Oral Abstract Abstract
The Prevalence and Risk Factors of Diabetic Nephropathy among Children with Type 2 Diabetes Mellitus
Dr Everlyn Coxin SIEW, University Malaya Medical Centre; Dr Karmila Abu Bakar, University Malaya Medical Centre; Dr Nurshadia Samingan, University Malaya Medical Centre; Prof Muhammad Yazid Jalaludin, University Malaya Medical Centre
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Youth-onset Type 2 Diabetes Mellitus (T2DM) is an aggressive disease with early occurrence of diabetic nephropathy (DN), which can lead to end-stage renal failure (ESRF). The prevalence of DN among Malaysian children with T2DM is not known. Risk factors associated with DN in T2DM children showed inconsistent findings among published studies. The main objectives of this study were to evaluate the prevalence of DN and determine the risk factors associated with DN among children with T2DM followed up at University Malaya Medical Centre (UMMC).
All patients diagnosed with T2DM before 18 years old from 1st January 2007 until 31st December 2020, with at least one year of follow-up were included. This retrospective case-control study compared the case (patient who developed DN) and control (patient without DN). DN was diagnosed with the presence of microalbuminuria or macroalbuminuria. Logistic regression was performed to determine the independent variables associated with DN.
Forty-two patients (48% male) with mean age of 12.5 ± 2.3 years and median diabetes duration of 4.4 (2.9-6.9) years were analysed. The prevalence of DN was 47%. The mean age of onset of DN was 14.9 ± 2.8 years, after a median duration of T2DM of 1.8 (0.7-2.9) years. Three significant risk factors associated with the development of DN were NAFLD [OR=107.51, (95% CI 2.10 - 5496.57)], serum LDL-C at diagnosis [OR=3.43, (95% CI 1.13 - 6.99)], and A1C in first three years of T2DM [OR=3.14, (95% CI 1.05-9.34)].
The prevalence of DN among T2DM children at UMMC is high. Risk factors significantly associated with DN were A1c levels in the first three years of diabetes, LDL-C at diagnosis, and presence of NAFLD.