title: The effect of obesity and type 1 diabetes on renal function in children and adolescents.
abstract: BACKGROUND
  Early signs of renal complications can be common in youths with type 1 diabetes (T1D). Recently, there has been an increasing interest in potential renal complications associated with obesity, paralleling the epidemics of this condition, although there are limited data in children.
  
  
  OBJECTIVE
  Obese children and adolescents present signs of early alterations in renal function similar to non-obese peers with T1D.
  
  
  METHODS
  Eighty-three obese (age: 11.6 ± 3.0 yr), 164 non-obese T1D (age: 12.4 ± 3.2 yr), and 71 non-obese control (age: 12.3 ± 3.2 yr) children and adolescents were enrolled in the study.
  
  
  METHODS
  Anthropometric parameters and blood pressure were measured. Renal function was assessed by albumin excretion rate (AER), serum cystatin C, creatinine and estimated glomerular filtration rate (e-GFR), calculated using the Bouvet's formula.
  
  
  RESULTS
  Obese and non-obese T1D youths had similar AER [8.9(5.9-10.8) vs. 8.7(5.9-13.1) µg/min] and e-GFR levels (114.8 ± 19.6 vs. 113.4 ± 19.1 mL/min), which were higher than in controls [AER: 8.1(5.9-8.7) µg/min, e-GFR: 104.7 ± 18.9 mL/min]. Prevalence of microalbuminuria and hyperfiltration was similar between obese and T1D youths and higher than their control peers (6.0 vs. 8.0 vs. 0%, p = 0.02; 15.9 vs. 15.9 vs. 4.3%, p = 0.03, respectively). Body mass index (BMI) z-score was independently related to e-GFR (r = 0.328; p < 0.001), and AER (r = 0.138; p = 0.017). Hemoglobin A1c (HbA1c) correlated with AER (r = 0.148; p = 0.007) but not with eGFR (r = 0.041; p = 0.310).
  
  
  CONCLUSIONS
  Obese children and adolescents show early alterations in renal function, compared to normal weight peers, and they have similar renal profiles than age-matched peers with T1D.
authors.affiliation: Department of Pediatrics, University of Chieti, Chieti, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Franchini
authors.affiliation: Department of Pediatrics, University of Chieti, Chieti, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Savino
authors.affiliation: Department of Pediatrics, University of Chieti, Chieti, Italy.|Clinical Research Centre, Center of Excellence on Aging, 'G. D'Annunzio' University Foundation, University of Chieti, Chieti, Italy.
authors.forename: M Loredana
authors.initials: ML
authors.lastname: Marcovecchio
authors.affiliation: Department of Pediatrics, University of Chieti, Chieti, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Tumini
authors.affiliation: Department of Pediatrics, University of Chieti, Chieti, Italy.|Clinical Research Centre, Center of Excellence on Aging, 'G. D'Annunzio' University Foundation, University of Chieti, Chieti, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Chiarelli
authors.affiliation: Department of Pediatrics, University of Chieti, Chieti, Italy.|Clinical Research Centre, Center of Excellence on Aging, 'G. D'Annunzio' University Foundation, University of Chieti, Chieti, Italy.
authors.forename: Angelika
authors.initials: A
authors.lastname: Mohn
mesh_terms: D000293:Adolescent; D000419:Albuminuria / Q000209:etiology; D015415:Biomarkers / Q000097:blood / Q000652:urine; D015992:Body Mass Index; D002648:Child; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D055316:Cystatin C / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications / Q000503:physiopathology* / Q000652:urine; D003928:Diabetic Nephropathies / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D063766:Pediatric Obesity / Q000097:blood / Q000503:physiopathology* / Q000652:urine; D015995:Prevalence; D051437:Renal Insufficiency / Q000150:complications / Q000209:etiology* / Q000503:physiopathology; D012307:Risk Factors
chemical_list: D015415:Biomarkers; C525030:CST3 protein, human; D055316:Cystatin C; D003404:Creatinine
keywords: children; diabetes mellitus; hyperfiltration; microalbuminuria; obesity; type 1