{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T03:30:47Z","timestamp":1777951847156,"version":"3.51.4"},"reference-count":26,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100020595","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["NSTC\u2010114\u20102314\u2010B\u2010860\u2010002"],"award-info":[{"award-number":["NSTC\u2010114\u20102314\u2010B\u2010860\u2010002"]}],"id":[{"id":"10.13039\/100020595","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Diabetes Invest"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Adolescents with type 1 diabetes (T1D) face premature atherosclerosis, but standard carotid intima\u2010media thickness (IMT) may lack sensitivity for the earliest vascular injuries. Since urinary albumin\u2010to\u2010creatinine ratio (UACR) reflects systemic endothelial dysfunction, we investigated the triple\u2010line pattern (TLP) as a marker of peripheral remodeling and its dose\u2013response relationship with low\u2010grade albuminuria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The Subclinical Cardiovascular Disease in Type 1 Diabetes Mellitus (SCVD T1DM) cohort study prospectively recruited 283 adolescents with T1D and 106 age\u2010 and sex\u2010matched controls. IMT was measured at the common carotid artery and common femoral artery (CFA) using high\u2010resolution ultrasound. Logistic regression tested categorical UACR thresholds, and restricted cubic spline models evaluated the continuous dose\u2013response association between UACR and TLP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      TLP prevalence was higher in type 1 diabetes than in controls (63.9% vs 49.1%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.008). While type 1 diabetes was associated with carotid thickening, TLP was linked to structural changes in the lower extremities. TLP\u2010positive participants had greater mean CFA IMT (0.56\u2009\u00b1\u20090.06 vs 0.44\u2009\u00b1\u20090.06\u2009mm,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). UACR \u226515\u2009mg\/g independently predicted TLP (odds ratio 2.83, 95% confidence interval 1.01\u20137.92,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.048), whereas UACR \u226530\u2009mg\/g was not significant. Spline analysis showed no significant nonlinearity (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0for nonlinearity\u2009=\u20090.424), with risk increasing above approximately 15\u2009mg\/g.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>TLP is a prevalent marker of incipient peripheral vascular remodeling in adolescents with type 1 diabetes without macroalbuminuria. A UACR \u226515\u2009mg\/g identifies subclinical vascular risk below conventional thresholds, supporting TLP as a potential tool for refined early risk stratification in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jdi.70283","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T04:48:07Z","timestamp":1773118087000},"page":"835-843","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of low\u2010grade albuminuria and triple\u2010line pattern as markers of early peripheral vascular remodeling in adolescents with type 1 diabetes"],"prefix":"10.1111","volume":"17","author":[{"given":"Jung\u2010Chi","family":"Hsu","sequence":"first","affiliation":[{"name":"Department of Internal Medicine National Taiwan University Hospital, Jinshan Branch  New Taipei City Taiwan"},{"name":"Division of Cardiology, Department of Internal Medicine National Taiwan University Hospital and College of Medicine  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fu\u2010Sung","family":"Lo","sequence":"additional","affiliation":[{"name":"Division of Pediatric Endocrinology, Department of Pediatrics Chang Gung Memorial Hospital, Chung Gung University College of Medicine  Taoyuan City Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiann\u2010Shing","family":"Jeng","sequence":"additional","affiliation":[{"name":"Department of Neurology National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen\u2010Yu","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Pediatrics National Taiwan University College of Medicine  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandy Huey\u2010Jen","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine National Taiwan University Hospital, National Taiwan University College of Medicine  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hsiang","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Dentistry National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tien\u2010Jyun","family":"Chang","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine National Taiwan University Hospital  Taipei Taiwan"},{"name":"School of Medicine National Taiwan University College of Medicine  Taipei Taiwan"},{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine National Taiwan University Hospital Yun\u2010Lin Branch  Douliu Yun\u2010Lin Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7523-7166","authenticated-orcid":false,"given":"Ta\u2010Chen","family":"Su","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine National Taiwan University Hospital and College of Medicine  Taipei Taiwan"},{"name":"Division of Cardiology, Department of Internal Medicine Tungs' Taichung MetroHarbor Hospital  Taichung Taiwan"},{"name":"Institute of Environmental and Occupational Health Sciences National Taiwan University College of Public Health  Taipei Taiwan"},{"name":"School of Post\u2010Baccalaureate Medicine National Chung Hsing University College of Medicine  Taichung 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