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High hemoglobin A1c...
High hemoglobin A1c variability is associated with early risk of microalbuminuria in children with T1D
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Raman, S. (författare)
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Dai, H. (författare)
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DeLurgio, S. A. (författare)
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visa fler...
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Williams, D. D. (författare)
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- Lind, Marcus, 1976 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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Patton, S. R. (författare)
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Spertus, J. A. (författare)
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Kosiborod, M. (författare)
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Clements, M. A. (författare)
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visa färre...
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(creator_code:org_t)
- 2015-09-17
- 2016
- Engelska.
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Ingår i: Pediatric diabetes. - : Hindawi Limited. - 1399-543X .- 1399-5448. ; 17:6, s. 398-406
- Relaterad länk:
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https://europepmc.or...
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- OBJECTIVE: To test the hypothesis that HbA1c variability, as measured by standard deviation (SD), is associated with increased risk for incident microalbuminuria and persistent microalbuminuria in pediatric type 1 diabetes (T1D). METHODS: A retrospective analysis using data from electronic health records was performed on 1195 patients from a pediatric diabetes clinic network in the Midwest USA from 1993 to 2009 with >/=1 yr of T1D, >/=4 total HbA1c values, >/=2 HbA1c values/yr, >/=1 urine microalbumin. Microalbuminuria, the main outcome was defined as albumin excretion rate >/=20 mcg/min or 2 of 3 consecutive urine microalbumin/creatinine >/=30 mg/gm. Patients who had persistently high microalbumin or who were treated with an angiotensin-converting-enzyme inhibitor within 1 yr were considered to have persistent microalbuminuria. Sex, race, age, diagnosis age, and duration were covariates. RESULTS: Median numbers of per-patient HbA1c and microalbumin results were 14 and 3, respectively. Median intrapersonal mean HbA1c and SD were 8.62% (70.72 mol/mol) and 1.47% (16.07 mmol/mol), respectively. The median interquartile range (IQR) of diagnosis age was 9.4 yr (6.26-12.02) and diabetes duration was 4.97 yr (2.93-7.64). A total of 172 patients (14.4%) developed microalbuminuria; 55 (4.6%) had persistent microalbuminuria. Patients with higher SD of HbA1c had shorter time to microalbuminuria. In time-dependent Cox Proportional Hazard models, updated SD of HbA1c was significantly associated with microalbuminuria [univariate hazard ratio (HR) 1.48 (1.25-1.76); multivariable HR 1.28 (1.04-1.58)], whereas updated mean HbA1c was not [univariate HR 1.08 (0.97-1.22); multivariable HR 1.05 (0.92-1.2)]. Patients with persistent microalbuminuria had similar HRs. CONCLUSIONS: HbA1c variability is independently associated with development of microalbuminuria in children with T1D, highlighting the importance of maintaining stable glycemic control in pediatric patients.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
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- Av författaren/redakt...
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Raman, S.
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Dai, H.
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DeLurgio, S. A.
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Williams, D. D.
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Lind, Marcus, 19 ...
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Patton, S. R.
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visa fler...
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Spertus, J. A.
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Kosiborod, M.
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Clements, M. A.
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visa färre...
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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Pediatric diabet ...
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Göteborgs universitet