Risk Factors Associated With the Development of Nephropathy 10 Years After Diagnosis in Taiwanese Children With Juvenile-Onset Type 1 Diabetes—A Cohort Study From the CGJDES
Objective: To examine the risk factors for diabetic nephropathy (DN) 10 years after the diagnosis of juvenile-onset type 1 diabetes mellitus (T1DM) in a Taiwanese population.Research Design and Methods: This retrospective, observational, longitudinal cohort study of 224 patients with T1DM for &g...
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| Format: | Article |
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Frontiers Media S.A.
2018-08-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fendo.2018.00429/full |
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| author | Ching-Chien Yang Chia-Hung Lin Chia-Hung Lin Nan-Kai Wang Nan-Kai Wang Chi-Chun Lai Chi-Chun Lai Fu-Sung Lo Fu-Sung Lo The Chang Gung Juvenile Diabetes Eye Study Group Tun-Lu Chen An-Ning Chao Kuan-Jen Chen Yih-Shiou Hwang Yen-Po Chen Yih-Hsin Chen |
| author_facet | Ching-Chien Yang Chia-Hung Lin Chia-Hung Lin Nan-Kai Wang Nan-Kai Wang Chi-Chun Lai Chi-Chun Lai Fu-Sung Lo Fu-Sung Lo The Chang Gung Juvenile Diabetes Eye Study Group Tun-Lu Chen An-Ning Chao Kuan-Jen Chen Yih-Shiou Hwang Yen-Po Chen Yih-Hsin Chen |
| author_sort | Ching-Chien Yang |
| collection | DOAJ |
| description | Objective: To examine the risk factors for diabetic nephropathy (DN) 10 years after the diagnosis of juvenile-onset type 1 diabetes mellitus (T1DM) in a Taiwanese population.Research Design and Methods: This retrospective, observational, longitudinal cohort study of 224 patients with T1DM for >10 years (mean duration 12.6 years) included participants from the Chang Gung Juvenile Diabetes Eye Study Group. The patients received a T1DM diagnosis before the age of 18 years and were treated at the pediatric endocrine department of Chang Gung Memorial Hospital in Taiwan. The epidemiological and laboratory data such as age, sex, duration of diabetes, self-reported smoking, blood pressure, lipid profiles, urinalysis, and glycated hemoglobin A1c (HbA1c) levels were collected from medical records retrospectively for investigating the relationship between the clinical parameters and the development of DN in T1DM.Results: During follow-up, 44 of the 224 patients (19.6%) developed DN, of whom 61.4% were female. Cox proportional hazards model analysis indicated that the female (HR 3.40, 95% CI 1.66–6.96, p = 0.001), smoking (HR 3.60, 95% CI 1.28–10.10, p = 0.015), HbA1c level (HR 1.27, 95% CI 1.07–1.49, p = 0.005), diastolic blood pressure (HR 1.06, 95% CI 1.03–1.09, p < 0.001) were significantly correlated with DN after adjustment for multiple variables. The tight glucose control with multiple daily injections produced 49 % risk reduction (HR 0.51, 95% CI 0.26–0.98, p = 0.043).Conclusions: The risk of DN in patients with juvenile-onset T1DM 10 years after the T1DM diagnosis was increased with female, smoking, high HbA1c, diastolic blood pressure levels and attenuated by intensive therapy. |
| first_indexed | 2024-12-22T15:33:03Z |
| format | Article |
| id | doaj.art-d7177847255f4230b989feda1aafac9d |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-12-22T15:33:03Z |
| publishDate | 2018-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-d7177847255f4230b989feda1aafac9d2022-12-21T18:21:19ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922018-08-01910.3389/fendo.2018.00429386188Risk Factors Associated With the Development of Nephropathy 10 Years After Diagnosis in Taiwanese Children With Juvenile-Onset Type 1 Diabetes—A Cohort Study From the CGJDESChing-Chien Yang0Chia-Hung Lin1Chia-Hung Lin2Nan-Kai Wang3Nan-Kai Wang4Chi-Chun Lai5Chi-Chun Lai6Fu-Sung Lo7Fu-Sung Lo8The Chang Gung Juvenile Diabetes Eye Study GroupTun-Lu ChenAn-Ning ChaoKuan-Jen ChenYih-Shiou HwangYen-Po ChenYih-Hsin ChenDivision of Pediatric Endocrinology and Genetics, Department of Pediatrics, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, TaiwanDivision of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, TaiwanDepartment of Medicine, College of Medicine, Taoyuan, TaiwanDepartment of Medicine, College of Medicine, Taoyuan, TaiwanDepartment of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, TaiwanDepartment of Medicine, College of Medicine, Taoyuan, TaiwanDepartment of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, TaiwanDivision of Pediatric Endocrinology and Genetics, Department of Pediatrics, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, TaiwanDepartment of Medicine, College of Medicine, Taoyuan, TaiwanObjective: To examine the risk factors for diabetic nephropathy (DN) 10 years after the diagnosis of juvenile-onset type 1 diabetes mellitus (T1DM) in a Taiwanese population.Research Design and Methods: This retrospective, observational, longitudinal cohort study of 224 patients with T1DM for >10 years (mean duration 12.6 years) included participants from the Chang Gung Juvenile Diabetes Eye Study Group. The patients received a T1DM diagnosis before the age of 18 years and were treated at the pediatric endocrine department of Chang Gung Memorial Hospital in Taiwan. The epidemiological and laboratory data such as age, sex, duration of diabetes, self-reported smoking, blood pressure, lipid profiles, urinalysis, and glycated hemoglobin A1c (HbA1c) levels were collected from medical records retrospectively for investigating the relationship between the clinical parameters and the development of DN in T1DM.Results: During follow-up, 44 of the 224 patients (19.6%) developed DN, of whom 61.4% were female. Cox proportional hazards model analysis indicated that the female (HR 3.40, 95% CI 1.66–6.96, p = 0.001), smoking (HR 3.60, 95% CI 1.28–10.10, p = 0.015), HbA1c level (HR 1.27, 95% CI 1.07–1.49, p = 0.005), diastolic blood pressure (HR 1.06, 95% CI 1.03–1.09, p < 0.001) were significantly correlated with DN after adjustment for multiple variables. The tight glucose control with multiple daily injections produced 49 % risk reduction (HR 0.51, 95% CI 0.26–0.98, p = 0.043).Conclusions: The risk of DN in patients with juvenile-onset T1DM 10 years after the T1DM diagnosis was increased with female, smoking, high HbA1c, diastolic blood pressure levels and attenuated by intensive therapy.https://www.frontiersin.org/article/10.3389/fendo.2018.00429/fulltype 1 diabetes mellitusdiabetic nephropathyadolescentschildrenrisk factors |
| spellingShingle | Ching-Chien Yang Chia-Hung Lin Chia-Hung Lin Nan-Kai Wang Nan-Kai Wang Chi-Chun Lai Chi-Chun Lai Fu-Sung Lo Fu-Sung Lo The Chang Gung Juvenile Diabetes Eye Study Group Tun-Lu Chen An-Ning Chao Kuan-Jen Chen Yih-Shiou Hwang Yen-Po Chen Yih-Hsin Chen Risk Factors Associated With the Development of Nephropathy 10 Years After Diagnosis in Taiwanese Children With Juvenile-Onset Type 1 Diabetes—A Cohort Study From the CGJDES Frontiers in Endocrinology type 1 diabetes mellitus diabetic nephropathy adolescents children risk factors |
| title | Risk Factors Associated With the Development of Nephropathy 10 Years After Diagnosis in Taiwanese Children With Juvenile-Onset Type 1 Diabetes—A Cohort Study From the CGJDES |
| title_full | Risk Factors Associated With the Development of Nephropathy 10 Years After Diagnosis in Taiwanese Children With Juvenile-Onset Type 1 Diabetes—A Cohort Study From the CGJDES |
| title_fullStr | Risk Factors Associated With the Development of Nephropathy 10 Years After Diagnosis in Taiwanese Children With Juvenile-Onset Type 1 Diabetes—A Cohort Study From the CGJDES |
| title_full_unstemmed | Risk Factors Associated With the Development of Nephropathy 10 Years After Diagnosis in Taiwanese Children With Juvenile-Onset Type 1 Diabetes—A Cohort Study From the CGJDES |
| title_short | Risk Factors Associated With the Development of Nephropathy 10 Years After Diagnosis in Taiwanese Children With Juvenile-Onset Type 1 Diabetes—A Cohort Study From the CGJDES |
| title_sort | risk factors associated with the development of nephropathy 10 years after diagnosis in taiwanese children with juvenile onset type 1 diabetes a cohort study from the cgjdes |
| topic | type 1 diabetes mellitus diabetic nephropathy adolescents children risk factors |
| url | https://www.frontiersin.org/article/10.3389/fendo.2018.00429/full |
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