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dc.contributor.authorMarcovecchio, M Loredana
dc.contributor.authorChiesa, Scott T
dc.contributor.authorArmitage, Jane
dc.contributor.authorDaneman, Denis
dc.contributor.authorDonaghue, Kim C
dc.contributor.authorJones, Timothy W
dc.contributor.authorMahmud, Farid H
dc.contributor.authorMarshall, Sally M
dc.contributor.authorNeil, H Andrew W
dc.contributor.authorDalton, R Neil
dc.contributor.authorDeanfield, John
dc.contributor.authorDunger, David
dc.contributor.authorAdolescent Type 1 Diabetes Cardio-Renal Intervention Trial (AdDIT) Study Group
dc.date.accessioned2018-10-10T10:45:28Z
dc.date.available2018-10-10T10:45:28Z
dc.date.issued2018-09
dc.identifier.issn0149-5992
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/283545
dc.description.abstractOBJECTIVE: Baseline data from the Adolescent Type 1 Diabetes Cardio-Renal Intervention Trial (AdDIT) indicated that tertiles of urinary albumin-to-creatinine ratios (ACRs) in the normal range at age 10-16 years are associated with risk markers for diabetic nephropathy (DN) and cardiovascular disease (CVD). We aimed to determine whether the top ACR tertile remained associated with DN and CVD risk over the 2-4-year AdDIT study. RESEARCH DESIGN AND METHODS: One hundred fifty adolescents (mean age 14.1 years [SD 1.6]) with baseline ACR in the upper tertile (high-ACR group) recruited to the AdDIT trial, who remained untreated, and 396 (age 14.3 years [1.6]) with ACR in the middle and lower tertiles (low-ACR group), who completed the parallel AdDIT observational study, were evaluated prospectively with assessments of ACR and renal and CVD markers, combined with carotid intima-media thickness (cIMT) at baseline and end of study. RESULTS: After a median follow-up of 3.9 years, the cumulative incidence of microalbuminuria was 16.3% in the high-ACR versus 5.5% in the low-ACR group (log-rank P < 0.001). Cox models showed independent contributions of the high-ACR group (hazard ratio 4.29 [95% CI 2.08-8.85]) and HbA1c (1.37 [1.10-1.72]) to microalbuminuria risk. cIMT change from baseline was significantly greater in the high- versus low-ACR group (mean difference 0.010 mm [0.079], P = 0.006). Changes in estimated glomerular filtration rate, systolic blood pressure, and hs-CRP were also significantly greater in the high-ACR group (P < 0.05). CONCLUSIONS: ACR at the higher end of the normal range at the age of 10-16 years is associated with an increased risk of progression to microalbuminuria and future CVD risk, independently of HbA1c.
dc.description.sponsorshipAdDIT was funded by Diabetes UK, Juvenile Diabetes Research Foundation, the British Heart Foundation and in Canada the JDRF- Canadian Clinical Trial Network (CCTN), the Canadian Diabetes Association and the Heart and Stroke Foundation Canada.
dc.format.mediumPrint-Electronic
dc.languageeng
dc.publisherAmerican Diabetes Association
dc.subjectAdolescent Type 1 Diabetes Cardio-Renal Intervention Trial (AdDIT) Study Group
dc.subjectKidney
dc.subjectHumans
dc.subjectDiabetic Nephropathies
dc.subjectAlbuminuria
dc.subjectCardiovascular Diseases
dc.subjectDiabetic Angiopathies
dc.subjectDiabetes Mellitus, Type 1
dc.subjectCreatinine
dc.subjectGlomerular Filtration Rate
dc.subjectUrinalysis
dc.subjectRisk Factors
dc.subjectBlood Pressure
dc.subjectAdolescent
dc.subjectChild
dc.subjectFemale
dc.subjectMale
dc.subjectCarotid Intima-Media Thickness
dc.titleRenal and Cardiovascular Risk According to Tertiles of Urinary Albumin-to-Creatinine Ratio: The Adolescent Type 1 Diabetes Cardio-Renal Intervention Trial (AdDIT).
dc.typeArticle
prism.endingPage1969
prism.issueIdentifier9
prism.publicationDate2018
prism.publicationNameDiabetes Care
prism.startingPage1963
prism.volume41
dc.identifier.doi10.17863/CAM.30908
dcterms.dateAccepted2018-06-17
rioxxterms.versionofrecord10.2337/dc18-1125
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2018-09
dc.contributor.orcidJones, Timothy W [0000-0002-7989-1998]
dc.contributor.orcidMahmud, Farid H [0000-0002-4988-8480]
dc.contributor.orcidDunger, David [0000-0002-2566-9304]
dc.identifier.eissn1935-5548
rioxxterms.typeJournal Article/Review
pubs.funder-project-idJuvenile Diabetes Research Foundation Ltd (JDRF) (8-2007-902)
pubs.funder-project-idBritish Heart Foundation (via University College London (UCL)) (07CC14)
pubs.funder-project-idDiabetes UK (RD06/0003341)
pubs.funder-project-idDiabetes UK (None)
pubs.funder-project-idDiabetes UK (None)
cam.issuedOnline2018-07-19


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