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Clustering of cardio-metabolic risk factors in parents of adolescents with type 1 diabetes and microalbuminuria

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M. Loredana Marcovecchio, Päivi H. Tossavainen, Katharine Owen, Catherine Fullah, Paul Benitez-Aguirre, Stefano Masi, Ken Ong, Helen Nguyen, Scott T. Chiesa, Neil Dalton, John Deanfield, David B. Dunger

Original languageEnglish
JournalPEDIATRIC DIABETES
Early online date8 Mar 2017
DOIs
Accepted/In press6 Feb 2017
E-pub ahead of print8 Mar 2017

King's Authors

Abstract

Objective: To evaluate the association between a clustering of cardio-metabolic risk factors in parents and the development of microalbuminuria (MA) in their offspring with childhood-onset type 1 diabetes (T1D). Methods: The study population comprised 53 parents (mean age [±SD]: 56.7±6.2years) of 35 T1D young people with MA (MA+) and 86 parents (age: 56.1±6.3years) of 50 matched offspring with normoalbuminuria (MA-), who underwent clinical, biochemical and cardiovascular imaging assessments. The primary study endpoint was the difference between parents from the MA+ and MA- groups in a cardio-metabolic risk score, calculated as the average value of the standardized measures (z-scores) for waist circumference, blood pressure, fasting glucose, insulin, HDL-cholesterol and triglycerides levels. Cardiovascular parameters, including carotid intima-media thickness (cIMT), flow-mediated dilatation (FMD) and pulse wave velocity (PWV), were also assessed. A DXA scan was performed to assess body composition. Results: The cardio-metabolic risk score was significantly higher in parents of MA+ compared to parents of MA- offspring (mean [95% CI]: 1.066[0.076; 2.056] vs -0.268[-0.997; 0.460], P = .03). Parents of MA+ offspring had slightly higher values of waist circumference, lipids, insulin and blood pressure, although only diastolic blood pressure was statistically different between the 2 groups (P = .0085). FMD, cIMT, PWV (all P > .3), and DXA parameters (all P > .2) were not significantly different between the 2 groups. Conclusions: Parents of young offspring with childhood-onset T1D and MA showed an abnormal metabolic profile, reflected by a calculated risk score. The finding supports the role of a familial predisposition to risk of developing diabetic nephropathy.

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