Adolescent Type 1 Diabetes Cardio-Renal Intervention Trial (AdDIT): urinary screening and baseline biochemical and cardiovascular assessments

M Loredana Marcovecchio, John Woodside, Timothy Jones, Denis Daneman, Andrew Neil, Toby Prevost, R Neil Dalton, John Deanfield, David B Dunger, Carlo Acerini, Binu Anand, Tim Barrett, Virginia Birrell, Fiona Campbell, Fran Ackland, Tim Cheetham, Chris Cooper, Ian Doughty, Atanu Dutta, Julie Edge Julian P H Shield, James Heywood, Nicola Leech, Nick Mann, Richard Parker, Gerry Rayman, Jonathon Mark Robinson, Michelle Russell-Taylor, Vengudi Sankar, Nandu Thalange, Mark Wilson, Phil Bergman, Christine Rodda, Fergus Cameron , Andrew Cotterill, Jennifer Couper, Elizabeth Davis, Kim Donaghue, Maria Craig, Bruce King, Charles Verge, Farid Mahmud, Cheril Clarson, Jacqueline Curtis, Etien Sochett

Research output: Contribution to journalArticle (Academic Journal)

44 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)805-13
Number of pages9
JournalDiabetes Care
Volume37
Issue number3
DOIs
Publication statusPublished - 2014

Keywords

  • Adolescent
  • Albuminuria
  • Angiotensin-Converting Enzyme Inhibitors
  • Apolipoprotein A-I
  • Biomarkers
  • C-Reactive Protein
  • Carotid Intima-Media Thickness
  • Creatinine
  • Cystatin C
  • Diabetes Mellitus, Type 1
  • Diabetic Angiopathies
  • Diabetic Nephropathies
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Male
  • Prediabetic State
  • Pulse Wave Analysis
  • Risk Factors
  • Young Adult
  • Journal Article
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

Fingerprint Dive into the research topics of 'Adolescent Type 1 Diabetes Cardio-Renal Intervention Trial (AdDIT): urinary screening and baseline biochemical and cardiovascular assessments'. Together they form a unique fingerprint.

Cite this