TY - JOUR
T1 - The incidences of and risk factors for severe retinopathy requiring photocoagulation and albuminuria in Japanese patients with childhood-onset type 1 diabetes
AU - The Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes (JSGIT)
AU - Takaike, Hiroko
AU - Uchigata, Yasuko
AU - Matsuura, Nobuo
AU - Sasaki, Nozomu
AU - Amemiya, Shin
AU - Urakami, Tatsuhiko
AU - Kawamura, Tomoyuki
AU - Kikuchi, Nobuyuki
AU - Sugihara, Shigetaka
AU - Adachi, Masanori
AU - Tachibana, Katsuhiko
AU - Aso, Taiji
AU - Kizu, Rika
AU - Fujimoto, Masatoshi
AU - Fujitsuka, Satoshi
AU - Motegi, Akira
AU - Morinishi, Yoichi
AU - Fujiwara, Ikuma
AU - Ogawa, Eishin
AU - Fukushima, Naoki
AU - Hanaki, Keiichi
AU - Kanzaki, Susumu
AU - Hasegawa, Yukihiro
AU - Hirano, Takeki
AU - Horikawa, Reiko
AU - Hotsubo, Tomoyuki
AU - Igarashi, Yutaka
AU - Inoue, Masaru
AU - Kanzaki, Susumu
AU - Isshiki, Gen
AU - Hashimoto, Tomomi
AU - Ito, Yoshiya
AU - Mukai, Tokuo
AU - Jinno, Kazuhiko
AU - Kanematsu, Sachiko
AU - Sasaki, Kaori
AU - Kasahara, Yoshihito
AU - Kida, Kaichi
AU - Takemoto, Koji
AU - Shiga, Kentaro
AU - Kohno, Hitoshi
AU - Kinjo, Saori
AU - Minagawa, Masanori
AU - Kinoshita, Kaori
AU - Kinugasa, Akihiko
AU - Ohki, Yukashi
AU - Kishi, Megumi
AU - Kobayashi, Koji
AU - Mochizuki, Mie
AU - Koike, Akemi
N1 - Funding Information:
Acknowledgements This study was supported by a grant-in-aid from the Japan Diabetes Foundation. We would like to thank the following doctors who were members of the Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes (JSGIT): Masanori Adachi, M.D., and Katsuhiko Tachibana, M.D., Kanagawa Children’s Medical Center; Taiji Aso, M.D., and Rika Kizu, M.D., Department of Pediatrics, Yokosuka Kyousai Hospital; Masatoshi Fujimoto, M.D., Department of Pediatrics, St. Marianna University; Satoshi Fujitsuka, M.D., Akira Motegi, M.D., and Yoichi Morinishi, M.D., Department of Pediatrics, National Defence Medical Collage; Ikuma Fujiwara, M.D., and Eishin Ogawa, M.D., Department of Pediatrics,
PY - 2018/5/1
Y1 - 2018/5/1
N2 - The aim of this study was to clarify the incidences of and the risk factors for severe retinopathy requiring photocoagulation therapy and albuminuria in Japanese patients with childhood-onset type 1 diabetes mellitus. A total of 756 patients from a cohort study by the Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes were included in the study. Patients were registered in 1995 or 2000, and HbA1cwas measured every 4 months and analyzed in central hospital for an average of 6 years. The presence of severe retinopathy requiring laser photocoagulation and the presence of albuminuria was checked for during the period 2010–2011. During a median of 18 (range: 15–21) years, 34 out of 756 patients underwent laser photocoagulation and 57 out of 605 patients developed albuminuria. A Cox proportional hazards model showed that the risk of severe retinopathy requiring laser photocoagulation increased by 1.15 (95% confidence interval [CI] 1.03–1.29, p = 0.012) with each increase of a year in the age at onset, by 4.03 (95% CI 1.20–13.5, p = 0.024) in females, and by 2.05 (95% CI 1.69–2.49, p < 0.0001) with each increase of 1% in HbA1c. The risk of albuminuria increased significantly, by 1.09 (95% CI 1.01–1.18 p = 0.037), with each increase of a year in the age at onset and by 2.38 (95% CI 1.93–2.97 p < 0.0001) with each increase of 1% in HbA1c. In Japanese patients with childhood-onset type 1 diabetes, older age at the onset of diabetes, female rather than male gender, and higher HbA1c were found to increase the risk of requiring photocoagulation. No patients with HbA1c < 7.5% developed severe retinopathy requiring photocoagulation therapy. The risk of developing albuminuria increased with age at onset of diabetes and HbA1c. Female gender was a strong risk factor for severe retinopathy requiring photocoagulation, but not for albuminuria.
AB - The aim of this study was to clarify the incidences of and the risk factors for severe retinopathy requiring photocoagulation therapy and albuminuria in Japanese patients with childhood-onset type 1 diabetes mellitus. A total of 756 patients from a cohort study by the Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes were included in the study. Patients were registered in 1995 or 2000, and HbA1cwas measured every 4 months and analyzed in central hospital for an average of 6 years. The presence of severe retinopathy requiring laser photocoagulation and the presence of albuminuria was checked for during the period 2010–2011. During a median of 18 (range: 15–21) years, 34 out of 756 patients underwent laser photocoagulation and 57 out of 605 patients developed albuminuria. A Cox proportional hazards model showed that the risk of severe retinopathy requiring laser photocoagulation increased by 1.15 (95% confidence interval [CI] 1.03–1.29, p = 0.012) with each increase of a year in the age at onset, by 4.03 (95% CI 1.20–13.5, p = 0.024) in females, and by 2.05 (95% CI 1.69–2.49, p < 0.0001) with each increase of 1% in HbA1c. The risk of albuminuria increased significantly, by 1.09 (95% CI 1.01–1.18 p = 0.037), with each increase of a year in the age at onset and by 2.38 (95% CI 1.93–2.97 p < 0.0001) with each increase of 1% in HbA1c. In Japanese patients with childhood-onset type 1 diabetes, older age at the onset of diabetes, female rather than male gender, and higher HbA1c were found to increase the risk of requiring photocoagulation. No patients with HbA1c < 7.5% developed severe retinopathy requiring photocoagulation therapy. The risk of developing albuminuria increased with age at onset of diabetes and HbA1c. Female gender was a strong risk factor for severe retinopathy requiring photocoagulation, but not for albuminuria.
KW - Child-onset type 1 diabetes
KW - Laser photocoagulation
KW - Macroalbuminuria
KW - Microalbuminuria
KW - Microangiopathy
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U2 - 10.1007/s13340-017-0336-9
DO - 10.1007/s13340-017-0336-9
M3 - Article
AN - SCOPUS:85046795245
VL - 9
SP - 121
EP - 128
JO - Diabetology International
JF - Diabetology International
SN - 2190-1678
IS - 2
ER -