Higher prevalence of elevated albumin excretion in youth with type 2 than type 1 diabetes: the SEARCH for Diabetes in Youth study.
OBJECTIVE
To estimate the prevalence of an elevated albumin-to-creatinine ratio (ACR) (> or = 30 microg/mg) among youth with type 1 or type 2 diabetes and to identify factors associated with elevated ACR and their effect on the relationship between elevated ACR and type of diabetes.


METHODS
Cross-sectional data were analyzed from 3,259 participants with onset of diabetes at < 20 years of age in the SEARCH for Diabetes in Youth, a multicenter observational study of diabetes in youth. Multiple logistic regression was used to explore determinants of elevated ACR and factors accounting for differences in this prevalence between type 2 and type 1 diabetes.


RESULTS
The prevalence of elevated ACR was 9.2% in type 1 and 22.2% in type 2 diabetes (prevalence ratio 2.4 [95% CI 1.9-3.0]; P < 0.0001). In multiple logistic regression analysis, female sex, A1C and triglyceride values, hypertension, and type of diabetes (type 2 versus type 1) were significantly associated with elevated ACR. Adjustment for variables related to insulin resistance (obesity, hypertension, dyslipidemia, and inflammation) attenuated, but did not completely explain, the association of diabetes type with elevated ACR.


CONCLUSIONS
Youth with type 2 diabetes have a higher prevalence of elevated ACR than youth with type 1 diabetes, in an association that apparently does not completely depend on age, duration of diabetes, race/ethnicity, sex, level of glycemic control, or features of insulin resistance.
Maahs
David M
DM
Barbara Davis Center for Childhood Diabetes, University of Colorado Health Sciences Center, P.O. Box 6511, Mail Stop A140, Aurora, CO 80045, USA. david.maahs@uchsc.edu
Snively
Beverly M
BM
Bell
Ronny A
RA
Dolan
Lawrence
L
Hirsch
Irl
I
Imperatore
Giuseppina
G
Linder
Barbara
B
Marcovina
Santica M
SM
Mayer-Davis
Elizabeth J
EJ
Pettitt
David J
DJ
Rodriguez
Beatriz L
BL
Dabelea
Dana
D
D000293:Adolescent; D017668:Age of Onset; D000419:Albuminuria / Q000453:epidemiology*; D002648:Child; D003404:Creatinine / Q000652:urine; D003922:Diabetes Mellitus, Type 1 / Q000652:urine*; D003924:Diabetes Mellitus, Type 2 / Q000652:urine*; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence
D003404:Creatinine