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Ueno A, Onishi Y, Mise K, Yamaguchi S, Kanno A, Nojima I, Higuchi C, Uchida HA, Shikata K, Miyamoto S, Nakatsuka A, Eguchi J, Hida K, Katayama A, Watanabe M, Nakato T, Tone A, Teshigawara S, Matsuoka T, Kamei S, Murakami K, Shimizu I, Miyashita K, Ando S, Nunoue T, Wada J. Plasma angiotensin-converting enzyme 2 (ACE2) is a marker for renal outcome of diabetic kidney disease (DKD) (U-CARE study 3). BMJ Open Diabetes Res Care 2024; 12:e004237. [PMID: 38816205 PMCID: PMC11141182 DOI: 10.1136/bmjdrc-2024-004237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Accepted: 05/15/2024] [Indexed: 06/01/2024] Open
Abstract
INTRODUCTION ACE cleaves angiotensin I (Ang I) to angiotensin II (Ang II) inducing vasoconstriction via Ang II type 1 (AT1) receptor, while ACE2 cleaves Ang II to Ang (1-7) causing vasodilatation by acting on the Mas receptor. In diabetic kidney disease (DKD), it is still unclear whether plasma or urine ACE2 levels predict renal outcomes or not. RESEARCH DESIGN AND METHODS Among 777 participants with diabetes enrolled in the Urinary biomarker for Continuous And Rapid progression of diabetic nEphropathy study, the 296 patients followed up for 9 years were investigated. Plasma and urinary ACE2 levels were measured by the ELISA. The primary end point was a composite of a decrease of estimated glomerular filtration rate (eGFR) by at least 30% from baseline or initiation of hemodialysis or peritoneal dialysis. The secondary end points were a 30% increase or a 30% decrease in albumin-to-creatinine ratio from baseline to 1 year. RESULTS The cumulative incidence of the renal composite outcome was significantly higher in group 1 with lowest tertile of plasma ACE2 (p=0.040). Group 2 with middle and highest tertile was associated with better renal outcomes in the crude Cox regression model adjusted by age and sex (HR 0.56, 95% CI 0.31 to 0.99, p=0.047). Plasma ACE2 levels demonstrated a significant association with 30% decrease in ACR (OR 1.46, 95% CI 1.044 to 2.035, p=0.027) after adjusting for age, sex, systolic blood pressure, hemoglobin A1c, and eGFR. CONCLUSIONS Higher baseline plasma ACE2 levels in DKD were protective for development and progression of albuminuria and associated with fewer renal end points, suggesting plasma ACE2 may be used as a prognosis marker of DKD. TRIAL REGISTRATION NUMBER UMIN000011525.
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Affiliation(s)
- Asami Ueno
- Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yasuhiro Onishi
- Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Koki Mise
- Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Satoshi Yamaguchi
- Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Ayaka Kanno
- Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Ichiro Nojima
- Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Chigusa Higuchi
- Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Haruhito A Uchida
- Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kenichi Shikata
- Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Satoshi Miyamoto
- Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Atsuko Nakatsuka
- Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Jun Eguchi
- Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kazuyuki Hida
- Department of Diabetology and Metabolism, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Akihiro Katayama
- Department of Diabetology and Metabolism, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Mayu Watanabe
- Department of Diabetology and Metabolism, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Tatsuaki Nakato
- Department of Internal Medicine, Okayama Saiseikai General Hospital, Okayama, Japan
| | - Atsuhito Tone
- Department of Internal Medicine, Okayama Saiseikai General Hospital, Okayama, Japan
| | | | - Takashi Matsuoka
- Department of Diabetic Medicine, Kurashiki Central Hospital, Kurashiki, Japan
| | - Shinji Kamei
- Department of Diabetic Medicine, Kurashiki Central Hospital, Kurashiki, Japan
| | - Kazutoshi Murakami
- Department of Diabetic Medicine, Kurashiki Central Hospital, Kurashiki, Japan
| | - Ikki Shimizu
- Sakakibara Heart Institute of Okayama, Okayama, Japan
| | | | | | | | - Jun Wada
- Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Soheilipour F, Abbasi Kasbi N, Imankhan M, Eskandari D. Complications and Treatment of Early-Onset Type 2 Diabetes. Int J Endocrinol Metab 2023; 21:e135004. [PMID: 38028250 PMCID: PMC10676662 DOI: 10.5812/ijem-135004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 07/12/2023] [Accepted: 07/15/2023] [Indexed: 12/01/2023] Open
Abstract
Context Global reports have revealed a dramatic rise in the number of patients diagnosed with type 2 diabetes (T2DM) over the past three decades in all age groups, even in children and adolescents. The physiologic phenomenon of insulin resistance during puberty, as well as genetic and epigenetic factors, are implicated in this phenomenon. It seems that patients with early-onset T2DM experience a more aggressive clinical course; however, limited treatments available for these patients pose a challenge. This narrative review intends to scrutinize the micro- and macrovascular complications and treatments of patients with early-onset T2DM. Methods The literature search was conducted in the PubMed database to identify all relevant original English articles published from the beginning of 2018 until January 2023. Results Vascular complications, such as albuminuria, hypertension, cardiovascular diseases, and retinopathy, were seen to be more common in early-onset T2DM compared to type 1 diabetes. The odds ratio of vascular complications was higher in early-onset compared to late-onset T2DM. In children and adolescents with T2DM, the only approved medications included metformin, insulin, and glucagon-like peptide-1 agonists. Treatment of early-onset T2DM with metformin monotherapy cannot yield durable glycemic control, and most patients need early combination therapy. Conclusions During the past years, the frequency of early-onset T2DM has been growing at an alarming rate. Vascular complications in these patients seem more aggressive and more challenging to control. Hence, further clinical trials should be conducted to develop novel therapeutic approaches and evaluate their long-term benefits in terms of glycemic control and preventing future complications.
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Affiliation(s)
- Fahimeh Soheilipour
- Minimally Invasive Surgery Research Center, Aliasghar Children Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Naghmeh Abbasi Kasbi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Delaram Eskandari
- Department of Endocrinology, Rasool Akram Medical Complex, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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El-Hady E, Behairy A, Goda NA, Abdelbaset-Ismail A, Ahmed AE, Al-Doaiss AA, Abd El-Rahim I, Alshehri MA, Aref M. Comparative physiological, morphological, histological, and AQP2 immunohistochemical analysis of the Arabian camels (Camelus dromedarius) and oxen kidney: Effects of adaptation to arid environments. FRONTIERS IN ANIMAL SCIENCE 2023. [DOI: 10.3389/fanim.2023.1078159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2023] Open
Abstract
Compared to other mammals, Arabian camels are ideal models for exploring the structural adaptations that enable camels to survive in arid environments. Thus, this study aimed to explore how evolutionary adaptation to arid conditions modifies the characteristics of the kidneys in Arabian camels (Camelus dromedarius) compared to oxen. Urine samples were physically and chemically analyzed. Harvested kidneys were subjected to topographical and fast spin echo magnetic resonance (FSE-MR) imaging. Histology, histomorphometry, and Aquaporin-2 (AQP2) expression by immunohistochemistry were also performed. Here, in dromedaries, sodium and potassium values in the urine were much higher (p=0.001, for both), whereas chloride was much lower (p=0.004) than the values of oxen. Compared with oxen, the level of the hormone aldosterone in serum was significantly lower (p=0.002), whereas creatinine and urea were significantly higher (p=0.005 and p=0.001, respectively). Uric acid in dromedaries and oxen did not differ significantly (p=0.349). Like sodium levels (p=0.001) in dromedary serum, chloride was also much higher (p=0.002) than in oxen. The average value of potassium was much lower (p=0.009) than that of oxen. Morphologically, anatomical and FSE MRI studies revealed that minor and major calyces were not found in dromedary kidneys. The renal pelvis was not found in oxen, and the major calyx was directly connected to the ureter. The dromedary kidney contained a wider medullary portion as well as increased diameters for renal corpuscles (RCs), proximal convoluted tubules (PCTs), and collecting tubules (CTs, p<0.05) compared with the oxen. We also noted that AQP2 was significantly expressed in dromedary nephron components, except for RCs, compared with oxen as shown by immunohistochemistry. Overall, these data strongly suggest that the dromedary has a greater ability to adapt to harsh desert conditions in terms of producing highly concentrated urine than oxen.
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The Significance of Exposure to Pregestational Type 2 Diabetes in Utero on Fetal Renal Size and Subcutaneous Fat Thickness. Int J Nephrol 2022; 2022:3573963. [PMID: 35812800 PMCID: PMC9262542 DOI: 10.1155/2022/3573963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 05/21/2022] [Accepted: 05/24/2022] [Indexed: 11/18/2022] Open
Abstract
Objectives. To determine the relationship between exposure to pregestational type 2 diabetes (T2D) and renal size and subcutaneous fat thickness in fetuses during routine obstetrical ultrasound. Methods. This was a case-control study (January 1, 2019 to December 31, 2019). Routine obstetrical ultrasounds performed between 18 and 22 weeks’ gestation at a tertiary-care fetal assessment unit were reviewed. “Cases” comprised ultrasounds of fetuses exposed to pregestational T2D in utero. The control group was assembled from ultrasounds of healthy controls. Postprocessing measurements of fetal renal size and abdominal wall thickness from stored images were performed by two independent observers, and findings were compared between groups. Results. There were 54 cases and 428 ultrasounds of healthy controls. The mean maternal age of cases was 32.1 years (SD 6.2) compared to 33.2 years (SD 5.3) for healthy controls, and the majority of ultrasounds were performed in multiparous patients (83%). At the 18 to 22 week ultrasound, there was a significant reduction in renal size amongst fetuses exposed to maternal T2D in utero compared to controls; among cases, the mean renal width was 8.0 mm (95% CI 7.8–8.1) compared to 11.4 mm (95% CI 10.6–12.7) in controls (
); the mean renal thickness among cases was 8.1 mm (95% CI 7.9–8.2) compared to 11.5 mm (95% CI 10.7–12.9) in controls (
). There was no obvious difference in estimated fetal weight between groups, yet fetuses exposed to maternal T2D had increased subcutaneous abdominal wall fat thickness at this early gestational age (
). Conclusions. Fetal renal size in cases exposed to pregestational T2D is significantly smaller compared to controls, and subcutaneous abdominal wall fat is significantly thicker. Given emerging evidence about the developmental origins of disease, further study is needed to correlate the association between fetal renal size and fat distribution in the fetus and the long-term risk of chronic renal disease and diabetes in these offspring.
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Fang L, Zhou L, Tamm M, Roth M. OM-85 Broncho-Vaxom ®, a Bacterial Lysate, Reduces SARS-CoV-2 Binding Proteins on Human Bronchial Epithelial Cells. Biomedicines 2021; 9:1544. [PMID: 34829773 PMCID: PMC8615539 DOI: 10.3390/biomedicines9111544] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 10/22/2021] [Accepted: 10/23/2021] [Indexed: 12/21/2022] Open
Abstract
In clinical studies, OM-85 Broncho-Vaxom®, a bacterial lysate, reduced viral respiratory tract infection. Infection of epithelial cells by SARS-CoV-2 depends on the interaction of its spike-protein (S-protein) with host cell membrane proteins. In this study, we investigated the effect of OM-85 on the expression of S-protein binding proteins by human bronchial epithelial cells. Human bronchial epithelial cells were treated with OM-85 over 5 days. The expression of SARS-CoV-2 receptor angiotensin converting enzyme 2 (ACE2), transmembrane protease serine subtype 2 (TMPRSS2), dipeptidyl peptidase-4 (DPP4), and a disintegrin and metalloprotease 17 (ADAM17) were determined by Western blotting and quantitative RT-PCR. Soluble (s)ACE2, heparan sulfate, heparanase, and hyaluronic acid were assessed by ELISA. OM-85 significantly reduced the expression of ACE2 (p < 0.001), TMPRSS2 (p < 0.001), DPP4 (p < 0.005), and cellular heparan sulfate (p < 0.01), while ADAM17 (p < 0.02) expression was significantly upregulated. Furthermore, OM-85 increased the level of sACE2 (p < 0.05), hyaluronic acid (p < 0.002), and hyaluronan synthase 1 (p < 0.01). Consequently, the infection by a SARS-CoV-2 spike protein pseudo-typed lentivirus was reduced in cells pretreated with OM-85. All effects of OM-85 were concentration- and time-dependent. The results suggest that OM-85 might reduce the binding of SARS-CoV-2 S-protein to epithelial cells by modification of host cell membrane proteins and specific glycosaminoglycans. Thus, OM-85 might be considered as an add-on for COVID-19 therapy.
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Affiliation(s)
- Lei Fang
- Pulmonary Cell Research, Department of Biomedicine & Internal Medicine, University Hospital Basel, CH-4031 Basel, Switzerland
| | - Liang Zhou
- Pulmonary Cell Research, Department of Biomedicine & Internal Medicine, University Hospital Basel, CH-4031 Basel, Switzerland
| | - Michael Tamm
- Pulmonary Cell Research, Department of Biomedicine & Internal Medicine, University Hospital Basel, CH-4031 Basel, Switzerland
| | - Michael Roth
- Pulmonary Cell Research, Department of Biomedicine & Internal Medicine, University Hospital Basel, CH-4031 Basel, Switzerland
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Sex and kidney ACE2 expression in primary focal segmental glomerulosclerosis: A NEPTUNE study. PLoS One 2021; 16:e0252758. [PMID: 34097714 PMCID: PMC8184004 DOI: 10.1371/journal.pone.0252758] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 05/22/2021] [Indexed: 02/06/2023] Open
Abstract
Background Angiotensin-converting enzyme 2 (ACE2) has been implicated in the pathogenesis of experimental kidney disease. ACE2 is on the X chromosome, and in mice, deletion of ACE2 leads to the development of focal segmental glomerulosclerosis (FSGS). The relationship between sex and renal ACE2 expression in humans with kidney disease is a gap in current knowledge. Methods We studied renal tubulointerstitial microarray data and clinical variables from subjects with FSGS enrolled in the Nephrotic Syndrome Study Network (NEPTUNE) study. We compared relationships between ACE2 expression and age, estimated glomerular filtration rate (eGFR), urinary albumin to creatinine ratio (UACR), interstitial fibrosis, tubular atrophy, and genes implicated in inflammation and fibrosis in male and female subjects. Results ACE2 mRNA expression was lower in the tubulointerstitium of males compared to females (P = 0.0026). Multiple linear regression analysis showed that ACE2 expression was related to sex and eGFR but not to age or treatment with renin angiotensin system blockade. ACE2 expression is also related to interstitial fibrosis, and tubular atrophy, in males but not in females. Genes involved in inflammation (CCL2 and TNF) correlated with ACE2 expression in males (TNF: r = -0.65, P < 0.0001; CCL2: r = -0.60, P < 0.0001) but not in females. TGFB1, a gene implicated in fibrosis correlated with ACE2 in both sexes. Conclusions Sex is an important determinant of ACE2 expression in the tubulointerstitium of the kidney in FSGS. Sex also influences the relationships between ACE2, kidney fibrosis, and expression of genes involved in kidney inflammation.
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Slaght JL, Wicklow BA, Dart AB, Sellers EAC, Gabbs M, Carino M, McGavock JM. Physical activity and cardiometabolic health in adolescents with type 2 diabetes: a cross-sectional study. BMJ Open Diabetes Res Care 2021; 9:9/1/e002134. [PMID: 33990367 PMCID: PMC8127979 DOI: 10.1136/bmjdrc-2021-002134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 04/14/2021] [Accepted: 04/25/2021] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Youth living with type 2 diabetes display increased risk of cardiovascular disease (CVD). It is unclear if regular physical activity (PA) modifies this risk. RESEARCH DESIGN AND METHODS We compared CVD risk factors in a cross-sectional study of 164 youth with type 2 diabetes stratified according to weekly vigorous-intensity PA. Outcomes were hemoglobin A1c (HbA1c), ambulatory blood pressure (BP; ambulatory 24-hour readings), plasma lipoproteins, and albuminuria. The main exposure, vigorous-intensity PA, was quantified with the Adolescent Physical Activity Recall Questionnaire. RESULTS Youth were 15±3 years, and 78% lived rurally and 68% were female, with a mean body mass index (BMI) Z-score of 2.4±1.1 and a mean HbA1c of 9.6% ±2.6%. Youth who participated in regular vigorous-intensity PA (40%; n=67) achieved nearly twice the dose of PA than peers who did not (62 vs 34 metabolic equivalent score-hour/week, p=0.001). After adjusting for duration of diabetes, BMI Z-score, sex, and smoking, youth who engaged in vigorous-intensity PA displayed lower HbA1c (9.1% vs 9.9%, p=0.052), diastolic BP (70 mm Hg vs 73 mm Hg, p=0.002), diastolic load (20% vs 26%, p=0.023), and mean arterial pressure (87.3 mm Hg vs 90.3 mm Hg, p<0.01), compared with youth who did not. Compared with youth who did not participate in regular vigorous-intensity PA, those who did also displayed lower odds of albuminuria after adjusting for duration of diabetes, sex, smoking, rural residence, and BMI Z-score (adjusted OR: 0.40, 95% CI 0.19 to 0.84). CONCLUSIONS Among youth with type 2 diabetes, participation in vigorous-intensity PA is associated with lower CVD risk.
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Affiliation(s)
- Jana L Slaght
- Pediatrics and Child Health, University of Manitoba Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Theme, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
| | - Brandy Alexandra Wicklow
- Pediatrics and Child Health, University of Manitoba Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Theme, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Theme, Pediatric Endocrinology and Metabolism, Department of Paediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Allison B Dart
- Pediatrics and Child Health, University of Manitoba Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Theme, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
| | - Elizabeth A C Sellers
- Pediatrics and Child Health, University of Manitoba Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Theme, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Theme, Pediatric Endocrinology and Metabolism, Department of Paediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Melissa Gabbs
- Pediatrics and Child Health, University of Manitoba Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Theme, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
| | - Marylin Carino
- Pediatrics and Child Health, University of Manitoba Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Theme, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
| | - Jonathan M McGavock
- Pediatrics and Child Health, University of Manitoba Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Theme, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
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Carino M, Elia Y, Sellers E, Curtis J, McGavock J, Scholey J, Hamilton J, Clarson C, Pinto T, Hadjiyannakis S, Mertens L, Samaan MC, Ho J, Nour M, Panagiotopoulos C, Jetha M, Gabbs M, Mahmud FH, Wicklow B, Dart A. Comparison of Clinical and Social Characteristics of Canadian Youth Living With Type 1 and Type 2 Diabetes. Can J Diabetes 2021; 45:428-435. [PMID: 33714663 DOI: 10.1016/j.jcjd.2021.01.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/11/2021] [Accepted: 01/16/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Our aim in this study was to describe the clinical and social characteristics of 2 Canadian cohorts of adolescents with diabetes. METHODS Participants from the Improving renal Complications in Adolescents with type 2 diabetes through REsearch (iCARE) study (n=322) and the Early Determinants of Cardio-Renal Disease in Youth With Type 1 Diabetes (n=199) study were compared. RESULTS Adolescents were 10 to 18 years of age (mean ± standard deviation: 14.8±2.4 years). The T2DM cohort had a shorter duration of diabetes. Both groups had glycated hemoglobin levels above target. The type 2 diabetes (T2D) cohort was comprised of predominantly Indigenous youth. The type 1 diabetes (T1D) cohort was 58.3% European/Caucasian, with a high proportion (41.7%) of visible minority groups (Afro-Caribbean, Asian/Pacific Islander, Hispanic). The prevalence of obesity, hypertension, left ventricular hypertrophy, albuminuria and hyperfiltration was higher in the T2D cohort. The T1D cohort was more socially and economically advantaged in all 4 dimensions of health inequality. CONCLUSIONS There are significant differences in clinical and social characteristics of adolescents with T2D and T1D in Canada. Both have inadequate glycemic control with evidence of onset and progression of diabetes-related complications.
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Affiliation(s)
- Marylin Carino
- Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
| | - Yesmino Elia
- Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; Can-SOLVE CKD SPOR Network, Canada
| | - Elizabeth Sellers
- Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada; Department of Pediatrics and Child Health, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jacqueline Curtis
- Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Jon McGavock
- Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada; Department of Pediatrics and Child Health, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - James Scholey
- Can-SOLVE CKD SPOR Network, Canada; Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jill Hamilton
- Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Cheril Clarson
- Department of Pediatrics, University of Western Ontario, Western University, London, Ontario, Canada
| | - Teresa Pinto
- Department of Pediatrics, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Stasia Hadjiyannakis
- Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Luc Mertens
- Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - M Constantine Samaan
- Department of Pediatrics, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Josephine Ho
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Munier Nour
- Department of Pediatrics, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Constadina Panagiotopoulos
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mary Jetha
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Melissa Gabbs
- Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
| | - Farid H Mahmud
- Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; Can-SOLVE CKD SPOR Network, Canada
| | - Brandy Wicklow
- Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada; Department of Pediatrics and Child Health, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada; Can-SOLVE CKD SPOR Network, Canada
| | - Allison Dart
- Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada; Department of Pediatrics and Child Health, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada; Can-SOLVE CKD SPOR Network, Canada.
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