The aim: of this study was the evaluation of some factors having an influence on post-exercise albuminuria level in children with newly diagnosed type 1 diabetes as a prognostic factor of developing nephropathy.
Material and methods: 24 newly diagnosed type 1 diabetic children, aged 5.5-16.9 years, mean 10.2+/-3.2, were examined. In order to provoke albuminuria the patients underwent standardized exercise test using treadmill ramp according to the Bruce protocol. Pre- and post-exercise albuminuria and C-peptide levels by radioimmunoassay were evaluated. In urine of patients the albumin / creatinine ratio (ACR) was determined.
Results: the tendency towards an increase in ACR ratio in children after exercise (10.5 mg/g (4-27.5) in comparison to the value in pre-exercise urine (7 mg/g (2.5-13), p=0.17) was observed. In 67% of patients (16/24) the ACR ratio was higher in post-exercise urine. In 25% of children (6/24) the ACR ratio was above 30 mg/g which was considered as post-exercise microalbuminuria. Next, parameters of metabolic control of type 1 diabetes were compared between patients with and without post-exercise microalbuminuria. No differences in the serum glucose, HbA1c, BMI, triglycerides, total cholesterol, insulin dose, frequency of ketoacidosis and C-peptide level between these groups of children were noted.
Conclusions: we concluded that the post-exercise microalbuminuria as a marker of diabetic nephropathy risk may be observed in some patients already at the clinical onset of type 1 diabetes but further evaluation is needed to verify this hypothesis.