Association of Obesity with Microalbuminuria in Children and Adolescents with Diabetes Mellitus in a Tertiary Care Hospital of Bangladesh.

Abstract

The study, a cross sectional survey, was carried out at the Changing Diabetes in Children (CDiC) Outpatient Department of CDiC, BIRDEM-2 Hospital over a 1-year period from July 2018 to June 2019. Diabetes mellitus was diagnosed according to WHO, ISPAD and Mohan's criteria. Height, weight and waist circumference were recorded and body mass index (BMI) scores were calculated as weight (kg)/height (m²). BMI was classified using the cutoff points (<5th percentile underweight, 5th - 85th percentile normal, 85th - <95th percentile overweight and ≥95th percentile as obese) using the Center for Disease control and Prevention growth chart. To determine microalbuminuria, urine microalbumin and spot urine creatinine were measured by Immunoturbidimetry method using 2000 DCA plus analyzer and Albumin Creatinine Ratio (ACR) was calculated. Microalbuminuria was defined when two consecutive samples of spot urine were positive. Statistical analysis was performed with the help of software SPSS for Windows (statistical package for social science), 20.0 version. Association between the two groups was evaluated by using Students chi square test. Of the total participant 512, type 1 diabetes mellitus were 61.9% and type 2 diabetes mellitus 38.1% were observed that microalbuminuria was 88.7% and macroalbuminuria was 3.6% in diabetes mellitus children and adolescents. The study revealed that overweight and obesity were high in microalbuminuria than other parameters of BMI and that were statistically significant (p<0.001). Early diagnosis and screening of these diabetic children and adolescents with obesity can regress microalbuminuria and also prevent further progression.