MON-234 Elevated HbA1C, Lower Lean Mass, and Length of Diabetes is related to Glomerular Hyperfiltration in Children and Adolescents with Type 1 Diabetes Mellitus

Abstract Disclosure: L. Sloan: None. L.S. Haber: None. L.F. Laurindo: None. H.V. Chagas: None. J.F. Haber: None. K.P. Sloan: None. S.M. Barbalho: None. E.F. Chagas: None. Type 1 diabetes (T1DM) is an autoimmune condition with absolute insulin deficiency resulting in hyperglycemia. It is estimated that this disease accounts for 5%-10% of all reported diabetic cases, with a rising global incidence and a significant burden on healthcare systems. The chronicity and severity of hyperglycemia, combined with genetic, hemodynamic, metabolic, and environmental factors increase the risk of Diabetic Kidney Disease (DKD). This study aimed to investigate the association of hyperglycemia, body composition and glomerular hyperfiltration in children and adolescents with T1DM. This is a cross-sectional observational study that included 80 patients of both genders (male = 47; female = 33) with ages between 4 and 19 years old, diagnosed with T1DM for at least twelve months, and with C-peptide values < 0.3 ng/ml who received medical care by an interdisciplinary health team between the years of 2019 and 2020 at the Specialty Medical Outpatient Clinic of the University of Marilia, Brazil. Demographic and anthropometric (weight, height, body mass index, and body composition) variables, along with length of disease (years), total daily insulin, glycated hemoglobin (HbA1c), and physical activity level (PAL) were collected to characterize the sample and explore exposure factors for the dependent variable glomerular hyperfiltration. GFR was estimated using the CKiD equation. Multiple linear regression and binary logistic regression analysis were performed with the significance level adopted of p<0.05. Our results showed that 18.8% of the included patients had increased values for eGFR ≥135 mL/min/1.73m2 and most had poor glycemic control (75.0%). All patients with HbA1c levels above 8% presented with an eGFR >130. A significant effect of HbA1c, lean body mass (%), and length of disease was observed, and the multiple linear regression analysis explained 28.8% of the variation of the eGFR values (R: 0.4777; R2: 0.288). Considering the regression coefficient, the increase in HbA1c, the reduction in lean mass percentage, and having a diagnosis time of less than 5 years are related to glomerular hyperfiltration (eGFR ≥135 mL/min/1.73m2). Our study indicates that children and adolescents with T1DM that have elevated HbA1c, lower body lean mass, and with less than five years of diagnosis of diabetes are more likely to have higher eGFR values. Studies in the early stages of eGFR changes are necessary for a better understanding of the progression of DKD when intervention could have the greatest impact in the prevention of the disease. Presentation: Monday, July 14, 2025