Risk factors for microalbuminuria in children and adolescents with type 1 diabetes

Objectives: The aim of this study was to investigate the influence of sex, age, diabetes duration, puberty, blood pressure, glycemic control and paren tal blood pressure on blood pressure ou children with type 1 microalbuminur ia in diabetes. Study design: The study was a multicenter cross-sectional survey including 702 children and adolescents (age = 14.3+/-2.9 yr) with type 1 diabetes dur ation of 7.6+/-3.1 yr. One third of the population had not undergone pubert al development. Blood pressure was measured in children and their parents u sing a Dinamap instrument. Microalbuminuria was defined as a urinary albumi n excretion rate greater than or equal to 15 mu g/min measured on at least two out of three urine collections. HbA(1c), centrally measured by HPLC, wa s 8.7+/-1.5%. Results: The proportion of permanent micro-albuminuria was 5.1+/-1.6%. The prevalence was significantly enhanced after 10 yr of diabetes duration (11. 6+/-5.2%) and complete puberty (8.2+/-3.1%). Independent risk factors for m icroalbuminuria tested in a logistic regression model were diabetes duratio n (OR/1 yr = 1.04-1.32), complete puberty (OR = 5.02-8.0), and maternal hyp ertension (OR = 1.94-4.28). HbA(1c) had a borderline independent and signif icant effect (OR/1% = 0.96-1.62; p = 0.07). Conclusions: Our results indicate that pubertal adolescents with a long dur ation of the disease and maternal history of hypertension are candidates fo r targeted interventions with the objective of reducing the rate of develop ing nephropathy in these individuals.