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Abstract
Diabetic nephropathy is a critical complication of patients with type 1 diabetes, while epidemiological studies were scarce among Asian countries. We conducted a cross-sectional study to identify factors associated with diabetic nephropathy by questionnaires, using student’s t-test, chi-square test, and multivariable logistic regression. Among 898 participants, 16.7% had diabetic nephropathy. Compared with non-diabetic nephropathy patients, the patients with diabetic nephropathy had significantly higher percentage with onset age of type 1 diabetes between puberty and under 30 years old (female ≥ 12 or male ≥ 13 years old to 29 years old), longer diabetes duration, having family history of diabetes and diabetic nephropathy, accompanied with hypertension, hyperlipidemia, or coronary artery disease (CAD). Compared with patients with onset age before puberty, the odds of diabetic nephropathy occurrence increased to 1.61 times in patients with onset age between puberty and under 30 years old (p = 0.012) after adjusting diabetes duration. Age of diabetes onset between puberty and under 30 years old, diabetes duration, HbA1c, hospital admission within 3 years, diabetic retinopathy, hypertension, systolic blood pressure (SBP), triglyceride levels, and use of angiotensin converting enzyme inhibitor (ACEI) and/or angiotensin receptor blockers (ARB) were independent factors associated with diabetic nephropathy Screening for proteinuria is important in daily clinical practice and should be part of diabetes self-management education for patients with type 1 diabetes.
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1 National Taiwan University Hospital Bei-Hu Branch, Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei, Taiwan (GRID:grid.412094.a) (ISNI:0000 0004 0572 7815)
2 Taichung Veterans General Hospital, Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung, Taiwan (GRID:grid.410764.0) (ISNI:0000 0004 0573 0731); National Yang Ming Chiao Tung University, Department of Internal Medicine, School of Medicine, Taipei, Taiwan (GRID:grid.260539.b) (ISNI:0000 0001 2059 7017); Taipei Veterans General Hospital, Section of Endocrinology and Metabolism, Department of Internal Medicine, Taipei, Taiwan (GRID:grid.278247.c) (ISNI:0000 0004 0604 5314); National Chung-Hsing University, Institute of Medical Technology, College of Life Science, Taichung, Taiwan (GRID:grid.260542.7) (ISNI:0000 0004 0532 3749); National Health Research Institutes, Zhunan Township, Taiwan (GRID:grid.59784.37) (ISNI:0000 0004 0622 9172)
3 Ministry of Health and Welfare, Tao-Yuan General Hospital, Taoyuan City, Taiwan (GRID:grid.454740.6)
4 Changhua County Public Health Bureau, Changhua, Taiwan (GRID:grid.487401.e)
5 Chung Shang Medical University, Institute of Medicine, Taichung, Taiwan (GRID:grid.411641.7) (ISNI:0000 0004 0532 2041); Chung Shang Medical University Hospital, Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung, Taiwan (GRID:grid.411645.3) (ISNI:0000 0004 0638 9256)
6 National Yang Ming Chiao Tung University, Department of Internal Medicine, School of Medicine, Taipei, Taiwan (GRID:grid.260539.b) (ISNI:0000 0001 2059 7017); Taipei Veterans General Hospital, Section of Endocrinology and Metabolism, Department of Internal Medicine, Taipei, Taiwan (GRID:grid.278247.c) (ISNI:0000 0004 0604 5314)
7 Tri-Service General Hospital, Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei, Taiwan (GRID:grid.278244.f) (ISNI:0000 0004 0638 9360)
8 National Cheng Kung University, Department of Internal Medicine, School of Medicine, College of Medicine, Tainan City, Taiwan (GRID:grid.64523.36) (ISNI:0000 0004 0532 3255); National Cheng Kung University Hospital, Division of Endocrinology and Metabolism, Department of Internal Medicine, Tainan City, Taiwan (GRID:grid.412040.3) (ISNI:0000 0004 0639 0054)
9 National Taiwan University Hospital, Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei, Taiwan (GRID:grid.412094.a) (ISNI:0000 0004 0572 7815); National Taiwan University School of Medicine, Taipei, Taiwan (GRID:grid.19188.39) (ISNI:0000 0004 0546 0241); National Taiwan University College of Medicine, Graduate Institute of Clinical Medicine, Taipei, Taiwan (GRID:grid.19188.39) (ISNI:0000 0004 0546 0241)
10 Kaoshiung Chang Gung Memorial Hospital, Kaoshiung, Taiwan (GRID:grid.413804.a)
11 Yuanlin Christian Hospital, Changhua, Taiwan (GRID:grid.413804.a)
12 Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan (GRID:grid.454212.4) (ISNI:0000 0004 1756 1410)
13 Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan (GRID:grid.454211.7) (ISNI:0000 0004 1756 999X)
14 Changhua Christian Hospital, Changhua, Taiwan (GRID:grid.413814.b) (ISNI:0000 0004 0572 7372)
15 SinLau Hospital, Tainan, Taiwan (GRID:grid.413814.b)
16 Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan (GRID:grid.415011.0) (ISNI:0000 0004 0572 9992)
17 Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan (GRID:grid.413878.1) (ISNI:0000 0004 0572 9327)
18 Lee Yau-Jiunn Clinic, Pingtung, Taiwan (GRID:grid.413878.1)
19 Far Eastern Memorial Hospital, Taipei, Taiwan (GRID:grid.414746.4) (ISNI:0000 0004 0604 4784)
20 China Medical University Hospital, Taichung, Taiwan (GRID:grid.411508.9) (ISNI:0000 0004 0572 9415)
21 MacKay Memorial Hospital, New Taipei City, Taiwan (GRID:grid.413593.9) (ISNI:0000 0004 0573 007X)
22 Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan (GRID:grid.412027.2) (ISNI:0000 0004 0620 9374)
23 Cheng Hsin General Hospital, Taipei, Taiwan (GRID:grid.413846.c) (ISNI:0000 0004 0572 7890)
24 Samuel Chen Clinic, Nantou, Taiwan (GRID:grid.413846.c)
25 Dr. Su Diabetes Clinic, New Taipei City, Taiwan (GRID:grid.413846.c)
26 Feng-Yuan Hospital, Ministry of Health and Welfare, Taichung, Taiwan (GRID:grid.454740.6)
27 Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan (GRID:grid.452837.f) (ISNI:0000 0004 0413 0128)
28 Liao Chung Chia Clinic, Taichung, Taiwan (GRID:grid.452837.f)
29 Ansn Clinic, Hsinchu City, Taiwan (GRID:grid.452837.f)
30 Landseed Hospital, Taoyuan, Taiwan (GRID:grid.452620.7)
31 Show Chwan Memorial Hospital, Changhua, Taiwan (GRID:grid.452796.b) (ISNI:0000 0004 0634 3637)
32 Geng Sin Clinic, Changhua, Taiwan (GRID:grid.452796.b)
33 Shigang District Public Health Center, Taichung, Taiwan (GRID:grid.452796.b)
34 Cheng Ching Hospital, Taichung, Taiwan (GRID:grid.413844.e) (ISNI:0000 0004 0638 8798)
35 Jing Pin Clinic, Kaohsiung, Taiwan (GRID:grid.413844.e)
36 Huang Hsin Yang Clinic, Taitung, Taiwan (GRID:grid.497181.2)
37 Changhua Christian Hospital Yuan Branch, Yunlin, Taiwan (GRID:grid.413814.b) (ISNI:0000 0004 0572 7372)
38 Wei-Gong Memorial Hospital, Miaoli, Taiwan (GRID:grid.413814.b)
39 Neng-Chun Diabetes Clinic, Yilan, Taiwan (GRID:grid.413814.b)
40 Neihu Cathay Clinic, Taipei, Taiwan (GRID:grid.413814.b)
41 Da Chia Clinic, Kaohsiung, Taiwan (GRID:grid.413814.b)
42 Yuan Cheng Clinic, Kaohsiung, Taiwan (GRID:grid.413814.b)
43 Taipei Shen’s Diabetes Center, Taipei, Taiwan (GRID:grid.413814.b)
44 Tseng Han-Chi’s General Hospital, Nantou, Taiwan (GRID:grid.413814.b)
45 National Taiwan University Hospital, Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei, Taiwan (GRID:grid.412094.a) (ISNI:0000 0004 0572 7815); National Taiwan University School of Medicine, Taipei, Taiwan (GRID:grid.19188.39) (ISNI:0000 0004 0546 0241)