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dc.contributor.authorBenitez-Aguirre, Paul Z
dc.contributor.authorMarcovecchio, Loredana
dc.contributor.authorChiesa, Scott T
dc.contributor.authorCraig, Maria E
dc.contributor.authorWong, Tien Y
dc.contributor.authorDavis, Elizabeth A
dc.contributor.authorCotterill, Andrew
dc.contributor.authorCouper, Jenny J
dc.contributor.authorCameron, Fergus J
dc.contributor.authorMahmud, Farid H
dc.contributor.authorNeil, H Andrew W
dc.contributor.authorJones, Timothy W
dc.contributor.authorHodgson, Lauren AB
dc.contributor.authorDalton, R Neil
dc.contributor.authorMarshall, Sally M
dc.contributor.authorDeanfield, John
dc.contributor.authorDunger, David B
dc.contributor.authorDonaghue, Kim C
dc.contributor.authorAdolescent Type 1 Diabetes Cardio-Renal Intervention Trial (AdDIT)
dc.date.accessioned2021-12-07T00:30:42Z
dc.date.available2021-12-07T00:30:42Z
dc.date.issued2022-05
dc.identifier.issn0012-186X
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/331245
dc.description.abstractAIMS/HYPOTHESIS: We hypothesised that adolescents with type 1 diabetes with a urinary albumin/creatinine ratio (ACR) in the upper tertile of the normal range (high ACR) are at greater risk of three-step diabetic retinopathy progression (3DR) independent of glycaemic control. METHODS: This was a prospective observational study in 710 normoalbuminuric adolescents with type 1 diabetes from the non-intervention cohorts of the Adolescent Cardio-Renal Intervention Trial (AdDIT). Participants were classified as 'high ACR' or 'low ACR' (lowest and middle ACR tertiles) using baseline standardised log10 ACR. The primary outcome, 3DR, was determined from centrally graded, standardised two-field retinal photographs. 3DR risk was determined using multivariable Cox regression for the effect of high ACR, with HbA1c, BP, LDL-cholesterol and BMI as covariates; diabetes duration was the time-dependent variable. RESULTS: At baseline mean ± SD age was 14.3 ± 1.6 years and mean ± SD diabetes duration was 7.2 ± 3.3 years. After a median of 3.2 years, 83/710 (12%) had developed 3DR. In multivariable analysis, high ACR (HR 2.1 [1.3, 3.3], p=0.001), higher mean IFCC HbA1c (HR 1.03 [1.01, 1.04], p=0.001) and higher baseline diastolic BP SD score (HR 1.43 [1.08, 1.89], p=0.01) were independently associated with 3DR risk. CONCLUSIONS/INTERPRETATION: High ACR is associated with greater risk of 3DR in adolescents, providing a target for future intervention studies. TRIAL REGISTRATION: isrctn.org ISRCTN91419926.
dc.description.sponsorshipNational Health and Medical Research Council of Australia (NHMRC) 632521, Juvenile Diabetes Foundation International, British Heart Foundation, Diabetes UK, Canadian Clinical Trial Network.
dc.publisherSpringer Science and Business Media LLC
dc.rightsAll Rights Reserved
dc.rights.urihttp://www.rioxx.net/licenses/all-rights-reserved
dc.titleUrinary albumin/creatinine ratio tertiles predict risk of diabetic retinopathy progression: a natural history study from the Adolescent Cardio-Renal Intervention Trial (AdDIT) observational cohort.
dc.typeArticle
dc.publisher.departmentDepartment of Paediatrics
dc.date.updated2021-12-03T15:07:27Z
prism.publicationNameDiabetologia
dc.identifier.doi10.17863/CAM.78690
dcterms.dateAccepted2021-12-01
rioxxterms.versionofrecord10.1007/s00125-022-05661-1
rioxxterms.versionAM
dc.contributor.orcidBenitez-Aguirre, Paul Z [0000-0002-7687-2898]
dc.contributor.orcidMarcovecchio, Loredana [0000-0002-4415-316X]
dc.identifier.eissn1432-0428
rioxxterms.typeJournal Article/Review
cam.issuedOnline2022-02-19
cam.orpheus.successWed Mar 23 10:26:18 GMT 2022 - Embargo updated
cam.orpheus.counter2
cam.depositDate2021-12-03
pubs.licence-identifierapollo-deposit-licence-2-1
pubs.licence-display-nameApollo Repository Deposit Licence Agreement
rioxxterms.freetoread.startdate2023-02-19


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