Serum Uric Acid (SUA), Urinary Albumin Excretion (UAE), and Hypertension (HTN) in Adolescents with Type 2 Diabetes (T2D) in the TODAY Study

Serum Uric Acid (SUA), Urinary Albumin Excretion (UAE), and Hypertension (HTN) in Adolescents with Type 2 Diabetes (T2D) in the TODAY Study

Elevated SUA is increasingly recognized as a risk factor for kidney disease in adults with diabetes, yet there are limited data in youth. We hypothesized that elevated SUA would predict development of elevated UAE and HTN over time in teens with T2D. Serum creatinine, cystatin C, SUA, and urine albu...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Diabetes (New York, N.Y.) N.Y.), 2018-07, Vol.67 (Supplement_1)
Hauptverfasser: BJORNSTAD, PETTER, LAFFEL, LORI M., LYNCH, JANE L., GHORMLI, LAURE EL, WEINSTOCK, RUTH S., TOLLEFSEN, SHERIDA E., NADEAU, KRISTEN J.
Format: Artikel
Sprache:eng
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page
container_issue Supplement_1
container_start_page
container_title Diabetes (New York, N.Y.)
container_volume 67
creator BJORNSTAD, PETTER
LAFFEL, LORI M.
LYNCH, JANE L.
GHORMLI, LAURE EL
WEINSTOCK, RUTH S.
TOLLEFSEN, SHERIDA E.
NADEAU, KRISTEN J.
description Elevated SUA is increasingly recognized as a risk factor for kidney disease in adults with diabetes, yet there are limited data in youth. We hypothesized that elevated SUA would predict development of elevated UAE and HTN over time in teens with T2D. Serum creatinine, cystatin C, SUA, and urine albumin to creatinine ratio (ACR) were assessed in 539 youth, ages 12-17 with T2D duration
doi_str_mv 10.2337/db18-339-OR
format Article
fullrecord <record><control><sourceid>crossref</sourceid><recordid>TN_cdi_crossref_primary_10_2337_db18_339_OR</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>10_2337_db18_339_OR</sourcerecordid><originalsourceid>FETCH-crossref_primary_10_2337_db18_339_OR3</originalsourceid><addsrcrecordid>eNqVj81KxDAUhYMoWH9WvsBddtBq0oC1y2A7dGVhmoKuQn8yTKRNhyRF-wy-tOngC8hdnMvhW5wPoTuCH2NKk6e-JS8RpWlU7s5QQFL_0Th5P0cBxiSOSJIml-jK2k-M8bO_AP1U0swj1EZ1wDrVQ1jVbPOwFroxC7ChnUelIf_ujHRq0hDWLPdAo3solqM0Tmp76gv-tgGPsn4apO2kdha-lDsA9xjEkKmmlU5aCHmcnUh3kMDLjH1A5eZ-uUEX-2aw8vYvr9H9NuevRdSZyVoj9-Jo1OhXCYLF6itWX-F9Rbmj_6N_AXodWmU</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Serum Uric Acid (SUA), Urinary Albumin Excretion (UAE), and Hypertension (HTN) in Adolescents with Type 2 Diabetes (T2D) in the TODAY Study</title><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><creator>BJORNSTAD, PETTER ; LAFFEL, LORI M. ; LYNCH, JANE L. ; GHORMLI, LAURE EL ; WEINSTOCK, RUTH S. ; TOLLEFSEN, SHERIDA E. ; NADEAU, KRISTEN J.</creator><creatorcontrib>BJORNSTAD, PETTER ; LAFFEL, LORI M. ; LYNCH, JANE L. ; GHORMLI, LAURE EL ; WEINSTOCK, RUTH S. ; TOLLEFSEN, SHERIDA E. ; NADEAU, KRISTEN J.</creatorcontrib><description>Elevated SUA is increasingly recognized as a risk factor for kidney disease in adults with diabetes, yet there are limited data in youth. We hypothesized that elevated SUA would predict development of elevated UAE and HTN over time in teens with T2D. Serum creatinine, cystatin C, SUA, and urine albumin to creatinine ratio (ACR) were assessed in 539 youth, ages 12-17 with T2D duration &lt;2 years at baseline in the TODAY study. Estimated GFR (eGFR) was calculated using creatinine and cystatin C. HTN was defined as systolic (SBP) or diastolic blood pressure (DBP) ≥130/80 mm Hg and elevated albumin excretion (UAE) as ACR ≥30mg/g. Mean arterial pressure (MAP) was calculated ([SBP + 2 (DBP)]/3). Generalized estimating equations and Cox proportional hazard models evaluated the relationship between SUA and outcome variables longitudinally over 7 years, adjusting for age, sex, race/ethnicity, BMI, A1c, eGFR, ACEi/ARB use, and TODAY treatment group assignment. Hyperuricemia (≥6.8 mg/dL) was present in 25.6%, HTN in 18.7%, and elevated UAE in 6.1% at baseline, and boys had higher baseline SUA than girls (6.7±1.4 vs. 5.4±1.2 mg/dl, p&lt;0.0001). Over 7 years, 37.4% developed HTN and 18.0% elevated UAE. Baseline SUA correlated with increase in SBP (β±SE: 0.66±0.16, p&lt;.0001), DBP (0.37±0.15, p=0.01), MAP (0.47±0.14, p=0.001), and log UAE (0.05±0.02, p=0.01) over time in multivariable models. Higher baseline SUA increased risk of incident HTN (HR: 1.20, 95% CI 1.05-1.36, p=0.007, per 1 mg/dL increase in SUA) and incident elevated UAE (HR: 1.23, 95% CI 1.03-1.47, p=0.02, per 1 mg/dL increase in SUA) in fully adjusted models. Hyperuricemia was common in youth with T2D; higher baseline SUA independently increased risk for onset of HTN and elevated UAE over 7 years. Therapies lowering SUA may hold promise to impede development of diabetic kidney disease and HTN in T2D youth.</description><identifier>ISSN: 0012-1797</identifier><identifier>EISSN: 1939-327X</identifier><identifier>DOI: 10.2337/db18-339-OR</identifier><language>eng</language><ispartof>Diabetes (New York, N.Y.), 2018-07, Vol.67 (Supplement_1)</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids></links><search><creatorcontrib>BJORNSTAD, PETTER</creatorcontrib><creatorcontrib>LAFFEL, LORI M.</creatorcontrib><creatorcontrib>LYNCH, JANE L.</creatorcontrib><creatorcontrib>GHORMLI, LAURE EL</creatorcontrib><creatorcontrib>WEINSTOCK, RUTH S.</creatorcontrib><creatorcontrib>TOLLEFSEN, SHERIDA E.</creatorcontrib><creatorcontrib>NADEAU, KRISTEN J.</creatorcontrib><title>Serum Uric Acid (SUA), Urinary Albumin Excretion (UAE), and Hypertension (HTN) in Adolescents with Type 2 Diabetes (T2D) in the TODAY Study</title><title>Diabetes (New York, N.Y.)</title><description>Elevated SUA is increasingly recognized as a risk factor for kidney disease in adults with diabetes, yet there are limited data in youth. We hypothesized that elevated SUA would predict development of elevated UAE and HTN over time in teens with T2D. Serum creatinine, cystatin C, SUA, and urine albumin to creatinine ratio (ACR) were assessed in 539 youth, ages 12-17 with T2D duration &lt;2 years at baseline in the TODAY study. Estimated GFR (eGFR) was calculated using creatinine and cystatin C. HTN was defined as systolic (SBP) or diastolic blood pressure (DBP) ≥130/80 mm Hg and elevated albumin excretion (UAE) as ACR ≥30mg/g. Mean arterial pressure (MAP) was calculated ([SBP + 2 (DBP)]/3). Generalized estimating equations and Cox proportional hazard models evaluated the relationship between SUA and outcome variables longitudinally over 7 years, adjusting for age, sex, race/ethnicity, BMI, A1c, eGFR, ACEi/ARB use, and TODAY treatment group assignment. Hyperuricemia (≥6.8 mg/dL) was present in 25.6%, HTN in 18.7%, and elevated UAE in 6.1% at baseline, and boys had higher baseline SUA than girls (6.7±1.4 vs. 5.4±1.2 mg/dl, p&lt;0.0001). Over 7 years, 37.4% developed HTN and 18.0% elevated UAE. Baseline SUA correlated with increase in SBP (β±SE: 0.66±0.16, p&lt;.0001), DBP (0.37±0.15, p=0.01), MAP (0.47±0.14, p=0.001), and log UAE (0.05±0.02, p=0.01) over time in multivariable models. Higher baseline SUA increased risk of incident HTN (HR: 1.20, 95% CI 1.05-1.36, p=0.007, per 1 mg/dL increase in SUA) and incident elevated UAE (HR: 1.23, 95% CI 1.03-1.47, p=0.02, per 1 mg/dL increase in SUA) in fully adjusted models. Hyperuricemia was common in youth with T2D; higher baseline SUA independently increased risk for onset of HTN and elevated UAE over 7 years. Therapies lowering SUA may hold promise to impede development of diabetic kidney disease and HTN in T2D youth.</description><issn>0012-1797</issn><issn>1939-327X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNqVj81KxDAUhYMoWH9WvsBddtBq0oC1y2A7dGVhmoKuQn8yTKRNhyRF-wy-tOngC8hdnMvhW5wPoTuCH2NKk6e-JS8RpWlU7s5QQFL_0Th5P0cBxiSOSJIml-jK2k-M8bO_AP1U0swj1EZ1wDrVQ1jVbPOwFroxC7ChnUelIf_ujHRq0hDWLPdAo3solqM0Tmp76gv-tgGPsn4apO2kdha-lDsA9xjEkKmmlU5aCHmcnUh3kMDLjH1A5eZ-uUEX-2aw8vYvr9H9NuevRdSZyVoj9-Jo1OhXCYLF6itWX-F9Rbmj_6N_AXodWmU</recordid><startdate>20180701</startdate><enddate>20180701</enddate><creator>BJORNSTAD, PETTER</creator><creator>LAFFEL, LORI M.</creator><creator>LYNCH, JANE L.</creator><creator>GHORMLI, LAURE EL</creator><creator>WEINSTOCK, RUTH S.</creator><creator>TOLLEFSEN, SHERIDA E.</creator><creator>NADEAU, KRISTEN J.</creator><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20180701</creationdate><title>Serum Uric Acid (SUA), Urinary Albumin Excretion (UAE), and Hypertension (HTN) in Adolescents with Type 2 Diabetes (T2D) in the TODAY Study</title><author>BJORNSTAD, PETTER ; LAFFEL, LORI M. ; LYNCH, JANE L. ; GHORMLI, LAURE EL ; WEINSTOCK, RUTH S. ; TOLLEFSEN, SHERIDA E. ; NADEAU, KRISTEN J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-crossref_primary_10_2337_db18_339_OR3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>BJORNSTAD, PETTER</creatorcontrib><creatorcontrib>LAFFEL, LORI M.</creatorcontrib><creatorcontrib>LYNCH, JANE L.</creatorcontrib><creatorcontrib>GHORMLI, LAURE EL</creatorcontrib><creatorcontrib>WEINSTOCK, RUTH S.</creatorcontrib><creatorcontrib>TOLLEFSEN, SHERIDA E.</creatorcontrib><creatorcontrib>NADEAU, KRISTEN J.</creatorcontrib><collection>CrossRef</collection><jtitle>Diabetes (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>BJORNSTAD, PETTER</au><au>LAFFEL, LORI M.</au><au>LYNCH, JANE L.</au><au>GHORMLI, LAURE EL</au><au>WEINSTOCK, RUTH S.</au><au>TOLLEFSEN, SHERIDA E.</au><au>NADEAU, KRISTEN J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Serum Uric Acid (SUA), Urinary Albumin Excretion (UAE), and Hypertension (HTN) in Adolescents with Type 2 Diabetes (T2D) in the TODAY Study</atitle><jtitle>Diabetes (New York, N.Y.)</jtitle><date>2018-07-01</date><risdate>2018</risdate><volume>67</volume><issue>Supplement_1</issue><issn>0012-1797</issn><eissn>1939-327X</eissn><abstract>Elevated SUA is increasingly recognized as a risk factor for kidney disease in adults with diabetes, yet there are limited data in youth. We hypothesized that elevated SUA would predict development of elevated UAE and HTN over time in teens with T2D. Serum creatinine, cystatin C, SUA, and urine albumin to creatinine ratio (ACR) were assessed in 539 youth, ages 12-17 with T2D duration &lt;2 years at baseline in the TODAY study. Estimated GFR (eGFR) was calculated using creatinine and cystatin C. HTN was defined as systolic (SBP) or diastolic blood pressure (DBP) ≥130/80 mm Hg and elevated albumin excretion (UAE) as ACR ≥30mg/g. Mean arterial pressure (MAP) was calculated ([SBP + 2 (DBP)]/3). Generalized estimating equations and Cox proportional hazard models evaluated the relationship between SUA and outcome variables longitudinally over 7 years, adjusting for age, sex, race/ethnicity, BMI, A1c, eGFR, ACEi/ARB use, and TODAY treatment group assignment. Hyperuricemia (≥6.8 mg/dL) was present in 25.6%, HTN in 18.7%, and elevated UAE in 6.1% at baseline, and boys had higher baseline SUA than girls (6.7±1.4 vs. 5.4±1.2 mg/dl, p&lt;0.0001). Over 7 years, 37.4% developed HTN and 18.0% elevated UAE. Baseline SUA correlated with increase in SBP (β±SE: 0.66±0.16, p&lt;.0001), DBP (0.37±0.15, p=0.01), MAP (0.47±0.14, p=0.001), and log UAE (0.05±0.02, p=0.01) over time in multivariable models. Higher baseline SUA increased risk of incident HTN (HR: 1.20, 95% CI 1.05-1.36, p=0.007, per 1 mg/dL increase in SUA) and incident elevated UAE (HR: 1.23, 95% CI 1.03-1.47, p=0.02, per 1 mg/dL increase in SUA) in fully adjusted models. Hyperuricemia was common in youth with T2D; higher baseline SUA independently increased risk for onset of HTN and elevated UAE over 7 years. Therapies lowering SUA may hold promise to impede development of diabetic kidney disease and HTN in T2D youth.</abstract><doi>10.2337/db18-339-OR</doi></addata></record>
fulltext fulltext
identifier ISSN: 0012-1797
ispartof Diabetes (New York, N.Y.), 2018-07, Vol.67 (Supplement_1)
issn 0012-1797
1939-327X
language eng
recordid cdi_crossref_primary_10_2337_db18_339_OR
source Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central
title Serum Uric Acid (SUA), Urinary Albumin Excretion (UAE), and Hypertension (HTN) in Adolescents with Type 2 Diabetes (T2D) in the TODAY Study
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-20T20%3A38%3A24IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-crossref&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Serum%20Uric%20Acid%20(SUA),%20Urinary%20Albumin%20Excretion%20(UAE),%20and%20Hypertension%20(HTN)%20in%20Adolescents%20with%20Type%202%20Diabetes%20(T2D)%20in%20the%20TODAY%20Study&rft.jtitle=Diabetes%20(New%20York,%20N.Y.)&rft.au=BJORNSTAD,%20PETTER&rft.date=2018-07-01&rft.volume=67&rft.issue=Supplement_1&rft.issn=0012-1797&rft.eissn=1939-327X&rft_id=info:doi/10.2337/db18-339-OR&rft_dat=%3Ccrossref%3E10_2337_db18_339_OR%3C/crossref%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_id=info:pmid/&rfr_iscdi=true