RELATIONSHIP BETWEEN BLOOD-PRESSURE AND URINARY ALBUMIN EXCRETION RATE IN YOUNG DANISH TYPE-1 DIABETIC-PATIENTS - COMPARISON TO NONDIABETICCHILDREN

In 1989 a nation-wide investigation of blood pressure and urinary albu min excretion rate (AER) was carried out in 506 boys and 441 girls wit h Type 1 diabetes (approximately 80 % of total) treated at 22 paediatr ic departments. In addition a reference population from 1979 consistin g of 663 healthy non-diabetic children (334 boys, 329 girls) served as a control group with respect to blood pressure and body mass index. M icroalbuminuria was defined as AER of 20-150 mug min-1 in at least two out of three timed overnight urine collections and was diagnosed in 3 0 adolescents (16 boys, 14 girls). Five patients (3 boys, 2 girls) had overt proteinuria (AER: > 150 mug min-1). Age-related percentile char ts based on one blood pressure reading were provided for normoalbuminu ric diabetic patients and the healthy control group. The study reveale d an increase in arterial blood pressure during the period of the pube rtal growth spurt for the diabetic and non-diabetic group. The changes were most pronounced for systolic blood pressure. No statistically si gnificant difference was observed in systolic and diastolic blood pres sure between normoalbuminuric diabetic children and healthy control ch ildren. However, diabetic females aged 15-18 years had significantly h igher diastolic blood pressure (75 +/- 1 mmHg, n = 139, mean +/- SE) t han healthy control females (72 +/- 1 mmHg, n = 155, p < 0.01), and si gnificantly (p < 0.001) higher body mass index (diabetic females: 22.3 +/- 0.2 kg m-2 vs healthy females: 20.9 +/- 0.2 kg M-2, mean +/- SE). Boys aged from 15 to 18 years with Type 1 diabetes had significantly higher systolic blood pressure (123 +/- 1 mmHg, n = 164) than girls (1 17 +/- 1 mmHg, n = 139, p < 0.0001), while girls aged from 15 to 1 8 y ears had significantly higher diastolic blood pressure (75 +/- 1 mmHg, n = 139) than boys (72 +/- 1 mmHg, n = 72, p < 0.01). Among the 30 ad olescents with persistent microalbuminuria, 18 (10 boys, 8 girls) had diastolic blood pressure above the upper quartile for normoalbuminuric patients, while 2 out of 5 with macroalbuminuria had diastolic blood pressure above this limit. By multiple logistic regression the only ri sk determinants for elevated urinary albumin levels were age and diast olic blood pressure. These findings suggest that elevated arterial blo od pressure is related to the increased prevalance of microalbuminuria observed in adolescents with Type 1 diabetes.