Social Determinants of Health Are Associated with Markers of Renal Injury in Adolescents with Type 1 Diabetes

The Journal of Pediatrics
Laura A M CummingsFarid H Mahmud

Abstract

To examine the relationship between the social determinants of health and markers of early renal injury in adolescent patients with type 1 diabetes (T1D). Renal outcomes included estimated glomerular filtration rate (eGFR) and albumin-creatinine excretion ratio (ACR). Differences in urinary and serum inflammatory markers also were assessed in relation to social determinants of health. Regression analysis was used to evaluate the association between the Ontario Marginalization Index (ON-Marg) as a measure of the social determinants of health, patient characteristics, ACR, eGFR, and renal filtration status (hyperfiltration vs normofiltration). Participants with T1D (n = 199) with a mean age of 14.4 ± 1.7 years and diabetes duration of 7.2 ± 3.1 years were studied. Mean eGFR was 122.0 ± 19.4 mL/min/1.73 m2. Increasing marginalization was positively associated with eGFR (P < .0001) but not with ACR (P = .605). Greater marginalization was associated with greater median levels of urinary interleukin (IL)-2, IL-12 (p40), macrophage-derived chemokine, monocyte chemoattractant protein-3, and tumor necrosis factor-β and serum IL-2. ON-Marg was significantly associated with eGFR after we controlled for age, sex, body mass index z score, e...Continue Reading

Citations

Jan 30, 2020·Journal of Pediatric Psychology·Ashley M ButlerDeborah Thompson
Feb 8, 2020·Diabetes Care·Kara R Mizokami-StoutUNKNOWN T1D Exchange Clinic Networ k
Apr 17, 2020·Clinical Kidney Journal·Greg D Guthrie, Samira Bell
May 6, 2020·International Journal of Molecular Sciences·Ting-Ting Chang, Jaw-Wen Chen
Oct 30, 2020·The Journal of Clinical Endocrinology and Metabolism·Jenny J CouperArul Earnest

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