Progression of early kidney injury in youth with type 2 diabetes: a follow-up analysis from the iCARE Cohort
Bibliographic record
Abstract
Abstract Background Youth with type 2 diabetes (T2D) have high rates of albuminuria and mental health comorbidities. This study’s objective was to describe changes in albuminuria and estimated-GFR over 2 years and determine whether better baseline mental health is associated with decreased progression of albuminuria. Methods The iCARE (improving renal Complications in Adolescents with type 2 diabetes through REsearch) study is a prospective cohort study of youth living with T2D. The main outcomes were urine albumin-to-creatinine ratio (ACR) and estimated-GFR measured at baseline and 2-year follow-up. Mediators of interest were measures of mental health assessed using the Kessler Psychological Distress Scale (K6), Perceived Stress Scale (PSS-14), Resilience Scale for Children and Adolescents, and Child and Youth Resilience Measure. Results There were 188 youth with T2D included; 68.1% were female, mean age was 14.2 years (SD 2.2), median HbA1C was 8.9%, and median duration of diabetes was 1.69 years (IQR 0.84–3.08). At baseline, 17.2% had significant psychological distress (K6 ≥13) and 54.6% significant perceived stress scores (≥27 on PSS-14). There were 27.1% with albuminuria (ACR ≥ 3mg/mmol) at baseline and 31.9% at 2-year follow-up. At 2-years, 59% had normal ACR, 10% regressed, 15% persisted, and 17% progressed. Median estimated-GFR was 143.2 mL/min/1.73m2 (IQR 131.4-156.8) at baseline (N = 186) and 142.4 mL/min/1.73m2 (IQR 128.2-155.3) at 2-year follow-up (N = 175). Measures of mental health scores were not associated with changes in albuminuria. Conclusions High rates of albuminuria, stress and distress were observed at baseline and 2-year follow-up in youth with T2D. While mental health was not significantly associated with albuminuria, further research is required to explore impacts of mental health in youth with T2D.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".