Assessment of cardiovascular risk in type 1 diabetes mellitus taking into account various markers of kidney damage

Objective. assessment of the relationship of markers of diabetic nephropathy (DN) with scales specific for type 1 diabetes mellitus (DM1) and predicting the risk of cardiovascular diseases (CVD). methods. screening of 176 dmi patients was carried out: mean age - 32 years [25.5-42.5]; dmi duration - 15 years [9- 20]; hbaic - 8.2% [7.2-9.6]. Microalbuminuria was not detected in 68.2% of the examined patients, 27% of patients had microalbuminuria, 4.5% had macroalbuminuria; the median albuminuria was 25.5 mg/day [15.o-36.5]. mean egfr (CKD-epi) was 80.55±18.13 ml/min/1.73 m2: ci - 30.i%, C2 - 58.5%, C3a - 8.5% and C3b - 2.9 %. the steno ti risk engine score assessing the 5-year cvd risk was 3.7% [2.i-8.0], the 10-year risk was 7.1% [4.2-8.15]. the Swedish tid risk score, which estimates the 5-year cvd risk, was o.93% [0.50-i.79]. the mean cvd risk in the group was assessed as low according to both scales. results. there was a significant moderate direct correlation of the albuminuria stage and an inverse correlation of egfr with 5-year risk (r=0.388 and r=-0.506; p<0.0001), 10-year risk (r=0.393 and r=-0.500); p<0.0001) according to the steno scale and the Swedish tid risk score (r=0.189; p=0.012 and r=-0.497; p<0.0001). there was a strong positive correlation between the steno risk score and the Swedish risk score (r=0.893; p<0.0001). Conclusion. The steno and Swedish tid risk scales correlate with the DN stage and are equivalent to each other for assessing cardiovascular risk in dmi patients. Swedish tid risk score does not require quantification of albumin loss and is more convenient in clinical practice. Thus, cvd risk assessment in dmi patients can be adequately carried out in routine clinical practice without determining microalbuminuria.

cardiovascular diseases, diabetic nephropathy, cardiovascular risk assessment, type 1 diabetes mellitus