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Urinary type IV collagen as a predictor for the incidence of microalbuminuria in young patients with Type 1 diabetes
Author(s) -
Morita M.,
Hanai K.,
Uchigata Y.
Publication year - 2014
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/dme.12317
Subject(s) - microalbuminuria , medicine , creatinine , hazard ratio , urinary system , urology , type 2 diabetes , renal function , incidence (geometry) , diabetes mellitus , gastroenterology , endocrinology , confidence interval , physics , optics
Aims To clarify whether urinary type IV collagen‐to‐creatinine ratio is a predictor for the incidence of microalbuminuria in patients with Type 1 diabetes. Methods A longitudinal observational cohort study was conducted; the subjects included normoalbuminuric patients diagnosed with Type 1 diabetes before the age of 30 years and who were less than 40 years old at the start of the observation. In total, 225 patients were enrolled (age, mean ± SD: 25 ± 5 years; male: 32.9%). The endpoint was the incidence of microalbuminuria, defined as 30 mg/g Cr ≤ urinary albumin‐to‐creatinine ratio < 300 mg/g Cr. Patients were divided into two groups based on the median of urinary type IV collagen‐to‐creatinine ratio levels. Results During the median follow‐up period of 8.8 years (range 1.0–12.8 years), 13 patients with high urinary type IV collagen‐to‐creatinine ratio progressed to microalbuminuria. Meanwhile, only one patient with low urinary type IV collagen‐to‐creatinine ratio reached the endpoint. Kaplan–Meier estimates for the time to reach the endpoint were significantly faster for patients with a high ratio than for those with a low ratio (log‐rank test, P < 0.001). In the multivariate Cox hazard analysis, the hazard ratio for patients with high vs. low urinary type IV collagen‐to‐creatinine ratio was 13.51 (95% CI 1.59–115.02, P = 0.017). When urinary type IV collagen‐to‐creatinine ratio was treated as a continuous variable, logarithmically transformed urinary type IV collagen‐to‐creatinine ratio, but not baseline albumin‐to‐creatinine ratio, was independently associated with reaching the endpoint (hazard ratio 19.23, 95% CI 1.53–242.30, P = 0.022). Conclusions Urinary type IV collagen may be an important predictor for the incidence of microalbuminuria in young patients with Type 1 diabetes.