title: A1C variability as an independent risk factor for microalbuminuria in young people with type 1 diabetes.
abstract: OBJECTIVE
  To assess the potential association between A1C variability (A1C-SD) and microalbuminuria in young people with type 1 diabetes.
  
  
  METHODS
  Serially collected samples for A1C measurement were available for 1,232 subjects with childhood-onset type 1 diabetes recruited to the Oxford Regional Prospective Study and the Nephropathy Family Study.
  
  
  RESULTS
  The median (range) number of A1C assessments was 4 (2-16). Mean intrapersonal A1C was 9.5% and A1C-SD was 0.91. Mean A1C and A1C-SD values were higher in subjects with microalbuminuria (n = 227) than in those with normoalbuminuria (10.3 vs. 9.4%; 1.12 vs. 0.86, P < 0.001). In a Cox regression model, A1C-SD was independently associated with microalbuminuria (hazard ratio 1.31 [95% CI 1.01-1.35]).
  
  
  CONCLUSIONS
  In the current study, A1C variability was an independent variable that added to the effect of A1C on the risk for microalbuminuria in youth with type 1 diabetes, a population highly vulnerable to vascular complications.
authors.affiliation: Department of Paediatrics, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK.
authors.forename: M Loredana
authors.initials: ML
authors.lastname: Marcovecchio
authors.forename: R Neil
authors.initials: RN
authors.lastname: Dalton
authors.forename: Francesco
authors.initials: F
authors.lastname: Chiarelli
authors.forename: David B
authors.initials: DB
authors.lastname: Dunger
mesh_terms: D000293:Adolescent; D000419:Albuminuria / Q000378:metabolism*; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D008297:Male; D016016:Proportional Hazards Models; D012307:Risk Factors
chemical_list: D006442:Glycated Hemoglobin