Predictors of microvascular complications in type 1 diabetic patients at onset: The role of metabolic memory

Pantò, F.

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Abstract

Background Several epidemiological studies showed a close association between metabolic control and microvascular complications in type 1 Diabetes Mellitus (T1DM). The aim of our longitudinal observational study was to evaluate the predictive role of the main clinical and biochemical parameters in determining microvascular complications. Methods 376 T1DM patients, hospitalized in our division from 1991 to 2005 (mean follow-up = 10.93 ± 4.26 years) were studied. Stepwise Cox regression analysis was used to identify the influence of residual ß-cell function, ß-cell autoimmunity, HbA1c levels and other clinical and laboratory parameters in the development of microalbuminuria and retinopathy. Results The probability of developing microalbuminuria was higher in males than in females (HR 1.82; 95% CI 1.01–3.28; p = 0.044), in patients with higher mean HbA1c values (HR 2.80; 95% CI 1.63–4.83; p < 0.001), longer duration of disease (HR 1.98; 95% CI 1.10–3.57; p = 0.022) and younger age of diabetes onset (HR 0.53; 95% CI 0.03–0.92; p = 0.026). An increased probability of developing retinopathy was found in patients with higher mean HbA1c levels during follow-up (HR 2.35; 95% CI 1.34–4.12, p = 0.003), as well as at onset (HR 1.85; 95% CI 1.06–3.24; p = 0.030). Conclusions Our study suggests that among the clinical, metabolic, immunological and biochemical factors evaluated at onset, only HbA1c is predictive for the microangiopathy development in T1DM.
Lingua originaleEnglish
pagine (da-a)266-274
Numero di pagine9
RivistaEuropean Journal of Internal Medicine
Volume22
Stato di pubblicazionePublished - 2011

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Type 1 Diabetes Mellitus
Immunologic Factors
Autoimmunity
Age of Onset
Observational Studies
Longitudinal Studies
Epidemiologic Studies
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Internal Medicine

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title = "Predictors of microvascular complications in type 1 diabetic patients at onset: The role of metabolic memory",
abstract = "Background Several epidemiological studies showed a close association between metabolic control and microvascular complications in type 1 Diabetes Mellitus (T1DM). The aim of our longitudinal observational study was to evaluate the predictive role of the main clinical and biochemical parameters in determining microvascular complications. Methods 376 T1DM patients, hospitalized in our division from 1991 to 2005 (mean follow-up = 10.93 ± 4.26 years) were studied. Stepwise Cox regression analysis was used to identify the influence of residual {\ss}-cell function, {\ss}-cell autoimmunity, HbA1c levels and other clinical and laboratory parameters in the development of microalbuminuria and retinopathy. Results The probability of developing microalbuminuria was higher in males than in females (HR 1.82; 95{\%} CI 1.01–3.28; p = 0.044), in patients with higher mean HbA1c values (HR 2.80; 95{\%} CI 1.63–4.83; p < 0.001), longer duration of disease (HR 1.98; 95{\%} CI 1.10–3.57; p = 0.022) and younger age of diabetes onset (HR 0.53; 95{\%} CI 0.03–0.92; p = 0.026). An increased probability of developing retinopathy was found in patients with higher mean HbA1c levels during follow-up (HR 2.35; 95{\%} CI 1.34–4.12, p = 0.003), as well as at onset (HR 1.85; 95{\%} CI 1.06–3.24; p = 0.030). Conclusions Our study suggests that among the clinical, metabolic, immunological and biochemical factors evaluated at onset, only HbA1c is predictive for the microangiopathy development in T1DM.",
author = "{Pant{\`o}, F.} and Aldo Galluzzo and Carla Giordano and Roberto Citarrella and Amato, {Marco Calogero} and Alessandro Ciresi and Mantione, {Lucilla Maria Grazia} and Angela Criscimanna and Allotta, {Maria Luisa} and Valentina Guarnotta and Maria Accidenti",
year = "2011",
language = "English",
volume = "22",
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TY - JOUR

T1 - Predictors of microvascular complications in type 1 diabetic patients at onset: The role of metabolic memory

AU - Pantò, F.

AU - Galluzzo, Aldo

AU - Giordano, Carla

AU - Citarrella, Roberto

AU - Amato, Marco Calogero

AU - Ciresi, Alessandro

AU - Mantione, Lucilla Maria Grazia

AU - Criscimanna, Angela

AU - Allotta, Maria Luisa

AU - Guarnotta, Valentina

AU - Accidenti, Maria

PY - 2011

Y1 - 2011

N2 - Background Several epidemiological studies showed a close association between metabolic control and microvascular complications in type 1 Diabetes Mellitus (T1DM). The aim of our longitudinal observational study was to evaluate the predictive role of the main clinical and biochemical parameters in determining microvascular complications. Methods 376 T1DM patients, hospitalized in our division from 1991 to 2005 (mean follow-up = 10.93 ± 4.26 years) were studied. Stepwise Cox regression analysis was used to identify the influence of residual ß-cell function, ß-cell autoimmunity, HbA1c levels and other clinical and laboratory parameters in the development of microalbuminuria and retinopathy. Results The probability of developing microalbuminuria was higher in males than in females (HR 1.82; 95% CI 1.01–3.28; p = 0.044), in patients with higher mean HbA1c values (HR 2.80; 95% CI 1.63–4.83; p < 0.001), longer duration of disease (HR 1.98; 95% CI 1.10–3.57; p = 0.022) and younger age of diabetes onset (HR 0.53; 95% CI 0.03–0.92; p = 0.026). An increased probability of developing retinopathy was found in patients with higher mean HbA1c levels during follow-up (HR 2.35; 95% CI 1.34–4.12, p = 0.003), as well as at onset (HR 1.85; 95% CI 1.06–3.24; p = 0.030). Conclusions Our study suggests that among the clinical, metabolic, immunological and biochemical factors evaluated at onset, only HbA1c is predictive for the microangiopathy development in T1DM.

AB - Background Several epidemiological studies showed a close association between metabolic control and microvascular complications in type 1 Diabetes Mellitus (T1DM). The aim of our longitudinal observational study was to evaluate the predictive role of the main clinical and biochemical parameters in determining microvascular complications. Methods 376 T1DM patients, hospitalized in our division from 1991 to 2005 (mean follow-up = 10.93 ± 4.26 years) were studied. Stepwise Cox regression analysis was used to identify the influence of residual ß-cell function, ß-cell autoimmunity, HbA1c levels and other clinical and laboratory parameters in the development of microalbuminuria and retinopathy. Results The probability of developing microalbuminuria was higher in males than in females (HR 1.82; 95% CI 1.01–3.28; p = 0.044), in patients with higher mean HbA1c values (HR 2.80; 95% CI 1.63–4.83; p < 0.001), longer duration of disease (HR 1.98; 95% CI 1.10–3.57; p = 0.022) and younger age of diabetes onset (HR 0.53; 95% CI 0.03–0.92; p = 0.026). An increased probability of developing retinopathy was found in patients with higher mean HbA1c levels during follow-up (HR 2.35; 95% CI 1.34–4.12, p = 0.003), as well as at onset (HR 1.85; 95% CI 1.06–3.24; p = 0.030). Conclusions Our study suggests that among the clinical, metabolic, immunological and biochemical factors evaluated at onset, only HbA1c is predictive for the microangiopathy development in T1DM.

UR - http://hdl.handle.net/10447/63631

M3 - Article

VL - 22

SP - 266

EP - 274

JO - European Journal of Internal Medicine

JF - European Journal of Internal Medicine

SN - 0953-6205

ER -