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Exp Clin Endocrinol Diabetes 2016; 124(01): 16-21
DOI: 10.1055/s-0035-1564128
Article
© Georg Thieme Verlag KG Stuttgart · New York

Low-grade Albuminuria and Risk Factors of Atherosclerosis in Children with in Type 1 Diabetes

J. Nazim
1   Endocrinology Department, University Children's Hospital, Kraków, Poland
,
B. Małachowska
2   Department of Paediatrics, Oncology, Haematology and Diabetology, Medical University of Lodz, Łódź, Poland
,
W. Fendler
2   Department of Paediatrics, Oncology, Haematology and Diabetology, Medical University of Lodz, Łódź, Poland
,
J. Starzyk
3   Pediatric Endocrinology Department, Jagiellonian University, Medical College, Kraków, Kraków, Poland
› Author Affiliations
Further Information

Publication History

received 30 June 2015

accepted 02 September 2015

Publication Date:
14 October 2015 (online)

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Abstract

Aims: Microalbuminuria reflects generalized vascular dysfunction and the risk of cardiovascular disease. The study aim was to examine the relationship between low-grade albuminuria and the selected risk factors for atherosclerosis, markers of endothelial dysfunction and inflammation in diabetic children and adolescents.

Methods: In 154 children with diabetes duration of at least 5 years we assessed: HbA1c, lipid profile, apolipoproteins, lipoprotein (a), asymmetric dimethylarginine (ADMA), von Willebrand factor, fibrinogen, uric acid, cystatin C, creatinine, 24-h blood pressure monitoring (ABPM) and albuminuria.

Results: Median albuminuria in the whole group was 2.02 μg/min. No correlations were found between albuminuria and lipids, apolipoproteins, fibrinogen, von Willebrand factor, cystatin C and GFR, HbA1c, and uric acid. A significant negative correlation was found between AER and ADMA (R=−0.24, p=0.0023) and positive correlation with all ABPM variables: mean SBP (R=0.23, p=0.0049), mean DBP (R=0.24, p=0.0023), daytime MAP (R=0.31, p=0.0001), nocturnal MAP (r=0.31, p<0.0001) and with percentage of blood pressure dipping (R=−0.17, p=0.0323). A trend was noted for a positive correlation between albuminuria and Lp(a) (R=0.15, p=0.059) and BMI Z-score (R=0.14, p=0.089).

Children with albuminuria below 5 μg/min. had significantly lower level of fibrinogen (2.96±0.57 g/l vs. 3.29±0.66 g/l, p=0.0167) and mean 24-h systolic and diastolic blood pressure, mean day and nocturnal blood pressure in comparison to the subjects with higher albuminuria.

Conclusions: diabetic children with acceptable diabetes control but high-normal albuminuria together with higher level of Lp(a), fibrinogen and blood pressure may require more attention in terms of prevention of early macroangiopathy development.

Key words

albuminuria - cardiovascular risk - diabetic children
 

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