Microalbuminuria in adolescents with insulin-dependent diabetes mellitus
J. J. Cook and D. Daneman
Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada.
Two hundred ten adolescents aged 12 to 18 years with insulin-dependent
diabetes mellitus were screened for microalbuminuria (albumin excretion
rate of 15 to 300 micrograms/min). Sixteen (7.6%) showed persistent
microalbuminuria (mean albumin excretion rate of 70.9 +/- 56.2
micrograms/min). There were no significant differences between those with
and without microalbuminuria with respect to age, sex, disease duration,
and blood pressure over the previous 9 months and hemoglobin A1c level
measured over the preceding 3 years. Within the group with
microalbuminuria, there was no correlation between albumin excretion rate
and blood pressure. However, there was a significant positive correlation
between log albumin excretion rate and mean hemoglobin A1c values measured
over the preceding 3 years. Our findings suggest that when microalbuminuria
has developed, poorer metabolic control is associated with a higher albumin
excretion rate. An actual rise in systemic blood pressure may not always
precede the development of microalbuminuria.
