TY - JOUR
T1 - Adolescent Type 1 Diabetes Cardio-Renal Intervention Trial (AdDIT)
T2 - urinary screening and baseline biochemical and cardiovascular assessments
AU - Marcovecchio, M Loredana
AU - Woodside, John
AU - Jones, Timothy
AU - Daneman, Denis
AU - Neil, Andrew
AU - Prevost, Toby
AU - Dalton, R Neil
AU - Deanfield, John
AU - Dunger, David B
AU - Acerini, Carlo
AU - Anand, Binu
AU - Barrett, Tim
AU - Birrell, Virginia
AU - Campbell, Fiona
AU - Ackland, Fran
AU - Cheetham, Tim
AU - Cooper, Chris
AU - Doughty, Ian
AU - Dutta, Atanu
AU - Edge , Julie
AU - Shield, Julian P H
AU - Heywood, James
AU - Leech, Nicola
AU - Mann, Nick
AU - Parker, Richard
AU - Rayman, Gerry
AU - Robinson, Jonathon Mark
AU - Russell-Taylor, Michelle
AU - Sankar, Vengudi
AU - Thalange, Nandu
AU - Wilson, Mark
AU - Bergman, Phil
AU - Rodda, Christine
AU - Cameron , Fergus
AU - Cotterill, Andrew
AU - Couper, Jennifer
AU - Davis, Elizabeth
AU - Donaghue, Kim
AU - Craig, Maria
AU - King, Bruce
AU - Verge, Charles
AU - Mahmud, Farid
AU - Clarson, Cheril
AU - Curtis, Jacqueline
AU - Sochett, Etien
PY - 2014
Y1 - 2014
N2 - OBJECTIVE: We assessed the association between early increases in albumin excretion and cardiovascular (CV) and renal markers in a large cohort of young people with type 1 diabetes.RESEARCH DESIGN AND METHODS: As part of preliminary screening for a multicenter, randomized controlled trial of statins/ACE inhibitors, we measured albumin-creatinine ratio (ACR) in six early morning urine samples from 3,353 adolescents (10-16 years of age) and calculated tertiles based on an established algorithm. From those subjects deemed to be at higher risk (upper ACR tertile), we recruited 400 into the intervention study (trial cohort). From those subjects deemed to be at lower risk (middle-lower ACR tertiles), we recruited 329 to the observation cohort. At baseline, vascular measurements (carotid intima-media thickness, pulse wave velocity [PWV], flow-mediated dilatation, digital pulse amplitude tonometry), renal markers (symmetric dimethylarginine, cystatin C, creatinine), and CV disease markers (lipids and apolipoproteins [Apo] A-1 and B, C-reactive protein, asymmetric dimethylarginine) were assessed.RESULTS: Age- and sex-adjusted PWV was higher in the trial than in the observational cohort (5.00 ± 0.84 vs. 4.86 ± 0.70 m/s; P = 0.021). Similarly, non-HDL cholesterol (2.95 ± 0.83 vs. 2.81 ± 0.78 mmol/L; P = 0.02) and ApoB-ApoA-1 ratio (0.50 ± 0.14 vs. 0.47 ± 0.11; P = 0.04) were higher in the trial cohort. Cystatin C and creatinine were decreased (0.88 ± 0.13 vs. 0.90 ± 0.13 mg/L, P = 0.04; 51.81 ± 10.45 vs. 55.35 ± 11.05 μmol/L, P < 0.001; respectively) and estimated glomerular filtration rate (137.05 ± 23.89 vs. 129.31 ± 22.41 mL/min/1.73 m(2); P < 0.001) increased in the trial compared with the observational cohort.CONCLUSIONS: Our data demonstrate that in adolescents with type 1 diabetes, the group with the highest tertile of albumin excretion showed more evidence of early renal and CV disease than those in the lower tertiles.
AB - OBJECTIVE: We assessed the association between early increases in albumin excretion and cardiovascular (CV) and renal markers in a large cohort of young people with type 1 diabetes.RESEARCH DESIGN AND METHODS: As part of preliminary screening for a multicenter, randomized controlled trial of statins/ACE inhibitors, we measured albumin-creatinine ratio (ACR) in six early morning urine samples from 3,353 adolescents (10-16 years of age) and calculated tertiles based on an established algorithm. From those subjects deemed to be at higher risk (upper ACR tertile), we recruited 400 into the intervention study (trial cohort). From those subjects deemed to be at lower risk (middle-lower ACR tertiles), we recruited 329 to the observation cohort. At baseline, vascular measurements (carotid intima-media thickness, pulse wave velocity [PWV], flow-mediated dilatation, digital pulse amplitude tonometry), renal markers (symmetric dimethylarginine, cystatin C, creatinine), and CV disease markers (lipids and apolipoproteins [Apo] A-1 and B, C-reactive protein, asymmetric dimethylarginine) were assessed.RESULTS: Age- and sex-adjusted PWV was higher in the trial than in the observational cohort (5.00 ± 0.84 vs. 4.86 ± 0.70 m/s; P = 0.021). Similarly, non-HDL cholesterol (2.95 ± 0.83 vs. 2.81 ± 0.78 mmol/L; P = 0.02) and ApoB-ApoA-1 ratio (0.50 ± 0.14 vs. 0.47 ± 0.11; P = 0.04) were higher in the trial cohort. Cystatin C and creatinine were decreased (0.88 ± 0.13 vs. 0.90 ± 0.13 mg/L, P = 0.04; 51.81 ± 10.45 vs. 55.35 ± 11.05 μmol/L, P < 0.001; respectively) and estimated glomerular filtration rate (137.05 ± 23.89 vs. 129.31 ± 22.41 mL/min/1.73 m(2); P < 0.001) increased in the trial compared with the observational cohort.CONCLUSIONS: Our data demonstrate that in adolescents with type 1 diabetes, the group with the highest tertile of albumin excretion showed more evidence of early renal and CV disease than those in the lower tertiles.
KW - Adolescent
KW - Albuminuria
KW - Angiotensin-Converting Enzyme Inhibitors
KW - Apolipoprotein A-I
KW - Biomarkers
KW - C-Reactive Protein
KW - Carotid Intima-Media Thickness
KW - Creatinine
KW - Cystatin C
KW - Diabetes Mellitus, Type 1
KW - Diabetic Angiopathies
KW - Diabetic Nephropathies
KW - Female
KW - Humans
KW - Hydroxymethylglutaryl-CoA Reductase Inhibitors
KW - Male
KW - Prediabetic State
KW - Pulse Wave Analysis
KW - Risk Factors
KW - Young Adult
KW - Journal Article
KW - Multicenter Study
KW - Randomized Controlled Trial
KW - Research Support, Non-U.S. Gov't
UR - http://care.diabetesjournals.org/content/37/3/805.full-text.pdf
U2 - 10.2337/dc13-1634
DO - 10.2337/dc13-1634
M3 - Article (Academic Journal)
C2 - 24198300
SN - 0149-5992
VL - 37
SP - 805
EP - 813
JO - Diabetes Care
JF - Diabetes Care
IS - 3
ER -
