Albuminuria according to status of autoimmunity and insulin sensitivity among youth with type 1 and type 2 diabetes

Amy K. Mottl, Abigail Lauer, Dana Dabelea, David M. Maahs, Ralph B. D'Agostino, Larry M. Dolan, Lisa K. Gilliam, Jean M. Lawrence, Beatriz Rodriguez, Santica M. Marcovina, Giuseppina Imperatore, Roopa Kanakatti Shankar, Maryam Afkarian, Kristi Reynolds, Angela D. Liese, Michael Mauer, Elizabeth J. Mayer-Davis

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Abstract

OBJECTIVE-To evaluate whether etiologic diabetes type is associated with the degree of albuminuria in children with diabetes. RESEARCH DESIGN AND METHODS-SEARCH is an observational, longitudinal study of children with diabetes. Youth with newly diagnosed diabetes were classified according to diabetes autoantibody (DAA) status and presence of insulin resistance. We defined insulin resistance as an insulin sensitivity score <25th percentile for the United States general youth population.DAA statuswas based on positivity for the 65-kD isoformof glutamate decarboxylase and insulinoma-associated protein 2 antigens. The four etiologic diabetes type groups were as follows: DAA+/insulin-sensitive (IS) (n = 1,351); DAA+/insulin- resistant (IR) (n = 438); DAA-/IR (n = 379); and DAA-/IS (n = 233). Urinary albumin:creatinine ratio (UACR) wasmeasured froma random urine specimen. Multivariable regression analyses assessed the independent relationship between the four diabetes type groups and magnitude of UACR. RESULTS-Adjusted UACR means across the four groups were as follows:DAA +/IS = 154μg/mg; DAA+/IR = 137 μg/mg; DAA -/IR = 257 μg/mg; and DAA-/IS = 131 μg/mg (P < 0.005). Only DAA-/IR was significantly different. We performed post hoc multivariable regression analysis restricted to the two IR groups to explore the contribution of DAA status and insulin sensitivity (continuous) to the difference in UACR between the IR groups. Only insulin sensitivity was significantly associated with UACR (β = 20.54; P < 0.0001). CONCLUSIONS-In youth with diabetes, the DAA-/IR group had a greater UACR than all other groups, possibly because of the greater magnitude of insulin resistance. Further exploration of the relationships between severity of insulin resistance, autoimmunity, and albuminuria in youth with diabetes is warranted.

Original languageEnglish (US)
Pages (from-to)3633-3638
Number of pages6
JournalDiabetes care
Volume36
Issue number11
DOIs
StatePublished - Nov 1 2013

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Albuminuria
Autoimmunity
Type 1 Diabetes Mellitus
Autoantibodies
Type 2 Diabetes Mellitus
Insulin Resistance
Insulin
Albumins
Creatinine
Class 8 Receptor-Like Protein Tyrosine Phosphatases
Regression Analysis
Glutamate Decarboxylase
Observational Studies
Longitudinal Studies
Research Design

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Mottl, A. K., Lauer, A., Dabelea, D., Maahs, D. M., D'Agostino, R. B., Dolan, L. M., ... Mayer-Davis, E. J. (2013). Albuminuria according to status of autoimmunity and insulin sensitivity among youth with type 1 and type 2 diabetes. Diabetes care, 36(11), 3633-3638. https://doi.org/10.2337/dc13-0568

Albuminuria according to status of autoimmunity and insulin sensitivity among youth with type 1 and type 2 diabetes. / Mottl, Amy K.; Lauer, Abigail; Dabelea, Dana; Maahs, David M.; D'Agostino, Ralph B.; Dolan, Larry M.; Gilliam, Lisa K.; Lawrence, Jean M.; Rodriguez, Beatriz; Marcovina, Santica M.; Imperatore, Giuseppina; Shankar, Roopa Kanakatti; Afkarian, Maryam; Reynolds, Kristi; Liese, Angela D.; Mauer, Michael; Mayer-Davis, Elizabeth J.

In: Diabetes care, Vol. 36, No. 11, 01.11.2013, p. 3633-3638.

Research output: Contribution to journalArticle

Mottl, AK, Lauer, A, Dabelea, D, Maahs, DM, D'Agostino, RB, Dolan, LM, Gilliam, LK, Lawrence, JM, Rodriguez, B, Marcovina, SM, Imperatore, G, Shankar, RK, Afkarian, M, Reynolds, K, Liese, AD, Mauer, M & Mayer-Davis, EJ 2013, 'Albuminuria according to status of autoimmunity and insulin sensitivity among youth with type 1 and type 2 diabetes', Diabetes care, vol. 36, no. 11, pp. 3633-3638. https://doi.org/10.2337/dc13-0568
Mottl, Amy K. ; Lauer, Abigail ; Dabelea, Dana ; Maahs, David M. ; D'Agostino, Ralph B. ; Dolan, Larry M. ; Gilliam, Lisa K. ; Lawrence, Jean M. ; Rodriguez, Beatriz ; Marcovina, Santica M. ; Imperatore, Giuseppina ; Shankar, Roopa Kanakatti ; Afkarian, Maryam ; Reynolds, Kristi ; Liese, Angela D. ; Mauer, Michael ; Mayer-Davis, Elizabeth J. / Albuminuria according to status of autoimmunity and insulin sensitivity among youth with type 1 and type 2 diabetes. In: Diabetes care. 2013 ; Vol. 36, No. 11. pp. 3633-3638.
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abstract = "OBJECTIVE-To evaluate whether etiologic diabetes type is associated with the degree of albuminuria in children with diabetes. RESEARCH DESIGN AND METHODS-SEARCH is an observational, longitudinal study of children with diabetes. Youth with newly diagnosed diabetes were classified according to diabetes autoantibody (DAA) status and presence of insulin resistance. We defined insulin resistance as an insulin sensitivity score <25th percentile for the United States general youth population.DAA statuswas based on positivity for the 65-kD isoformof glutamate decarboxylase and insulinoma-associated protein 2 antigens. The four etiologic diabetes type groups were as follows: DAA+/insulin-sensitive (IS) (n = 1,351); DAA+/insulin- resistant (IR) (n = 438); DAA-/IR (n = 379); and DAA-/IS (n = 233). Urinary albumin:creatinine ratio (UACR) wasmeasured froma random urine specimen. Multivariable regression analyses assessed the independent relationship between the four diabetes type groups and magnitude of UACR. RESULTS-Adjusted UACR means across the four groups were as follows:DAA +/IS = 154μg/mg; DAA+/IR = 137 μg/mg; DAA -/IR = 257 μg/mg; and DAA-/IS = 131 μg/mg (P < 0.005). Only DAA-/IR was significantly different. We performed post hoc multivariable regression analysis restricted to the two IR groups to explore the contribution of DAA status and insulin sensitivity (continuous) to the difference in UACR between the IR groups. Only insulin sensitivity was significantly associated with UACR (β = 20.54; P < 0.0001). CONCLUSIONS-In youth with diabetes, the DAA-/IR group had a greater UACR than all other groups, possibly because of the greater magnitude of insulin resistance. Further exploration of the relationships between severity of insulin resistance, autoimmunity, and albuminuria in youth with diabetes is warranted.",
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T1 - Albuminuria according to status of autoimmunity and insulin sensitivity among youth with type 1 and type 2 diabetes

AU - Mottl, Amy K.

AU - Lauer, Abigail

AU - Dabelea, Dana

AU - Maahs, David M.

AU - D'Agostino, Ralph B.

AU - Dolan, Larry M.

AU - Gilliam, Lisa K.

AU - Lawrence, Jean M.

AU - Rodriguez, Beatriz

AU - Marcovina, Santica M.

AU - Imperatore, Giuseppina

AU - Shankar, Roopa Kanakatti

AU - Afkarian, Maryam

AU - Reynolds, Kristi

AU - Liese, Angela D.

AU - Mauer, Michael

AU - Mayer-Davis, Elizabeth J.

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N2 - OBJECTIVE-To evaluate whether etiologic diabetes type is associated with the degree of albuminuria in children with diabetes. RESEARCH DESIGN AND METHODS-SEARCH is an observational, longitudinal study of children with diabetes. Youth with newly diagnosed diabetes were classified according to diabetes autoantibody (DAA) status and presence of insulin resistance. We defined insulin resistance as an insulin sensitivity score <25th percentile for the United States general youth population.DAA statuswas based on positivity for the 65-kD isoformof glutamate decarboxylase and insulinoma-associated protein 2 antigens. The four etiologic diabetes type groups were as follows: DAA+/insulin-sensitive (IS) (n = 1,351); DAA+/insulin- resistant (IR) (n = 438); DAA-/IR (n = 379); and DAA-/IS (n = 233). Urinary albumin:creatinine ratio (UACR) wasmeasured froma random urine specimen. Multivariable regression analyses assessed the independent relationship between the four diabetes type groups and magnitude of UACR. RESULTS-Adjusted UACR means across the four groups were as follows:DAA +/IS = 154μg/mg; DAA+/IR = 137 μg/mg; DAA -/IR = 257 μg/mg; and DAA-/IS = 131 μg/mg (P < 0.005). Only DAA-/IR was significantly different. We performed post hoc multivariable regression analysis restricted to the two IR groups to explore the contribution of DAA status and insulin sensitivity (continuous) to the difference in UACR between the IR groups. Only insulin sensitivity was significantly associated with UACR (β = 20.54; P < 0.0001). CONCLUSIONS-In youth with diabetes, the DAA-/IR group had a greater UACR than all other groups, possibly because of the greater magnitude of insulin resistance. Further exploration of the relationships between severity of insulin resistance, autoimmunity, and albuminuria in youth with diabetes is warranted.

AB - OBJECTIVE-To evaluate whether etiologic diabetes type is associated with the degree of albuminuria in children with diabetes. RESEARCH DESIGN AND METHODS-SEARCH is an observational, longitudinal study of children with diabetes. Youth with newly diagnosed diabetes were classified according to diabetes autoantibody (DAA) status and presence of insulin resistance. We defined insulin resistance as an insulin sensitivity score <25th percentile for the United States general youth population.DAA statuswas based on positivity for the 65-kD isoformof glutamate decarboxylase and insulinoma-associated protein 2 antigens. The four etiologic diabetes type groups were as follows: DAA+/insulin-sensitive (IS) (n = 1,351); DAA+/insulin- resistant (IR) (n = 438); DAA-/IR (n = 379); and DAA-/IS (n = 233). Urinary albumin:creatinine ratio (UACR) wasmeasured froma random urine specimen. Multivariable regression analyses assessed the independent relationship between the four diabetes type groups and magnitude of UACR. RESULTS-Adjusted UACR means across the four groups were as follows:DAA +/IS = 154μg/mg; DAA+/IR = 137 μg/mg; DAA -/IR = 257 μg/mg; and DAA-/IS = 131 μg/mg (P < 0.005). Only DAA-/IR was significantly different. We performed post hoc multivariable regression analysis restricted to the two IR groups to explore the contribution of DAA status and insulin sensitivity (continuous) to the difference in UACR between the IR groups. Only insulin sensitivity was significantly associated with UACR (β = 20.54; P < 0.0001). CONCLUSIONS-In youth with diabetes, the DAA-/IR group had a greater UACR than all other groups, possibly because of the greater magnitude of insulin resistance. Further exploration of the relationships between severity of insulin resistance, autoimmunity, and albuminuria in youth with diabetes is warranted.

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