RT Journal Article
SR Electronic
T1 Relative Hypoxia and Early Diabetic Kidney Disease in Type 1 Diabetes
JF Diabetes
JO Diabetes
FD American Diabetes Association
SP 2700
OP 2708
DO 10.2337/db20-0457
VO 69
IS 12
A1 Vinovskis, Carissa
A1 Li, Lu-Ping
A1 Prasad, Pottumarthi
A1 Tommerdahl, Kalie
A1 Pyle, Laura
A1 Nelson, Robert G.
A1 Pavkov, Meda E.
A1 van Raalte, Daniel
A1 Rewers, Marian
A1 Pragnell, Marlon
A1 Mahmud, Farid H.
A1 Cherney, David Z.
A1 Johnson, Richard J.
A1 Nadeau, Kristen J.
A1 Bjornstad, Petter
YR 2020
UL http://diabetes.diabetesjournals.org/content/69/12/2700.abstract
AB The objective of this study was to compare the ratio of renal oxygen availability (RO2) to glomerular filtration rate (GFR), a measure of relative renal hypoxia, in adolescents with and without type 1 diabetes (T1D) and relate the ratio to albuminuria, renal plasma flow (RPF), fat mass, and insulin sensitivity (M/I). RO2 was estimated by blood oxygen level–dependent MRI; fat mass was estimated by DXA; GFR and RPF were estimated by iohexol and p-aminohippurate clearance; albuminuria was estimated by urine albumin-to-creatinine ratio (UACR); and M/I was estimated from steady-state glucose infusion rate/insulin (mg/kg/min) by hyperglycemic clamp in 50 adolescents with T1D (age 16.1 ± 3.0 years, HbA1c 8.6 ± 1.2%) and 20 control patients of similar BMI (age 16.1 ± 2.9 years, HbA1c 5.2 ± 0.2%). The RO2:GFR (ms/mL/min) was calculated as RO2 (T2*, ms) divided by GFR (mL/min). Whole-kidney RO2:GFR was 25% lower in adolescents with T1D versus control patients (P < 0.0001). In adolescents with T1D, lower whole-kidney RO2:GFR was associated with higher UACR (r = −0.31, P = 0.03), RPF (r = −0.52, P = 0.0009), and fat mass (r = −0.33, P = 0.02). Lower medullary RO2:GFR was associated with lower M/I (r = 0.31, P = 0.03). In conclusion, adolescents with T1D exhibited relative renal hypoxia that was associated with albuminuria and with increased RPF, fat mass, and insulin resistance. These data suggest a potential role of renal hypoxia in the development of diabetic kidney disease.