A new strategy for vascular complications in young people with type 1 diabetes mellitus

被引：25

作者：

Marcovecchio, M. Loredana ^{[1
]}

Dalton, R. Neil ^{[2
]}

Daneman, Denis ^{[3
,4
]}

Deanfield, John ^{[5
]}

Jones, Timothy W. ^{[6
]}

Neil, Andrew W. ^{[7
]}

Dunger, David B. ^{[1
,8
]}

Acerini, C. ^{[9
]}

Ackland, F. ^{[10
]}

Anand, B. ^{[11
]}

Barrett, T. ^{[12
,13
]}

Birrell, V. ^{[14
]}

Campbell, F. ^{[15
]}

Charakida, M. ^{[16
]}

Cheetham, T. ^{[17
,18
]}

Chiesa, T. ^{[19
]}

Deanfield, J. ^{[19
]}

Cooper, C. ^{[20
]}

Doughty, I. ^{[21
]}

Dutta, A. ^{[22
]}

Edge, J. ^{[23
]}

Gray, A. ^{[24
]}

Hamilton-Shield, J. ^{[25
,26
]}

Mann, N. ^{[27
]}

Marcovecchio, M. L. ^{[9
]}

Marshall, S. ^{[18
]}

Rayman, G. ^{[28
]}

Robinson, J. M. ^{[29
,30
]}

Russell-Taylor, M. ^{[31
]}

Sankar, V. ^{[32
]}

Smith, A. ^{[33
]}

Thalange, N. ^{[34
]}

Yaliwal, C. ^{[27
]}

Benitez-Aguirre, P. ^{[35
,36
]}

Cameron, F. ^{[37
,38
]}

Cotterill, A. ^{[39
]}

Couper, J. ^{[40
,41
]}

Craig, M. ^{[35
,36
,42
]}

Davis, E. ^{[43
,44
]}

Donaghue, K. ^{[35
,36
]}

Jones, T. W. ^{[43
,44
]}

King, B. ^{[45
]}

Verge, C. ^{[42
,46
]}

Bergman, P. ^{[47
]}

Rodda, C. ^{[38
]}

Clarson, C. ^{[48
,49
]}

Curtis, J. ^{[50
,51
]}

Daneman, D. ^{[50
,51
]}

Mahmud, F. ^{[50
,51
]}

Sochett, E. ^{[50
,51
]}

机构：

[1] Univ Cambridge, Dept Paediat, Cambridge, England

[2] Guys & St Thomas NHS Fdn Trust, London, England

[3] Hosp Sick Children, Dept Paediat, Toronto, ON, Canada

[4] Univ Toronto, Toronto, ON, Canada

[5] UCL, Inst Cardiovasc Sci, Vasc Physiol Unit, London, England

[6] Univ Western Australia, Telethon Kids Inst, Perth, WA, Australia

[7] Univ Oxford, Oxford Ctr Diabet Endocrinol & Metab, Oxford, England

[8] Univ Cambridge, Wellcome Trust MRC Inst Metab Sci, Cambridge, England

[9] Univ Cambridge, Cambridge, England

[10] Northampton Gen Hosp, Northampton, England

[11] West Suffolk Hosp, NHS Fdn Trust, Bury St Edmunds, Suffolk, England

[12] Birmingham Childrens Hosp, Birmingham, W Midlands, England

[13] Univ Birmingham, Birmingham, W Midlands, England

[14] South Tees Hosp NHS Fdn Trust, James Cook Hosp, Middlesbrough, Cleveland, England

[15] Leeds Teaching Hosp NHS Trust, Leeds Gen Infirm, Leeds, W Yorkshire, England

[16] Kings Coll London, London, England

[17] Newcastle Upon Tyne Hosp NHS Fdn Trust, Royal Victoria Infirm, Newcastle Upon Tyne, Tyne & Wear, England

[18] Newcastle Univ, Newcastle Upon Tyne, Tyne & Wear, England

[19] UCL, London, England

[20] Stockport NHS Fdn Trust, Stepping Hill Hosp, Stockport, Lancs, England

[21] Royal Manchester Childrens Hosp, Manchester, Lancs, England

[22] Stoke Mandeville Hosp, Aylesbury, Bucks, England

[23] John Radcliffe Hosp, Oxford, England

[24] Univ Oxford, Oxford, England

[25] Univ Bristol, Bristol, Avon, England

[26] Univ Hosp Bristol NHS Fdn Trust, Bristol, Avon, England

[27] Royal Berkshire Hosp, Reading, Berks, England

[28] Ipswich Hosp NHS Trust, Ipswich, Suffolk, England

[29] Royal Albert Edward Infirm, Wrightington, England

[30] Wigan & Leigh NHS Fdn Trust, Wigan, England

[31] Buckingham Healthcare NHS Trust, Wycombe Hosp, High Wycombe, Bucks, England

[32] Bolton NHS Fdn Trust, Royal Bolton Hosp, Bolton, England

[33] Northampton Gen Hosp, Northampton, England

[34] Norfolk & Norwich Univ Hosp NHS Fdn Trust, Norwich, Norfolk, England

[35] Childrens Hosp Westmead, Sydney, NSW, Australia

[36] Univ Sydney, Sydney, NSW, Australia

[37] Royal Childrens Hosp, Murdoch Childrens Res Inst, Melbourne, Vic, Australia

[38] Univ Melbourne, Melbourne, Vic, Australia

[39] Univ Queensland, Brisbane, Qld, Australia

[40] Womens & Childrens Hosp, Adelaide, SA, Australia

[41] Univ Adelaide, Adelaide, SA, Australia

[42] Univ New South Wales, Sydney, NSW, Australia

[43] Princess Margaret Hosp Children, Perth, WA, Australia

[44] Univ Western Australia, Perth, WA, Australia

[45] Univ Newcastle, Newcastle, NSW, Australia

[46] Sydney Childrens Hosp, Sydney, NSW, Australia

[47] Monash Childrens Hosp, Clayton, Vic, Australia

[48] London Hlth Sci Ctr, London, ON, Canada

[49] Western Univ, London, ON, Canada

[50] Hosp Sick Children, Toronto, ON, Canada

来源：

NATURE REVIEWS ENDOCRINOLOGY | 2019年 / 15卷 / 07期

关键词：

ALBUMIN EXCRETION; LIFE EXPECTANCY; KIDNEY-DISEASE; CARDIOVASCULAR OUTCOMES; INSULIN SENSITIVITY; RENAL-DISEASE; HIGH-RISK; ADOLESCENTS; MICROALBUMINURIA; MORTALITY;

D O I：

10.1038/s41574-019-0198-2

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Diabetes vascular complications, including cardiovascular disease, diabetic nephropathy and retinopathy, have a negative effect on the long-term prognosis of young people with type 1 diabetes mellitus (T1DM). Poor glycaemic control and consequent increased HbA(1c) levels are major risk factors for the development of vascular complications. HbA(1c) levels are the main focus of current management strategies; however, the recommended target is rarely achieved in adolescents. Thus, a clear need exists for improved biomarkers to identify high-risk young people early and to develop new intervention strategies. Evidence is accumulating that early increases in urinary albumin excretion could be predictive of adolescents with T1DM who are at an increased risk of developing vascular complications, independent of HbA(1c) levels. These findings present an opportunity to move towards the personalized care of adolescents with T1DM, which takes into consideration changes in albumin excretion and other risk factors in addition to HbA(1c) levels.

引用

页码：429 / 435

页数：7

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