM.
To assess risk factors associated with microalbuminuria development in short-term evolution insulin-dependent diabetes mellitus (IDDM) we undertake a cross-sectional study with retrospective examination of the 34 patients diagnosed with IDDM between 1982 and 1983 and followed up for at least 7 years in an outpatient endocrinology clinic.


METHODS
(1) At IDDM diagnosis: age, sex, parameters of metabolic control (fasting glycemia, HbA1), islet-cell antibodies, insulin autoantibodies, endogenous insulin secretion (EIS) and HLA type. (2) At 1 year evolution: EIS re-evaluation. (3) From IDDM diagnosis (every 3-4 month): body mass index, insulin schedule and dose, and parameters of metabolic control. (4) At 7-year evolution: 24-h urinary albumin excretion (UAE) and arterial blood pressure measurements on two consecutive outpatient controls. Microalbuminuria was defined as UAE above 30 micrograms/min on the two consecutive measurements. After 7-year follow-up, 8 (23.5%; 95% Cl: 9.3 to 37.7%) patients developed microalbuminuria. Their metabolic control was worse (7 years mean HbA1: 10.7 vs. 9.7%; P = 0.04) and 1 year EIS lower (1.9 vs. 7.6 ng/ml.10 min; P = 0.03) than in normoalbuminuric patients. They also had higher prevalence of 'high-normal' arterial blood pressure (P = 0.03) and diabetic retinopathy (P = 0.01) than normoalbuminuric patients did. Stepwise logistic regression analysis showed that diabetic retinopathy was the only independent and significant risk factor related to microalbuminuria development (P = 0.01). We conclude that in subjects with short-term evolution IDDM, microalbuminuria development was associated with glycemic control, EIS and arterial blood pressure levels, however the strongest association was found with diabetic retinopathy occurrence.
González-Clemente
J M
JM
Endocrinology and Nutrition Unit, School of Medicine, University of Barcelona, Catalonia, Spain.
Esmatjes
E
E
Navarro
P
P
Ercilla
G
G
Casamitjana
R
R
Rios
M
M
Levy
I
I
Gomis
R
R
Vilardell
E
E
D000293:Adolescent; D017668:Age of Onset; D000419:Albuminuria / Q000453:epidemiology*; D000704:Analysis of Variance; D001323:Autoantibodies / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D002648:Child; D002784:Cholesterol / Q000097:blood; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000503:physiopathology / Q000652:urine*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006650:Histocompatibility Testing; D006801:Humans; D007330:Insulin Antibodies / Q000097:blood; D007515:Islets of Langerhans / Q000276:immunology; D008297:Male; D015999:Multivariate Analysis; D012044:Regression Analysis; D012189:Retrospective Studies; D014280:Triglycerides / Q000097:blood
D001323:Autoantibodies; D001786:Blood Glucose; D002784:Cholesterol; D006442:Glycated Hemoglobin; D007330:Insulin Antibodies; D014280:Triglycerides; C024211:islet cell antibody