title: Clustering of cardio-metabolic risk factors in parents of adolescents with type 1 diabetes and microalbuminuria.
abstract: OBJECTIVE
  To evaluate the association between a clustering of cardio-metabolic risk factors in parents and the development of microalbuminuria (MA) in their offspring with childhood-onset type 1 diabetes (T1D).
  
  
  METHODS
  The study population comprised 53 parents (mean age [±SD]: 56.7±6.2 years) of 35 T1D young people with MA (MA+) and 86 parents (age: 56.1±6.3 years) of 50 matched offspring with normoalbuminuria (MA-), who underwent clinical, biochemical and cardiovascular imaging assessments. The primary study endpoint was the difference between parents from the MA+ and MA- groups in a cardio-metabolic risk score, calculated as the average value of the standardized measures (z-scores) for waist circumference, blood pressure, fasting glucose, insulin, HDL-cholesterol and triglycerides levels. Cardiovascular parameters, including carotid intima-media thickness (cIMT), flow-mediated dilatation (FMD) and pulse wave velocity (PWV), were also assessed. A DXA scan was performed to assess body composition.
  
  
  RESULTS
  The cardio-metabolic risk score was significantly higher in parents of MA+ compared to parents of MA- offspring (mean [95% CI]: 1.066[0.076; 2.056] vs -0.268[-0.997; 0.460], P = .03). Parents of MA+ offspring had slightly higher values of waist circumference, lipids, insulin and blood pressure, although only diastolic blood pressure was statistically different between the 2 groups (P = .0085). FMD, cIMT, PWV (all P > .3), and DXA parameters (all P > .2) were not significantly different between the 2 groups.
  
  
  CONCLUSIONS
  Parents of young offspring with childhood-onset T1D and MA showed an abnormal metabolic profile, reflected by a calculated risk score. The finding supports the role of a familial predisposition to risk of developing diabetic nephropathy.
authors.affiliation: Department of Paediatrics, University of Cambridge, Cambridge, UK.
authors.forename: M Loredana
authors.initials: ML
authors.lastname: Marcovecchio
authors.affiliation: Department of Paediatrics, PEDEGO Research Unit and Medical Research Centre Oulu, Oulu, University Hospital and University of Oulu, Oulu, Finland.
authors.forename: Päivi H
authors.initials: PH
authors.lastname: Tossavainen
authors.affiliation: Oxford Centre for Diabetes, Endocrinology & Metabolism, University of Oxford, Oxford, UK.
authors.forename: Katharine
authors.initials: K
authors.lastname: Owen
authors.affiliation: Department of Paediatrics, University of Cambridge, Cambridge, UK.
authors.forename: Catherine
authors.initials: C
authors.lastname: Fullah
authors.affiliation: Institute of Endocrinology and Diabetes, University of Sydney, Sydney, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Benitez-Aguirre
authors.affiliation: Vascular Physiology Unit, Institute of Cardiovascular Science, University College London, London, UK.
authors.forename: Stefano
authors.initials: S
authors.lastname: Masi
authors.affiliation: MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
authors.forename: Ken
authors.initials: K
authors.lastname: Ong
authors.affiliation: Vascular Physiology Unit, Institute of Cardiovascular Science, University College London, London, UK.
authors.forename: Helen
authors.initials: H
authors.lastname: Nguyen
authors.affiliation: Vascular Physiology Unit, Institute of Cardiovascular Science, University College London, London, UK.
authors.forename: Scott T
authors.initials: ST
authors.lastname: Chiesa
authors.affiliation: WellChild Laboratory, King's College London, Evelina Children's Hospital, London, UK.
authors.forename: R Neil
authors.initials: RN
authors.lastname: Dalton
authors.affiliation: Vascular Physiology Unit, Institute of Cardiovascular Science, University College London, London, UK.
authors.forename: John
authors.initials: J
authors.lastname: Deanfield
authors.affiliation: Department of Paediatrics, University of Cambridge, Cambridge, UK.
authors.forename: David B
authors.identifier: http://orcid.org/0000-0002-2566-9304
authors.initials: DB
authors.lastname: Dunger
mesh_terms: D000293:Adolescent; D000419:Albuminuria / Q000209:etiology*; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D016022:Case-Control Studies; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010290:Parents; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
keywords: cardio-metabolic; microalbuminuria; parents; type 1 diabetes