The risk for diabetic nephropathy is low in young adults in a 17-year follow-up of the Diabetes Incidence Study in Sweden (DISS): Higher age and BMI at diabetes onset can be important risk factors
2015 (English)In: Diabetes/Metabolism Research Reviews, ISSN 1520-7552, E-ISSN 1520-7560, Vol. 31, no 2, 138-146 p.Article in journal (Refereed) Published
AIMS: To estimate the occurrence of diabetic nephropathy (DN) in a population-based cohort of patients diagnosed with diabetes as young adults (15-34 years). Methods: All 794 patients registered 1987-1988 in the Diabetes Incidence Study in Sweden (DISS) were invited to a follow-up study 15-19 years after diagnosis and 468 (58%) participated. Islet cell antibodies were used to classify type of diabetes.
RESULTS: After median 17 years of diabetes 15% of all patients, 14% T1DM and 25% T2DM, were diagnosed with DN. 91% had micro- and 8.6% macroalbuminuria. Older age at diagnosis (HR 1.05; 95% CI 1.01-1.10 per year) was an independent and a higher BMI at diabetes diagnosis (HR 1.04; 95% CI 1.00-1.09 per 1 kg/m(2) ) a near-significant predictor of development of DN. Age at onset of diabetes (p = 0.041), BMI (p = 0.012) and HbA1c (p < 0.001) were significant predictors of developing DN between 9 and 17 years of diabetes. At 17 years of diabetes duration, a high HbA1c level (OR 1.06; 95% CI 1.03-1.08 per 1 mmol/mol increase) and systolic blood pressure (OR 1.08; 95% CI 1.05-1.12 per 1 mmHg increase) were associated with DN.
CONCLUSIONS: Patients with T2DM diagnosed as young adults seem to have an increased risk to develop DN compared to those with T1DM. Older age and higher BMI at diagnosis of diabetes were risk markers of development of DN. In addition, poor glycaemic control but not systolic blood pressure at 9 years of follow up were risk markers for later development of DN.
Place, publisher, year, edition, pages
John Wiley & Sons, 2015. Vol. 31, no 2, 138-146 p.
diabetic nephropathy;hyperglycemia;blood pressure;type 1 diabetes mellitus;type 2 diabetes mellitus;islet antibodies
Endocrinology and Diabetes
IdentifiersURN: urn:nbn:se:umu:diva-91950DOI: 10.1002/dmrr.2574ISI: 000349969600003PubMedID: 25044633OAI: oai:DiVA.org:umu-91950DiVA: diva2:738619
FunderSwedish Research Council, 14531Swedish Research Council, 14287