P-0678 The factors associated with the risk of adverse outcomes in patients with long-term type 1 diabetes mellitus
Background: Patients with type 1 diabetes demonstrates increase of the prevalence of cardiovascular events and mortality compared to the general population.
Aim: to identify the most significant risk factors of adverse outcomes in patients with long-term type 1 diabetes mellitus (DM1).
Materials and methods: The study included 156 patients with long-term DM1 (more than 20 years). We have estimated the renal status, severity of cardiovascular pathology and incidence of adverse outcomes such as: doubling the level of creatinine, reaching the terminal stage of chronic kidney disease (CKD), developing nonfatal myocardial infarction, stroke, amputation, urgent hospitalization, death within 5 years of observation.
Results: The development of adverse outcomes during the 5-year follow-up period (28.2%) was associated with a higher value of the creatinine (267.8 [114,300] vs 102.6 [74.7,202.5], p=0.0014), triglycerides (1.68 [1.2,2.3] vs 1.32 [0.9,1.6], p=0.0152), albuminuria (986.6 [28.9, 1200.6] vs 521 [4.6,666.3], p=0.0018), parathyroid hormone (147.9 [43.9,149.5] vs 117.7 [32.3,104.65], p=0,0132), osteopontin (50.6 [23.8, 62.2] vs 38.9 [16.2,51.2], p=0.010), Nt-pro BNP (48.9 [5.4,8.3] vs 41.2 [0,50.3], p=0,042), C reactive protein (7.7 [2.3,6.5] vs 2.5 [0.9,5.8], p=0.047), hyperphosphatemia (1.39 [1.2,1.6] vs 1.24 [1.1,1.45], p=0,028) and vitamin D deficiency (12.9 [10.1,17.3] vs 15.2 [11.6, 18.7], p=0,012). 
Conclusion: the study demonstrated, that CKD and the conditions accompanying its course, especially mineral and bone disorders-CKD, dyslipidemia, systemic inflammation and endothelial dysfunction,  are powerful predictors of the development of adverse outcomes in type 1 diabetes patients.