Repository logo
 

Cardiac autonomic dysfunction is associated with high-risk albumin-to-creatinine ratio in young adolescents with type 1 diabetes in AdDIT (adolescent type 1 diabetes cardio-renal interventional trial).

Simple item page
cam.issuedOnline2015-01-08
dc.contributor.authorCho, Yoon Hi
dc.contributor.authorCraig, Maria E
dc.contributor.authorDavis, Elizabeth A
dc.contributor.authorCotterill, Andrew M
dc.contributor.authorCouper, Jennifer J
dc.contributor.authorCameron, Fergus J
dc.contributor.authorBenitez-Aguirre, Paul Z
dc.contributor.authorDalton, R Neil
dc.contributor.authorDunger, David B
dc.contributor.authorJones, Timothy W
dc.contributor.authorDonaghue, Kim C
dc.contributor.authorAdolescent Type 1 Diabetes Cardio-Renal Intervention Trial
dc.contributor.orcidDunger, David [0000-0002-2566-9304]
dc.date.accessioned2015-08-06T13:09:45Z
dc.date.available2015-08-06T13:09:45Z
dc.date.issued2015-04
dc.description.abstractOBJECTIVE: This study examined the association between cardiac autonomic dysfunction and high albumin-to-creatinine ratio (ACR) in adolescents with type 1 diabetes. RESEARCH DESIGN AND METHODS: Adolescents recruited as part of a multicenter screening study (n = 445, 49% female, aged 10-17 years, mean duration 6.9 years; mean HbA1c 8.4%, 68 mmol/mol) underwent a 10-min continuous electrocardiogram recording for heart rate variability analysis. Time-domain heart rate variability measures included baseline heart rate, SD of the R-R interval (SDNN), and root mean squared difference of successive R-R intervals (RMSSD). Spectral analysis included sympathetic (low-frequency) and parasympathetic (high-frequency) components. Standardized ACR were calculated from six early morning urine collections using an established algorithm, reflecting age, sex, and duration, and stratified into ACR tertiles, where the upper tertile reflects higher nephropathy risk. RESULTS: The upper-tertile ACR group had a faster heart rate (76 vs. 73 bpm; P < 0.01) and less heart rate variability (SDNN 68 vs. 76 ms, P = 0.02; RMSSD 63 vs. 71 ms, P = 0.04). HbA1c was 8.5% (69 mmol/mmol) in the upper tertile vs. 8.3% (67 mmol/mol) in the lower tertiles (P = 0.07). In multivariable analysis, upper-tertile ACR was associated with faster heart rate (β = 2.5, 95% CI 0.2-4.8, P = 0.03) and lower RMSSD (β = -9.5, 95% CI -18.2 to -0.8, P = 0.03), independent of age and HbA1c. CONCLUSIONS: Adolescents at potentially higher risk for nephropathy show an adverse cardiac autonomic profile, indicating sympathetic overdrive, compared with the lower-risk group. Longitudinal follow-up of this cohort will further characterize the relationship between autonomic and renal dysfunction and the effect of interventions in this population.
dc.description.sponsorshipNational Health and Medical Research Council, Australia (NHMRC) 632521, Australasian Paediatric Endocrine Group (APEG), Juvenile Diabetes Research Foundation, British Heart Foundation, Diabetes UK.
dc.description.versionThis is the accepted manuscript. The final version is available at http://care.diabetesjournals.org/content/early/2015/01/01/dc14-1848.
dc.identifier.citationCho et al. Diabetes Care (2015) Vol. 38 Issue 4, pp. 676-681 . DOI: 10.2337/dc14-1848
dc.identifier.eissn1935-5548
dc.identifier.issn0149-5992
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/249224
dc.languageEnglish
dc.language.isoeng
dc.publisherAmerican Diabetes Association
dc.publisher.urlhttp://dx.doi.org/10.2337/dc14-1848
dc.rioxxterms.funderBHF
dc.subjectAdolescent
dc.subjectAlbumins
dc.subjectAutonomic Nervous System
dc.subjectBlood Pressure
dc.subjectCreatinine
dc.subjectDiabetes Mellitus, Type 1
dc.subjectDiabetic Nephropathies
dc.subjectElectrocardiography
dc.subjectFemale
dc.subjectHeart
dc.subjectHeart Rate
dc.subjectHumans
dc.subjectMale
dc.subjectRisk Factors
dc.titleCardiac autonomic dysfunction is associated with high-risk albumin-to-creatinine ratio in young adolescents with type 1 diabetes in AdDIT (adolescent type 1 diabetes cardio-renal interventional trial).
dc.typeArticle
prism.endingPage681
prism.publicationDate2015
prism.publicationNameDiabetes Care
prism.startingPage676
prism.volume38
pubs.funder-project-idDiabetes UK (None)
pubs.funder-project-idBritish Heart Foundation (via University College London (UCL)) (07CC14)
pubs.funder-project-idJuvenile Diabetes Research Foundation Ltd (JDRF) (8-2007-902)
pubs.funder-project-idDiabetes UK (06/0003341)
rioxxterms.licenseref.startdate2015-01-08
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.typeJournal Article/Review
rioxxterms.versionofrecord10.2337/dc14-1848

Files

Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Cho et al 2015 Diabetes Care.pdf
Size:
239.67 KB
Format:
Adobe Portable Document Format
Licence
http://www.rioxx.net/licenses/all-rights-reserved
Download
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
3.82 KB
Format:
Item-specific license agreed upon to submission
Download

Collections

Scholarly Works - Paediatrics
Symplectic mapped items for data match