Microangiopathic complications in type 1 diabetes mellitus: differences in severity when isolated or associated with autoimmune polyendocrinopathies

CONTEXT: The development and evolution of different chronic diabetic complications may present variations among the different types and conditions of this disease.OBJECTIVE: To evaluate the degree of microangiopathy in Type 1 diabetes mellitus (DM1) associated with autoimmune polyendocrinopathies (O...

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Detalles Bibliográficos
Autores: Monteagudo, Patrícia Teófilo [UNIFESP], Freire, Maria Beatriz Sayeg [UNIFESP], Moraes, Nilva Simeren Bueno de [UNIFESP], Dib, Sergio Atala [UNIFESP]
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:1998
País:Brasil
Institución:Universidade Federal de São Paulo (UNIFESP)
Repositorio:Repositório Institucional da UNIFESP
Idioma:inglés
OAI Identifier:oai:repositorio.unifesp.br:11600/690
Acceso en línea:http://dx.doi.org/10.1590/S1516-31801998000600007
http://repositorio.unifesp.br/handle/11600/690
Access Level:acceso abierto
Palabra clave:Microangiopathy
Type 1 diabetes mellitus
Autoimmune poliendocrinopathies
Descripción
Sumario:CONTEXT: The development and evolution of different chronic diabetic complications may present variations among the different types and conditions of this disease.OBJECTIVE: To evaluate the degree of microangiopathy in Type 1 diabetes mellitus (DM1) associated with autoimmune polyendocrinopathies (OSAD) or isolated DM1 (iDM1).PATIENTS: OSAD (n=17) and iDM1 (n=13) were over 15 years old at diagnosis of DM and were matched for diabetes duration (13.9 ± 8.2 and 13.2 ± 5.9 years, respectively) and metabolic control (HbA1c: 6.4 ± 1.9 and 6.8 ± 1.4%).MAIN OUTCOME MEASURES: Urinary albumin excretion (UAE; ELISA), the inversion of serum creatinine (1/C) level and indirect ophthalmoscopy. RESULTS: Although the prevalence of hypertension was similar in both groups, the OSAD had inferior levels of UAE (7.4 ± 2.5 vs. 17.3 ± 9.2 µg/min; p< 0.05). Nephropathy was detected in 12% of the OSAD (none of them macroproteinuric) and in 39% of the iDM1 . The UAE in the iDM1 correlated negatively with 1/C values (r= -0.7, p< 0.005), but the same did not occur in the OSAD (r= 0.2, ns). Among patients with retinopathy, the severe form was found in 29% of the OSAD and in 46% of the iDM1.CONCLUSIONS: OSAD was associated with a lower degree of microangiopathy, in spite of age at diagnosis, duration of diabetes and the metabolic control. In contrast with the iDM1 , the increase in UAE of OSAD was not associated with reductions in GFR.