Abstract
Objectives
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.
Methods
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.
Results
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.
Conclusions
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.
Résumé
Objectifs
On en connaît peu sur la relation entre l’albuminurie chez les jeunes atteints du
diabète de type 2 (DT2) et le risque cardiovasculaire. Nous avions pour objectif de
déterminer si les jeunes atteints du DT2 qui ont une albuminurie démontrent une augmentation
du risque de maladie cardiovasculaire et/ou de dysfonctionnement cardiovasculaire
précoce par rapport aux jeunes atteints du DT2 qui n’ont pas d’albuminurie.
Méthodes
Nous avons réparti les jeunes atteints du DT2 en fonction de l’albuminurie. Nous avons
comparé les facteurs de risque cardiovasculaire, y compris l’indice de masse corporelle
(IMC), la pression artérielle sur une période de 24 heures, le bilan lipidique, la
consommation de tabac et l’exposition à la fumée du tabac, l’activité physique et
le temps d’écran habituels entre les groupes. Nous avons évalué la structure et le
fonctionnement du ventricule gauche, et l’épaisseur de l’intima-média carotidienne
(EIMc) des participants qui avaient subi une imagerie cardiaque.
Résultats
Parmi les 265 jeunes participants, 83 (31,3 %) avaient une albuminurie. L’ethnicité,
le sexe, le z-score de l’IMC, l’âge au diagnostic, la durée du diabète et le facteur
nucléaire hépatocytaire 1-alpha (HNF1-α, de l’anglais hepatocyte nuclear factor-1alpha) ne différaient pas entre les jeunes répartis en fonction de l’albuminurie. La consommation
de tabac, l’exposition à la fumée secondaire et les faibles niveaux d’activité physique
ne différaient pas entre les groupes. Les jeunes qui avaient une albuminurie étaient
plus susceptibles de faire de l’hypertension, et d’avoir une dyslipidémie et une mauvaise
régulation de la glycémie. La structure du ventricule gauche et l’EIMc ne différaient
pas entre les groupes, mais les jeunes qui avaient une albuminurie ne démontraient
pas de dysfonctionnement diastolique précoce du ventricule gauche.
Conclusions
Nous avons constaté l’augmentation des facteurs de risque de maladie cardiovasculaire
et de dysfonctionnement diastolique ventriculaire gauche chez les jeunes atteints
du DT2 qui ont une albuminurie par rapport aux jeunes qui n’ont pas d’albuminurie,
malgré la durée relativement courte de la maladie. Par conséquent, l’albuminurie peut
servir de marqueur précoce du risque de maladie cardiovasculaire chez les jeunes atteints
du DT2.
Keywords
Mots clés
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Article info
Publication history
Published online: April 13, 2021
Accepted:
April 4,
2021
Received in revised form:
March 11,
2021
Received:
October 30,
2020
Identification
Copyright
© 2021 Canadian Diabetes Association.
