Albumin Excretion Rate in Normal Adolescents: Relation to Insulin Resistance and Cardiovascular Risk Factors and Comparisons to Type 1 Diabetes Mellitus Patients

Background and objectives: Although albumin excretion rates have been related to cardiovascular morbidity and mortality in both diabetic and nondiabetic adults, little is known about the relation between albuminuria and either cardiovascular risk factors or the insulin resistance syndrome in adolescents. A normal range for albumin excretion in adolescents was estab-lished, correlations between albumin excretion and cardiovascular risk factors were evaluated, and albumin excretion in normal adolescents was compared with that in type 1 diabetes mellitus adolescents. Design, setting, participants, & measurements: Albumin excretion rate was measured in 368 normal and 175 diabetic adolescents. Multiple regression analysis was used to predict the relation of age, sex, Tanner stage, body mass index, and systolic blood pressure to albumin excretion in both cohorts. In addition, correlations between albumin excretion and age, blood pressure, body mass index, lipids, and measurements of insulin resistance were performed in the normal adolescents. Results: Mean albumin excretion was significantly lower in normal adolescents (4.0 g/min) than in type 1 diabetic adolescents (5.0g/min). Albumin excretion increasedwith age in diabetics. Albumin excretion did not significantly correlate with anymeasure of cardiovascular risk or insulin resistance but did significantly correlate with fasting insulin. Conclusions: Albumin excretion rate is not related to insulin resistance or traditional cardiovascular risk factors in adolescence but is related to fasting insulin. Diabetic adolescents have increased albumin excretion compared with normal adolescents. Clin J Am Soc Nephrol 3: 998–1005, 2008. doi: 10.2215/CJN.0463100