Progression to microalbuminuria in type 1 diabetes: development and validation of a prediction rule
Year: 2009
Type: article
Abstract: AIMS/HYPOTHESIS: Microalbuminuria is common in type 1 diabetes and is associated with an increased risk of renal and cardiovascular disease. We aimed to develop and validate a clinical prediction rule that estimates the absolute risk of microalbuminuria. METHODS: Data from the European Diabetes Prospective Complications Study (n = 1115) were used to develop the prediction rule (development set). Multivariable logistic regression analysis was used to assess the association between potential predictors and progression to microalbuminuria within 7 years. The performance of the prediction rule was assessed with calibration and discrimination (concordance statistic [c-statistic]) measures. The rule was validated in three other diabetes studies (Pittsburgh Epidemiology of Diabetes Complications [EDC] study, Finnish Diabetic Nephropathy [FinnDiane] study and Coronary Artery Calcification in Type 1 Diabetes [CACTI] study). RESULTS: Of patients in the development set, 13% were microalbuminuric after 7 years. Glycosylated haemoglobin, AER, WHR, BMI and ever smoking were found to be the most important predictors. A high-risk group (n = 87 [8%]) was identified with a risk of progression to microalbuminuria of 32%. Predictions showed reasonable discriminative ability, with c-statistic of 0.71. The rule showed good calibration and discrimination in EDC, FinnDiane and CACTI (c-statistic 0.71, 0.79 and 0.79, respectively). CONCLUSIONS/INTERPRETATION: We developed and validated a clinical prediction rule that uses relatively easily obtainable patient characteristics to predict microalbuminuria in patients with type 1 diabetes. This rule can help clinicians to decide on more frequent check-ups for patients at high risk of microalbuminuria in order to prevent long-term chronic complications.
Source: Diabetologia
Language: English
Subfield: Nephrology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,490
Funders: American Diabetes Association, Wilhelm och Else Stockmanns Stiftelse, Wellcome Trust, Folkhälsanin Tutkimussäätiö, Diabetes UK, European Commission, Signe ja Ane Gyllenbergin Säätiö, Samfundet Folkhälsan, National Institutes of Health, University of Colorado Denver, National Heart, Lung, and Blood Institute, National Institute of Diabetes and Digestive and Kidney Diseases, National Center for Research Resources
Awards: G1544922676, UCHSC Diabetes and Endocrinology Research Center, Complications and Comorbidities of Type 1 Diabetes, G248045910, G315284863, G3447962759, General Clinical Research Center, G3515674540, Epidemiology of Diabetes Complications (EDC) Phase II: Renewal, Coronary Artery Calcification in Type 1 Diabetes, G3949683738, G4468215933, G6600555270, G7350012196, G8834233, G8861735818, G9000015730, G9000190758, G9000234930, G90718159
OpenAlex ID: W2159486568