Urinary α 1 -microglobulin and albumin excretion in children and adolescents with type 1 diabetes.

BACKGROUND: The present study investigated the correlation between urinary α1 -microglobulin as a marker of tubular dysfunction and albumin excretion in children and adolescents with type 1 diabetes (T1D).

METHODS: Ninety-two Egyptian patients with T1D were included in the study (mean [± SD] age 14.14 ± 5.13 years). The duration of diabetes in all patients was >5 years (mean [± SD] duration 8.28 ± 2.62 years) and all had normal renal function. Forty healthy subjects were also included as a control group. Urinary albumin excretion was assessed in all patients and urinary α1 -microglobulin was measured in both patients and control in the morning urine specimen.

RESULTS: Analysis of the results showed that patients had significantly higher levels of urinary α1 -microglobulin than the controls (P < 0.01). Among the patients, there was a strong positive correlation between urinary α1 -microglobulin and urinary albumin excretion (P < 0.01). Positive correlations were also found between urinary α1 -microglobulin and duration of diabetes (P < 0.01), HbA1c (P < 0.05), and fasting and postprandial blood glucose (P < 0.05 for both).

CONCLUSION: The present study shows that urinary α1 -microglobulin is strongly correlated with urinary albumin excretion in children and adolescents with T1D. In addition, it demonstrates the importance of tubular dysfunction as an early and integral component of diabetic nephropathy syndrome in these patients. The results of the present study emphasize the value of tight glycemic control in slowing the progression of tubular dysfunction, especially in patients with a longer duration of diabetes.