title: Regression and progression of microalbuminuria in adolescents with childhood onset diabetes mellitus.
abstract: OBJECTIVE
  Although microalbuminuria is considered as an early marker of nephropathy in diabetic adults, available information in diabetic adolescents is limited. The aim of this study was to investigate prevalence and frequency of regression of microalbuminuria in type 1 (T1DM) and type 2 diabetes mellitus (T2DM) patients with childhood onset.
  
  
  METHODS
  One hundred and nine adolescents (median, 18.9 years; interquartile range (IQR), 16.5-21.0 years) with T1DM and 18 T2DM adolescents (median, 17.9 years; IQR, 16.8-18.4 years) with repeated measurements of microalbuminuria (first morning urine microalbumin/creatinine ratios) were included. The median duration of diabetes was 10.1 (7.8-14.0) years and 5.0 (3.5-5.6) years, respectively, and follow-up period ranged 0.5-7.0 years. Growth parameters, estimated glomerular filtration rate, glycosylated hemoglobin (HbA1c) and lipid profiles were obtained after reviewing medical record in each subject.
  
  
  RESULTS
  The prevalence of microalbuminuria at baseline and evaluation were 21.1% and 17.4% in T1DM, and 44.4% and 38.9% in T2DM. Regression of microalbuminuria was observed in 13 T1DM patients (56.5%) and 3 T2DM patients (37.5%), and progression rate was 10.5% and 20% in T1DM and T2DM respectively. In regression T1DM group, HbA1c at baseline and follow-up was lower, and C-peptide at baseline was higher compared to persistent or progression groups. In T2DM, higher triglyceride was observed in persistent group.
  
  
  CONCLUSIONS
  Considerable regression of microalbuminuria more than progression in diabetes adolescents indicates elevated urinary microalbumin excretion in a single test does not imply irreversible diabetic nephropathy. Careful monitoring and adequate intervention should be emphasized in adolescents with microalbuminuria to prevent rapid progression toward diabetic nephropathy.
authors.affiliation: Department of Pediatrics, Konkuk University Medical Center, Seoul, Korea.
authors.forename: Mi Kyung
authors.initials: MK
authors.lastname: Son
authors.affiliation: Department of Pediatrics, Konkuk University Medical Center, Seoul, Korea.
authors.forename: Ha Young
authors.initials: HY
authors.lastname: Yoo
authors.affiliation: Department of Pediatrics, Konkuk University Medical Center, Seoul, Korea. ; Department of Pediatrics, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Byung Ok
authors.initials: BO
authors.lastname: Kwak
authors.affiliation: Department of Pediatrics, Konkuk University Medical Center, Seoul, Korea. ; Department of Pediatrics, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Hye Won
authors.initials: HW
authors.lastname: Park
authors.affiliation: Department of Pediatrics, Konkuk University Medical Center, Seoul, Korea. ; Department of Pediatrics, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Kyo Sun
authors.initials: KS
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Konkuk University Medical Center, Seoul, Korea. ; Department of Pediatrics, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Sochung
authors.initials: S
authors.lastname: Chung
authors.affiliation: Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Hyun Wook
authors.initials: HW
authors.lastname: Chae
authors.affiliation: Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Ho-Seong
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Sowha Children's Hospital, Seoul, Korea.
authors.forename: Duk Hee
authors.initials: DH
authors.lastname: Kim
keywords: Adolescent; Albuminuria; Child; Type 1 diabetes mellitus; Type 2 diabetes mellitus