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Cardiac autonomic dysfunction is associated with high-risk albumin-to-creatinine ratio in young adolescents with type 1 diabetes in AdDIT

This study examined the association between cardiac autonomic dysfunction and high albumin-to-creatinine ratio (ACR) in adolescents with type 1 diabetes.

Authors:
Cho YH, Craig ME, Davis EA, Cotterill AM, Couper JJ, Cameron FJ, Benitez-Aguirre PZ, Dalton RN, Dunger DB, Jones TW, Donaghue KC

Authors notes:
Diabetes Care. 2015;38(4):676-681

Keywords:
Cardiac autonomic dysfunction, albumin-to-creatinine ratio, adolescents, type 1 diabetes, nephropathy

Abstract:
This study examined the association between cardiac autonomic dysfunction and high albumin-to-creatinine ratio (ACR) in adolescents with type 1 diabetes.

The upper-tertile ACR group had a faster heart rate and less heart rate variability.

HbA1c was 8.5% (69 mmol/mmol) in the upper tertile vs. 8.3% (67 mmol/mol) in the lower tertiles.

In multivariable analysis, upper-tertile ACR was associated with faster heart rate and lower RMSSD, independent of age and HbA1c.

Adolescents at potentially higher risk for nephropathy show an adverse cardiac autonomic profile, indicating sympathetic overdrive, compared with the lower-risk group.

Longitudinal follow-up of this cohort will further characterize the relationship between autonomic and renal dysfunction and the effect of interventions in this population.