2110-P: Risk Factors for Elevated Blood Pressure in Children with Type 1 Diabetes: Evidence from a Population-Based EHR Cohort and a Pediatric Biobank

Introduction and Objective: Elevated blood pressure (BP) is a common but underrecognized contributor to vascular complications in children with type 1 diabetes (T1D). We aimed to characterize BP patterns and kidney function trajectories in pediatric T1D and to identify clinical, immune, and genetic predictors of elevated BP. Methods: We examined longitudinal patterns of BP and eGFR in 2,395 children with T1D from the Utah Diabetes Database. In parallel, predictive modelling was performed in 289 ADDAM Biobank participants followed at Montreal Children’s Hospital to evaluate the clinical, immune, and genetic contributors to elevated BP during childhood using machine-learning approaches. Results: In UDDb, pediatric T1D patients showed BP variability and heterogeneous eGFR trajectories. Rapid eGFR decline was linked to older age at diagnosis, higher median systolic BP, and more BP measurements. In the ADDAM cohort, 48 children (16%) had elevated BP. Predictive performance was modest (best model: XGBoost, ROC AUC ≈0.69). Age at BP measurement and GAD65 autoantibody titers were key predictors, while BMI, hemoglobin A1C, and genetic risk score accounted for only some cases. Conclusion: Elevated BP and adverse kidney patterns are common in pediatric T1D and not fully explained by metabolic risk factors. Immune markers and BP trajectories may help identify children at higher vascular risk and support earlier kidney and cardiovascular assessment. Disclosure J.M. Lazaro Guevara: None. A. Sabbah: None. A. Eyesan: None. M.F. Pezzolesi: None. A. Makri: None. Funding FRQS (Fonds de recherche du Québec Santé)