The risk of proteinuria in Type 1 diabetes declined >=30% over the past 50 years, and improvements in metabolic control are believed to be largely responsible.
Little is known about secular changes in the risk of proteinuria in Type 2 diabetes.
We examined trends in the incidence rate of proteinuria in Pima Indians >=20 years of age with diabetes diagnosed between January 1,1955 and December 31,1994.
Among 1305 initially non-proteinuric diabetic subjects, 433 developed proteinuria during a median follow-up of 8.0 years (range 0.8 to 30.2 years).
With subjects with diabetes diagnosed between 1955 and 1964 serving as the reference group, the rate of proteinuria was similar (rate ratio 1.0 ; 95% confidence interval, 0.79 to 1.3) in the cohort diagnosed between 1965 and 1974,1.5 times as high (95% confidence interval, 1.1 to 2.0) in the cohort diagnosed between 1975 and 1984, and 1.9 times as high (95% confidence interval, 1.1 to 3.0) in the cohort diagnosed between 1985 and 1994, after adjusting for potential confounders in a generalized additive proportional hazards model.
Between the first and last cohorts, plasma glucose concentration declined, on average, by 17% (P=0.0001) and the mean arterial pressure declined by 11% (P=0.0001).
The incidence rate of proteinuria in Pima Indians with Type 2 diabetes increased nearly twofold in the last 40 years, despite improvements in plasma glucose and blood pressure. (...)
Mots-clés Pascal : Néphropathie, Diabète, Protéinurie, Fonction rénale, Association morbide, Exploration, Déterminisme génétique, Homme, Indien, Epidémiologie, Appareil urinaire pathologie, Rein pathologie, Endocrinopathie
Mots-clés Pascal anglais : Nephropathy, Diabetes mellitus, Proteinuria, Renal function, Concomitant disease, Exploration, Genetic determinism, Human, Indian, Epidemiology, Urinary system disease, Kidney disease, Endocrinopathy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0043001
Code Inist : 002B21E01B. Création : 31/05/1999.