• Chi-Yu Huang, Wei-Hsin Ting, Fu-Sung Lo, Jeng-Daw Tsai, Fang-Ju Sun, Chon-In Chan, Ya-Ting Chiang, Chao-Hsu Lin, Bi-Wen Cheng, Yi-Lei Wu, Chen-Mei Hung, and Yann-Jinn Lee.
• Department of Pediatric Endocrinology, MacKay Children's Hospital, Taiwan, ROC; MacKay Junior College of Medicine, Nursing, and Management, Taiwan, ROC; Department of Medicine, Mackay Medical College, Taiwan, ROC.
• J Formos Med Assoc. 2017 Dec 1; 116 (12): 924932924-932.

Backbroud/PurposeMicroalbuminuria and macroalbuminuria are markers of diabetic nephropathy (DN). The purpose of this study was to unravel the risk factors for DN in the young patients with type 1 diabetes (T1D).Methods341 patients (160 males) with T1D diagnosed at the age 7.6 ± 4.0 years with disease duration 11.5 ± 6.5 years were assessed. Among them, 185 were young adults (aged 18.0-36.2 years). Urinary albumin creatinine ratio (UACR) was checked on morning spot urine. Microalbuminuria and macroalbuminuria were defined as a UACR of 30-300 mg/g and >300 mg/g, respectively, in at least 2 consecutive specimens.Results50 (14.7%) patients were classified as microalbuminuria and 13 (3.8%) as macroalbuminuria. In all patients, multivariate logistic regression revealed that the most significant risk factors were average HbA1c (%), OR (95% CI) = 1.76 (1.37-2.25), P = 0.002); and male sex, OR = (odd ratio 2.31 (1.19-4.46), P = 0.013). In adult patients, the most significant factors were average HbA1c, OR = 1.74 (1.32-2.31), P = 0.003; and systolic blood pressure, OR = 1.06 (1.01-1.11), P = 0.011. Survival analysis showed average HbA1c levels significantly influenced the development of DN.ConclusionThe most important risk factors for DN were average HbA1c and age. When microalbuminuria is detected, proper treatment with ACEIs or ARBs and improving glycemic control can delay progression of DN.Copyright © 2017. Published by Elsevier B.V.

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