Endocrine Abstracts

Objective: Microalbuminuria is usually the first microvascular complication of type 1 diabetes mellitus (T1DM). We aimed to identify its frequency, time of occurrence and related risk factors.

Methods: Clinical reports of 201 children followed in our institution were retrospectively analysed (diabetes duration 3.8±3.6 years, age at diagnosis 8.1±3.7 years, HbA1c value 9.0±1.7%). Statistical analysis was performed with SPSS version.21 for Windows. Results are expressed in frequencies and means±S.D. Statistical significance was considered as P value <0.05.

Results: Seventeen (ten females; seven males) patients (8.5%) presented microalbuminuria in a mean time of 5.5±3.8 years: five children (29.4%) 2 years after diabetes onset and nine children (52.9%) 5 years after it (four children between 2 and 5 years of diabetes duration). In the logistic regression analysis, longer diabetes duration (6.3±3.7 years vs 3.5±3.5 years, P=0.005, OR=1.38), higher total cholesterol (TC) (180.6±57.5 mg/dl vs 159.1±31.0 mg/dl, P=0.03, OR=1.26), higher LDL (125.5±36.3 mg/dl vs 110.9±24.7 mg/dl, P=0.04, OR=1.44), higher TG (133.3±39.3 mg/dl vs 78.6±38.4 mg/dl, P=0.006, OR=1.63), higher HbA1c (9.6±1.9% vs 8.9±1.7%, P=0.02 OR=1.88) and higher BMI (23.1±4.9 kg/m² vs 20.3±4.1 kg/m², P=0.02, OR=1.13) were associated with microalbuminuria. There were no statistical significant differences regarding gender, puberty and HDL-C.

Conclusions: In children, nephropathy can occur soon after T1DM onset. Besides poor metabolic control and longer diabetes duration, obesity and dyslipidemia seem to play a significant role. According to our results, we suggest yearly screening of microalbuminuria after T1DM onset and early treatment of dyslipidemia and obesity.