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A 6-year nationwide cohort study of glycaemic control in young people with type 1 diabetes. Risk markers for the development of retinopathy, nephropathy and neuropathy. Danish Study Group of Diabetes in Childhood.

https://arctichealth.org/en/permalink/ahliterature32420
Source
J Diabetes Complications. 2000 Nov-Dec;14(6):295-300
Publication Type
Article
Author
B S Olsen
A. Sjølie
P. Hougaard
J. Johannesen
K. Borch-Johnsen
K. Marinelli
B. Thorsteinsson
S. Pramming
H B Mortensen
Author Affiliation
Department of Paediatrics, Glostrup University Hospital, DK-2600, Glostrup, Denmark.
Source
J Diabetes Complications. 2000 Nov-Dec;14(6):295-300
Language
English
Publication Type
Article
Keywords
Adolescent
Albuminuria - epidemiology
Blood Glucose - metabolism
Child
Cohort Studies
Denmark - epidemiology
Diabetes Mellitus, Type 1 - blood - drug therapy - physiopathology
Diabetic Nephropathies - epidemiology - prevention & control
Diabetic Neuropathies - epidemiology - prevention & control
Diabetic Retinopathy - epidemiology - prevention & control
Female
Humans
Male
Neurologic Examination
Perception
Probability
Risk factors
Vibration
Abstract
The study aimed to identify risk markers (present at the start of the study in 1989) for the occurrence and progression of microvascular complications 6 years later (in 1995) in a Danish nationwide cohort of children and adolescents with Type 1 diabetes (average age at entry 13.7 years). Probabilities for the development of elevated albumin excretion rate (AER), retinopathy, and increased vibration perception threshold (VPT) could then be estimated from a stepwise logistic regression model. A total of 339 patients (47% of the original cohort) were studied. Sex, age, diabetes duration, insulin regimen and dose, height, weight, HbA(1c), blood pressure, and AER were recorded. In addition, information on retinopathy, neuropathy (VPT), and anti-hypertensive treatment was obtained at the end of the study. HbA(1c) (normal range 4.3-5.8, mean 5.3%) and AER (upper normal limit or =20 microg min(-1)) was found in 12.8% of the patients in 1995, and risk markers for this were increased AER and high HbA(1c), in 1989 (both p6.5 V) was found in 62.5% of patients in 1995, for which the risk markers were male sex (p
PubMed ID
11120452 View in PubMed
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A1C variability predicts incident cardiovascular events, microalbuminuria, and overt diabetic nephropathy in patients with type 1 diabetes.

https://arctichealth.org/en/permalink/ahliterature149324
Source
Diabetes. 2009 Nov;58(11):2649-55
Publication Type
Article
Date
Nov-2009
Author
Johan Wadén
Carol Forsblom
Lena M Thorn
Daniel Gordin
Markku Saraheimo
Per-Henrik Groop
Author Affiliation
Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland. per-henrik.groop@helsinki.fi
Source
Diabetes. 2009 Nov;58(11):2649-55
Date
Nov-2009
Language
English
Publication Type
Article
Keywords
Adult
Albuminuria - epidemiology
Autoanalysis - methods
Biological Markers - blood
Blood pressure
Cardiovascular Diseases - epidemiology - mortality
Diabetes Mellitus, Type 1 - blood
Diabetic Angiopathies - epidemiology - mortality
Diabetic Nephropathies - epidemiology - mortality
Female
Finland - epidemiology
Follow-Up Studies
Glucose - metabolism
Hemoglobin A, Glycosylated - metabolism
Humans
Kidney Failure, Chronic - epidemiology
Lipids - blood
Male
Middle Aged
Patient Selection
Predictive value of tests
Risk factors
Survival Rate
Abstract
Recent data from the Diabetes Control and Complications Trial (DCCT) indicated that A1C variability is associated with the risk of diabetes microvascular complications. However, these results might have been influenced by the interventional study design. Therefore, we investigated the longitudinal associations between A1C variability and diabetes complications in patients with type 1 diabetes in the observational Finnish Diabetic Nephropathy (FinnDiane) Study.
A total of 2,107 patients in the FinnDiane Study had complete data on renal status and serial measurements of A1C from baseline to follow-up (median 5.7 years), and 1,845 patients had similar data on cardiovascular disease (CVD) events. Intrapersonal SD of serially measured A1C was considered a measure of variability.
During follow-up, 10.2% progressed to a higher albuminuria level or to end-stage renal disease, whereas 8.6% had a CVD event. The SD of serial A1C was 1.01 versus 0.75 (P
Notes
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PubMed ID
19651819 View in PubMed
Less detail

Adult stature and diabetes complications in patients with type 1 diabetes: the FinnDiane Study and the diabetes control and complications trial.

https://arctichealth.org/en/permalink/ahliterature150600
Source
Diabetes. 2009 Aug;58(8):1914-20
Publication Type
Article
Date
Aug-2009
Author
Johan Wadén
Carol Forsblom
Lena M Thorn
Markku Saraheimo
Milla Rosengård-Bärlund
Outi Heikkilä
Kustaa Hietala
Ken Ong
Nicholas Wareham
Per-Henrik Groop
Author Affiliation
Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.
Source
Diabetes. 2009 Aug;58(8):1914-20
Date
Aug-2009
Language
English
Publication Type
Article
Keywords
Adult
Age of Onset
Albuminuria - epidemiology
Body Height
Cardiovascular Diseases - epidemiology
Cross-Sectional Studies
Diabetes Mellitus, Type 1 - complications
Diabetic Angiopathies - epidemiology
Diabetic Nephropathies - epidemiology
Diabetic Retinopathy - epidemiology
Female
Finland
Hemoglobin A, Glycosylated - metabolism
Humans
Male
Middle Aged
Abstract
Short adult stature has previously been associated with cardiovascular disease, but its relationship with the microvascular complications of diabetes is uncertain. Therefore, we evaluated the association between adult stature and prevalence and incidence of diabetic microvascular complications.
This cross-sectional and longitudinal study comprises 3,968 adult patients with type 1 diabetes from the Finnish Diabetic Nephropathy (FinnDiane) Study and 1,246 adult patients from the Diabetes Control and Complications Trial (DCCT). In FinnDiane, diabetic nephropathy was defined as urinary albumin excretion > or = 300 mg/24 h, dialysis, or renal transplantation. Retinopathy was divided into background and proliferative (laser-treated) retinopathy. In the DCCT, original nephropathy (class 1-6) and retinopathy (Early Treatment of Diabetic Retinopathy Study) classifications were used.
In the FinnDiane study, patients in the lowest quartile of adult height had increased risks of prevalent diabetic nephropathy (odds ratio [OR] 1.71, 95% CI 1.44-2.02) and prevalent laser-treated retinopathy (1.66, 1.43-1.93) compared with other patients. Similarly, in the DCCT, patients in the lowest quartile of adult height had increased risks of incident diabetic nephropathy class 4-6 (hazard ratio 2.70, 95% CI 1.59-4.59) and incident proliferative retinopathy (2.06, 1.15-3.71). In the FinnDiane study, the associations were largely explained by childhood exposure to diabetes. However, in the DCCT, where a greater proportion of patients had diabetes onset >18 years, the association with nephropathy was independent of childhood diabetes exposure.
Short adult stature is associated with microvascular complications in patients with type 1 diabetes. These findings are compatible with either childhood diabetes exposure or "common soil" or both as potential explanations.
Notes
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PubMed ID
19491208 View in PubMed
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Albuminuria and estimated GFR 5 years after Escherichia coli O157 hemolytic uremic syndrome: an update.

https://arctichealth.org/en/permalink/ahliterature158651
Source
Am J Kidney Dis. 2008 Mar;51(3):435-44
Publication Type
Article
Date
Mar-2008
Author
Amit X Garg
Marina Salvadori
Justin M Okell
Heather R Thiessen-Philbrook
Rita S Suri
Guido Filler
Louise Moist
Douglas Matsell
William F Clark
Author Affiliation
Division of Nephrology, University of Western Ontario, London, Canada. amit.garg@lhsc.on.ca
Source
Am J Kidney Dis. 2008 Mar;51(3):435-44
Date
Mar-2008
Language
English
Publication Type
Article
Keywords
Albuminuria - epidemiology
Child
Child, Preschool
Disease Outbreaks
Escherichia coli O157
Female
Follow-Up Studies
Glomerular Filtration Rate
Hemolytic-Uremic Syndrome - complications - etiology - microbiology
Humans
Infant
Kidney Function Tests
Male
Ontario
Prognosis
Prospective Studies
Water Microbiology
Water supply
Abstract
Knowledge of the long-term prognosis of patients with diarrhea-associated hemolytic uremic syndrome (HUS) is important for patient counseling and follow-up. Estimates in the literature are highly variable, and previous studies did not use a healthy control group to establish outcomes attributable to HUS.
Prospective cohort study.
19 children who recovered from HUS after contamination of their municipal water supply by Escherichia coli O157:H7.
Outcomes of children who recovered from HUS were compared with a control group of 64 children who were healthy at the time of the outbreak. Both groups were similar in their demographics and follow-up testing.
Proteinuria, blood pressure, glomerular filtration rate (GFR) estimated by using serum creatinine or cystatin C level, and biochemical measures 5 years after the outbreak.
More children who recovered from HUS showed microalbuminuria than controls (20% versus 3%; relative risk, 6.0; 95% confidence interval, 1.1 to 32.8). There were no differences between groups in blood pressure or GFR when estimated by using serum creatinine level. GFR estimated by using cystatin C level was lower after HUS compared with controls (100 versus 110 mL/min/1.73 m(2); P = 0.02), but no child had a GFR less than 80 mL/min/1.73 m(2). Other results, including fasting glucose, albumin, and C-reactive protein levels, did not differ between groups.
Although the homogenous nature of this outbreak is a strength, long-term results may generalize less well to patients with other strains of toxigenic E coli or in other settings.
The prognosis of patients with HUS in this cohort was better than in other studies. Ongoing follow-up will clarify the clinical relevance of microalbuminuria and mild decreases in GFR 5 years after HUS recovery.
PubMed ID
18295059 View in PubMed
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Albuminuria and Microalbuminuria as Predictors of Cognitive Performance in a General Population: An 11-Year Follow-Up Study.

https://arctichealth.org/en/permalink/ahliterature298098
Source
J Alzheimers Dis. 2018; 62(2):635-648
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
2018
Author
Laura L Ekblad
Sini Toppala
Jouni K Johansson
Seppo Koskinen
Jouko Sundvall
Juha O Rinne
Pauli Puukka
Matti Viitanen
Antti Jula
Author Affiliation
Turku PET Centre, University of Turku, c/o Turku University Hospital, Turku, Finland.
Source
J Alzheimers Dis. 2018; 62(2):635-648
Date
2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Aged
Albuminuria - epidemiology
Cognition
Cognitive Dysfunction - epidemiology
Creatinine - urine
Cross-Sectional Studies
Female
Finland - epidemiology
Follow-Up Studies
Humans
Kidney - physiopathology
Linear Models
Male
Middle Aged
Multivariate Analysis
Neuropsychological Tests
Risk factors
Abstract
Microalbuminuria, defined as urine albumin-to-creatinine ratio (UACR)>3.0?mg/mmol and = 30?mg/mmol, is an early marker of endothelial damage of the renal glomeruli. Recent research suggests an association among microalbuminuria, albuminuria (UACR?>?3.0?mg/mmol), and cognitive impairment. Previous studies on microalbuminuria, albuminuria, and cognition in the middle-aged have not provided repeated cognitive testing at different time-points. We hypothesized that albuminuria (micro- plus macroalbuminuria) and microalbuminuria would predict cognitive decline independently of previously reported risk factors for cognitive decline, including cardiovascular risk factors. In addition, we hypothesized that UACR levels even below the cut-off for microalbuminuria might be associated with cognitive functioning. These hypotheses were tested in the Finnish nationwide, population-based Health 2000 Survey (n?=?5,921, mean age 52.6, 55.0% women), and its follow-up, Health 2011 (n?=?3,687, mean age at baseline 49.3, 55.6% women). Linear regression analysis was used to determine the associations between measures of albuminuria and cognitive performance. Cognitive functions were assessed with verbal fluency, word-list learning, word-list delayed recall (at baseline and at follow-up), and with simple and visual choice reaction time tests (at baseline only). Here, we show that micro- plus macroalbuminuria associated with poorer word-list learning and a slower reaction time at baseline, with poorer word-list learning at follow-up, and with a steeper decline in word-list learning during 11 years after multivariate adjustments. Also, higher continuous UACR consistently associated with poorer verbal fluency at levels below microalbuminuria. These results suggest that UACR might have value in evaluating the risk for cognitive decline.
PubMed ID
29480195 View in PubMed
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Association of albuminuria and cancer incidence.

https://arctichealth.org/en/permalink/ahliterature86667
Source
J Am Soc Nephrol. 2008 May;19(5):992-8
Publication Type
Article
Date
May-2008
Author
Jørgensen Lone
Heuch Ivar
Jenssen Trond
Jacobsen Bjarne K
Author Affiliation
Institute of Community Medicine, University of Tromsø, N-9037 Tromsø, Norway. lone.jorgensen@ism.uit.no
Source
J Am Soc Nephrol. 2008 May;19(5):992-8
Date
May-2008
Language
English
Publication Type
Article
Keywords
Aged
Albuminuria - epidemiology
Breast Neoplasms - epidemiology
Colorectal Neoplasms - epidemiology
Female
Follow-Up Studies
Humans
Incidence
Kidney Neoplasms - epidemiology
Longitudinal Studies
Lung Neoplasms - epidemiology
Male
Middle Aged
Neoplasms - epidemiology
Norway - epidemiology
Prostatic Neoplasms - epidemiology
Risk factors
Smoking - epidemiology
Urinary Bladder Neoplasms - epidemiology
Abstract
Albuminuria, which is associated with noncardiovascular mortality, might be a result of altered vascular permeability caused by cytokines and other tumor cell products. The aim of this population-based, longitudinal study was to examine whether elevated albumin-to-creatinine ratio (ACR) is associated with cancer incidence. A total of 5425 participants without diabetes or previous cancer in the Tromsø Study were followed; 590 had a first diagnosis of cancer during 10.3 yr of follow-up. The ACR at baseline significantly correlated with the incidence of cancer, even after adjustment for age, gender, body mass index, physical activity, and smoking (P
PubMed ID
18256361 View in PubMed
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Associations of microalbuminuria and blood pressure with carotid, aortic and femoral atheromatous plaques in elderly Finns.

https://arctichealth.org/en/permalink/ahliterature47001
Source
Diabetes Res Clin Pract. 2005 Sep;69(3):262-71
Publication Type
Article
Date
Sep-2005
Author
Ulla Rajala
Mauri Laakso
Markku Päivänsalo
Outi Pelkonen
Aimo Ruokonen
Ilkka Suramo
Sirkka Keinänen-Kiukaanniemi
Author Affiliation
Department of Public Health Science and General Practice, University of Oulu, Aapistie 1, 90220 Oulu, Finland. ulla.rajala@oulu.fi
Source
Diabetes Res Clin Pract. 2005 Sep;69(3):262-71
Date
Sep-2005
Language
English
Publication Type
Article
Keywords
Aged
Albuminuria - epidemiology
Aortic Valve Stenosis
Arteriosclerosis - epidemiology
Blood Glucose - metabolism
Blood Pressure - physiology
Body mass index
Carotid Artery Diseases - epidemiology
Cohort Studies
Female
Femoral Artery
Finland - epidemiology
Humans
Hypertension - epidemiology
Male
Abstract
AIMS: To evaluate the possible associations of microalbuminuria (MA) and blood pressure (BP) with the ultrasonographic manifestations of carotid, aortic and femoral atherosclerosis in 65-year-old Finns. METHODS: Ultrasonographic measurements were performed on 54 diabetic subjects, 97 subjects with impaired glucose tolerance (IGT) and 57 normoglycemic subjects (NGT). Urinary albumin and creatinine concentrations were measured from an early morning spot urine sample, and the urinary albumin-to-creatinine ratio (ACR) of > or = 2.5 mg/mmol in men and > or = 3.5 mg/mmol in women was used as a measure of MA. Hypertension was defined as either a systolic BP of > or = 160 mmHg or a diastolic BP of > or = 95 mmHg or being on antihypertensive medication. RESULTS: Eighteen subjects were microalbuminuric and 176 subjects normoalbuminuric. MA was associated with diabetes mellitus and high systolic and diastolic BP. The subjects were divided into two groups according to the median total number of carotid, aortic and femoral plaques: > or = 9 versus 0-8 plaques. A high number of plaques were associated with hypertension, male gender, smoking and MA. When the study subjects were stratified according to hypertension, it turned out that MA was associated with a high number of plaques in hypertensive, but not in nonhypertensive subjects. According to the results of logistic regression analysis with a high number of plaques as the dependent variable, the unadjusted OR for smoking was 6.0 (95% CI 2.4-15.3) in hypertensive subjects. Microalbuminuria was of borderline statistical significance (OR 4.5, 95% CI 0.9-22.9). After adjustment for systolic blood pressure and fasting glucose concentration, the OR for microalbuminuria was reduced to 3.3 (95% CI 0.6-18.4).
PubMed ID
16098923 View in PubMed
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Cardiovascular morbidity and mortality associated with the metabolic syndrome.

https://arctichealth.org/en/permalink/ahliterature47727
Source
Diabetes Care. 2001 Apr;24(4):683-9
Publication Type
Article
Date
Apr-2001
Author
B. Isomaa
P. Almgren
T. Tuomi
B. Forsén
K. Lahti
M. Nissén
M R Taskinen
L. Groop
Author Affiliation
Department of Internal Medicine, Jakobstad Hospital, Finland. bo.isomaa@fimnet.fi
Source
Diabetes Care. 2001 Apr;24(4):683-9
Date
Apr-2001
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Albuminuria - epidemiology
Blood Glucose - metabolism
Cardiovascular Diseases - epidemiology - mortality
Cholesterol - blood
Diabetes Mellitus, Type 2 - blood - complications - epidemiology
Family
Female
Finland - epidemiology
Glucose Intolerance - blood - complications - epidemiology
Hemoglobin A, Glycosylated - analysis
Humans
Hyperlipidemia - blood
Hypertension - epidemiology
Insulin Resistance - physiology
Lipoproteins, HDL Cholesterol - blood
Male
Middle Aged
Morbidity
Obesity - epidemiology
Prevalence
Research Support, Non-U.S. Gov't
Risk factors
Sex Factors
Sweden - epidemiology
Triglycerides - blood
Abstract
OBJECTIVE: To estimate the prevalence of and the cardiovascular risk associated with the metabolic syndrome using the new definition proposed by the World Health Organization RESEARCH DESIGN AND METHODS: A total of 4,483 subjects aged 35-70 years participating in a large family study of type 2 diabetes in Finland and Sweden (the Botnia study) were included in the analysis of cardiovascular risk associated with the metabolic syndrome. In subjects who had type 2 diabetes (n = 1,697), impaired fasting glucose (IFG)/impaired glucose tolerance (IGT) (n = 798) or insulin-resistance with normal glucose tolerance (NGT) (n = 1,988), the metabolic syndrome was defined as presence of at least two of the following risk factors: obesity, hypertension, dyslipidemia, or microalbuminuria. Cardiovascular mortality was assessed in 3,606 subjects with a median follow-up of 6.9 years. RESULTS: In women and men, respectively, the metabolic syndrome was seen in 10 and 15% of subjects with NGT, 42 and 64% of those with IFG/IGT, and 78 and 84% of those with type 2 diabetes. The risk for coronary heart disease and stroke was increased threefold in subjects with the syndrome (P
PubMed ID
11315831 View in PubMed
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Cause-specific mortality according to urine albumin creatinine ratio in the general population.

https://arctichealth.org/en/permalink/ahliterature268854
Source
PLoS One. 2014;9(3):e93212
Publication Type
Article
Date
2014
Author
Tea Skaaby
Lise Lotte Nystrup Husemoen
Tarunveer Singh Ahluwalia
Peter Rossing
Torben Jørgensen
Betina Heinsbæk Thuesen
Charlotta Pisinger
Knud Rasmussen
Allan Linneberg
Source
PLoS One. 2014;9(3):e93212
Date
2014
Language
English
Publication Type
Article
Keywords
Adult
Albuminuria - epidemiology - etiology - mortality - urine
Cardiovascular Diseases - mortality - urine
Cause of Death
Creatinine - urine
Denmark - epidemiology
Diabetes Mellitus - mortality - urine
Female
Follow-Up Studies
Humans
Male
Middle Aged
Population Surveillance
Proportional Hazards Models
Registries
Risk factors
Abstract
Urine albumin creatinine ratio, UACR, is positively associated with all-cause mortality, cardiovascular disease and diabetes in observational studies. Whether a high UACR is also associated with other causes of death is unclear. We investigated the association between UACR and cause-specific mortality.
We included a total of 9,125 individuals from two population-based studies, Monica10 and Inter99, conducted in 1993-94 and 1999-2001, respectively. Urine albumin creatinine ratio was measured from spot urine samples by standard methods. Information on causes of death was obtained from The Danish Register of Causes of Death until 31 December 2010. There were a total of 920 deaths, and the median follow-up was 11.3 years.
Multivariable Cox regression analyses with age as underlying time axis showed statistically significant positive associations between UACR status and risk of all-cause mortality, endocrine nutritional and metabolic diseases, mental and behavioural disorders, diseases of the circulatory system, and diseases of the respiratory system with hazard ratios 1.56, 6.98, 2.34, 2.03, and 1.91, for the fourth UACR compared with the first, respectively. Using UACR as a continuous variable, we also found a statistically significant positive association with risk of death caused by diseases of the digestive system with a hazard ratio of 1.02 per 10 mg/g higher UACR.
We found statistically significant positive associations between baseline UACR and death from all-cause mortality, endocrine nutritional and metabolic diseases, and diseases of the circulatory system and possibly mental and behavioural disorders, and diseases of the respiratory and digestive system.
Notes
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PubMed ID
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