title: Microalbuminuria and heart rate variability in adolescents with diabetes.
abstract: BACKGROUND
  Limited clinical and research data are available on early renal and cardiovascular complications in youth with diabetes. The possible associations of elevated microalbuminuria to creatinine (MC) ratios with heart rate variability (HRV) were explored in adolescents with type 1 (T1DM) or type 2 (T2DM) diabetes.
  
  
  METHODS
  A descriptive study was conducted with 41 adolescents with diabetes (n = 31 T1DM vs. n = 10 T2DM). Twenty-four hour Holter recordings for determining HRV, urine spot checks for MC ratio, and the most recent measures of glycosylated hemoglobin (A1c) were obtained.
  
  
  RESULTS
  HRV was significantly lower in the T2DM group, while body mass index percentile, triglycerides, and diastolic blood pressure were significantly higher. For the T1DM group, clinical case examples provided evidence of elevated MC ratios (>30 mirog/mg) occurring in two female subjects who also had decreased HRV measures.
  
  
  CONCLUSIONS
  Although HRV was not significantly associated with MC ratios for the sample, individual clinical findings can be a warning sign for some adolescents with diabetes. Current recommendations for screening of early renal complications and associated treatment are provided.
authors.affiliation: Diabetes Research and Education, College of Nursing, University of Arizona, P.O. Box 210203, Tucson, AZ 5721-0203, USA. mfaulkner@nursing.arizona.edu.
authors.forename: Melissa Spezia
authors.initials: MS
authors.lastname: Faulkner
authors.forename: Lauretta
authors.initials: L
authors.lastname: Quinn
authors.forename: Cynthia
authors.initials: C
authors.lastname: Fritschi
mesh_terms: D000293:Adolescent; D000419:Albuminuria / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism / Q000517:prevention & control; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000188:drug therapy / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy / Q000378:metabolism; D015716:Electrocardiography, Ambulatory; D005260:Female; D006442:Glycated Hemoglobin; D006801:Humans; D006973:Hypertension / Q000209:etiology; D015228:Hypertriglyceridemia / Q000209:etiology; D008297:Male; D008403:Mass Screening; D009722:Nurse Practitioners; D009730:Nursing Assessment; D009765:Obesity / Q000209:etiology; D010371:Pediatric Nursing; D018570:Risk Assessment; D012307:Risk Factors; D018709:Statistics, Nonparametric
chemical_list: D003404:Creatinine; D006442:Glycated Hemoglobin