Diabetes, Vol 45, Issue 1 51-55, Copyright © 1996 by American Diabetes Association

ARTICLES

Effect of puberty on markers of glomerular hypertrophy and hypertension in IDDM

ML Lawson, EB Sochett, PG Chait, JW Balfe and D Daneman
Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada.

Epidemiological data implicate puberty as a factor in the initiation of diabetic nephropathy. However, the mechanism remains unclear. We hypothesized that puberty would result in an increase in glomerular hypertrophy and hypertension; these two early concomitant events are seen as pivotal to the pathophysiology of diabetic nephropathy. We studied the effect of pubertal duration on three surrogate markers of glomerular hypertrophy/hypertension: kidney volume (KV), microalbuminuria (MA), and Na-Li countertransport (CT). We recruited 177 subjects (87 female and 90 male; aged 6.2-22.1 years) with IDDM of 5 to 10 years' duration (6.8 +/- 1.6 years) into three groups with different pubertal duration: prepubertal since IDDM diagnosis; prepubertal at diagnosis, now pubertal; or early puberty at diagnosis, now postpubertal. KV was measured by ultrasound and corrected for body surface area; MA was defined as urinary albumin excretion of 15-200 micrograms/min in two of three 24-h samples, and Na-Li CT was measured in erythrocytes. As pubertal duration increased, there was a disproportionate increase in mean KV (prepubertal, 247 +/- 6 [SE] ml/1.73 m2; pubertal, 282 +/- 7/1.73 m2; postpubertal, 295 +/- 7/1.73 m2, P = 0.001), prevalence of nephromegaly (KV > 300 ml/1.73 m2) (14, 31, and 45%, respectively, P = 0.001), and prevalence of MA (0, 9.7, and 20.5%, respectively, P = 0.003). Subjects with KV > 300 ml/1.73 m2 were eight times more likely to have MA than those with KV < 300 (odds ratio 8.1, 95% confidence interval 2.4-27.4, P = 0.0001). There was no effect of pubertal duration on Na-Li CT. Multiple regression with KV as the dependent variable found an association with pubertal duration, MA, Na-Li CT, and current HbA1c (P < 0.0001). Our findings indicate that pubertal duration is an important determinant of both KV and MA and suggest that nephromegaly precedes microalbuminuria. We postulate that these effects are attributable to the influence of the pubertal milieu on glomerular hypertrophy/hypertension.
CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				G. Zerbini, R. Bonfanti, F. Meschi, E. Bognetti, P. L. Paesano, L. Gianolli, M. Querques, A. Maestroni, G. Calori, A. Del Maschio, et al. Persistent Renal Hypertrophy and Faster Decline of Glomerular Filtration Rate Precede the Development of Microalbuminuria in Type 1 Diabetes Diabetes, September 1, 2006; 55(9): 2620 - 2625. [Abstract] [Full Text] [PDF]

				M. Svensson, L. Nystrom, S. Schon, G. Dahlquist, and on behalf of the Swedish Childhood Diabetes Study Age at Onset of Childhood-Onset Type 1 Diabetes and the Development of End-Stage Renal Disease: A nationwide population-based study. Diabetes Care, March 1, 2006; 29(3): 538 - 542. [Abstract] [Full Text] [PDF]

				K. N. Drummond, M. S. Kramer, S. Suissa, C. Levy-Marchal, S. Dell'Aniello, A. Sinaiko, and M. Mauer Effects of Duration and Age at Onset of Type 1 Diabetes on Preclinical Manifestations of Nephropathy Diabetes, July 1, 2003; 52(7): 1818 - 1824. [Abstract] [Full Text] [PDF]

				P. H. Lane Diabetic kidney disease: impact of puberty Am J Physiol Renal Physiol, October 1, 2002; 283(4): F589 - F600. [Abstract] [Full Text] [PDF]

				M. Mauer and K. Drummond The Early Natural History of Nephropathy in Type 1 Diabetes: I. Study Design and Baseline Characteristics of the Study Participants Diabetes, May 1, 2002; 51(5): 1572 - 1579. [Abstract] [Full Text] [PDF]

				J. Krakoff, R. L. Hanson, S. Kobes, and W. C. Knowler Comparison of the Effect of Plasma Glucose Concentrations on Microvascular Disease Between Pima Indian Youths and Adults Diabetes Care, June 1, 2001; 24(6): 1023 - 1028. [Abstract] [Full Text]

				T. Renne, J. Dedio, J. C. M. Meijers, D. Chung, and W. Muller-Esterl Mapping of the Discontinuous H-kininogen Binding Site of Plasma Prekallikrein. EVIDENCE FOR A CRITICAL ROLE OF APPLE DOMAIN-2 J. Biol. Chem., September 3, 1999; 274(36): 25777 - 25784. [Abstract] [Full Text] [PDF]

				S. Nader, M. G. Riad-Gabriel, and M. F. Saad The Effect of a Desogestrel-Containing Oral Contraceptive on Glucose Tolerance and Leptin Concentrations in Hyperandrogenic Women J. Clin. Endocrinol. Metab., September 1, 1997; 82(9): 3074 - 3077. [Abstract] [Full Text] [PDF]