Journal
SCIENTIFIC REPORTS
Volume 11, Issue 1, Pages -Publisher
NATURE PORTFOLIO
DOI: 10.1038/s41598-021-88786-4
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Funding
- NIH USA [DIACOMP - NIDDK 25034-61]
- NH& MRC of Australia [GNT1102935, 1160428]
- Diabetes Australia
- Mater Foundation
- Australian Government Research Training Program (RTP) Scholarships
- Sybil and Frank Maxfield HDR Top-up Scholarship in Diabetes
- National Health and Medical Research Council of Australia [1160428] Funding Source: NHMRC
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The study found that skin autofluorescence and risk for kidney disease were positively associated in young adults with type 1 diabetes, while eGFR and diabetes duration were closely related to DKD risk.
To examine if skin autofluorescence (sAF) differed in early adulthood between individuals with type 1 diabetes and age-matched controls and to ascertain if sAF aligned with risk for kidney disease. Young adults with type 1 diabetes (N=100; 20.0 +/- 2.8 years; M:F 54:46; FBG-11.6 +/- 4.9 mmol/mol; diabetes duration 10.7 +/- 5.2 years; BMI 24.5(5.3) kg/m(2)) and healthy controls (N=299; 20.3 +/- 1.8 years; M:F-83:116; FBG 5.2 +/- 0.8 mmol/L; BMI 22.5(3.3) kg/m(2)) were recruited. Skin autofluorescence (sAF) and circulating AGEs were measured. In a subset of both groups, kidney function was estimated by GFR(CKD-EPI CysC) and uACR, and DKD risk defined by uACR tertiles. Youth with type 1 diabetes had higher sAF and BMI, and were taller than controls. For sAF, 13.6% of variance was explained by diabetes duration, height and BMI (P-model=1.5x10(-12)). In the sub-set examining kidney function, eGFR and sAF were higher in type 1 diabetes versus controls. eGFR and sAF predicted 24.5% of variance in DKD risk (P-model=2.2x10(-9)), which increased with diabetes duration (51%; P-model<2.2x10(-16)) and random blood glucose concentrations (56%; P-model<2.2x10(-16)). HbA(1C) and circulating fructosamine albumin were higher in individuals with type 1 diabetes at high versus low DKD risk. eGFR was independently associated with DKD risk in all models. Higher eGFR and longer diabetes duration are associated with DKD risk in youth with type 1 diabetes. sAF, circulating AGEs, and urinary AGEs were not independent predictors of DKD risk. Changes in eGFR should be monitored early, in addition to uACR, for determining DKD risk in type 1 diabetes.
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