Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada.
Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada.
Can J Diabetes. 2021 Jul;45(5):458-465. doi: 10.1016/j.jcjd.2021.04.002. Epub 2021 Apr 20.
Little is known about the relationship between albuminuria in youth with type 2 diabetes (T2D) and cardiovascular risk. We aimed to determine whether youth with T2D and albuminuria have evidence of increased cardiovascular risk and/or early cardiovascular dysfunction compared with youth with T2D without albuminuria.
Youth with T2D were stratified by albuminuria status. Cardiovascular risk factors, including body mass index (BMI), 24-hour blood pressure, lipid profile, smoking and smoking exposure, habitual physical activity and screen time, were compared between groups. Left ventricular structure and function and carotid intima-media thickness (cIMT) were evaluated in participants who underwent cardiac imaging.
Two hundred sixty-five youth participated, 83 (31.3%) of whom had albuminuria. Ethnicity, sex, BMI z score, age at diagnosis, duration of diabetes and hepatocyte nuclear factor-1alpha status did not differ between youth stratified by albuminuria. Smoking, exposure to second-hand smoke and low physical activity levels did not differ between groups. Youth with albuminuria were more likely to have hypertension, dyslipidemia and poor glycemic control. Left ventricular structure and carotid cIMT did not differ between groups, but youth with albuminuria had evidence of early left ventricular diastolic dysfunction.
We found evidence of increased cardiovascular disease risk factors and left ventricular diastolic dysfunction in youth with T2D and albuminuria compared with those without albuminuria, despite a relatively short duration of disease. Thus, albuminuria may serve as a marker of early cardiovascular disease risk in youth with T2D.
关于 2 型糖尿病（T2D）青少年白蛋白尿与心血管风险之间的关系知之甚少。我们旨在确定与无白蛋白尿的 T2D 青少年相比，患有 T2D 且伴有白蛋白尿的青少年是否具有心血管风险增加和/或早期心血管功能障碍的证据。
根据白蛋白尿状态对 T2D 青少年进行分层。比较各组之间的心血管危险因素，包括体重指数（BMI）、24 小时血压、血脂谱、吸烟和二手烟暴露、习惯性体力活动和屏幕时间。对接受心脏成像的参与者进行左心室结构和功能以及颈动脉内膜中层厚度（cIMT）评估。
共有 265 名青少年参与了研究，其中 83 名（31.3%）患有白蛋白尿。按白蛋白尿分层的青少年在种族、性别、BMI z 评分、诊断时年龄、糖尿病病程和肝细胞核因子-1alpha 状态方面没有差异。吸烟、二手烟暴露和低体力活动水平在各组之间没有差异。白蛋白尿青少年更有可能患有高血压、血脂异常和血糖控制不佳。左心室结构和颈动脉 cIMT 在组间无差异，但白蛋白尿青少年有早期左心室舒张功能障碍的证据。
与无白蛋白尿的 T2D 青少年相比，我们发现患有 T2D 且伴有白蛋白尿的青少年存在心血管疾病危险因素增加和左心室舒张功能障碍的证据，尽管疾病持续时间相对较短。因此，白蛋白尿可能是 T2D 青少年早期心血管疾病风险的标志物。
