血压变异性与 2 型糖尿病患者的糖尿病肾病和动脉粥样硬化相关。
Visit-to-visit variability in systolic blood pressure is correlated with diabetic nephropathy and atherosclerosis in patients with type 2 diabetes.
机构信息
Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan.
出版信息
Atherosclerosis. 2012 Jan;220(1):155-9. doi: 10.1016/j.atherosclerosis.2011.10.033. Epub 2011 Nov 2.
OBJECTIVE
Recent studies make remarks on the effect of variability in systolic blood pressure (SBP) on the development of cardiovascular disease. The aim of this study was to investigate the relationship between the variability in SBP and the degree of diabetic nephropathy and atherosclerosis in patients with type 2 diabetes.
METHODS
We measured SBP in 422 consecutive patients with type 2 diabetes at every visit during a year, and we calculated the coefficient of variation (CV) of SBP. Then, we evaluated relationships of variability of SBP to degree of urinary albumin excretion (UAE), which is a useful marker for cardiovascular disease as well as diabetic nephropathy, ankle-brachial index (ABI) and pulse wave velocity (PWV).
RESULTS
CV of SBP positively correlated with logUAE (r=0.210, P<0.0001) or PWV (r=0.409, P<0.0001), whereas CV of SBP inversely correlated with ABI (r=-0.098, P=0.0463). Multiple regression analysis demonstrated that CV of SBP independently correlated with logUAE (β=0.149, P=0.0072), PWV (β=0.337, P<0.0001) or ABI (β=-0.162, P=0.0101).
CONCLUSIONS
Not only average SBP but also variability in SBP is correlated with diabetic nephropathy and atherosclerosis in patients with type 2 diabetes.
目的
最近的研究表明，收缩压（SBP）的变异性对心血管疾病的发展有影响。本研究旨在探讨 2 型糖尿病患者 SBP 变异性与糖尿病肾病和动脉粥样硬化程度之间的关系。
方法
我们在一年内的每次就诊时测量了 422 例连续 2 型糖尿病患者的 SBP，并计算了 SBP 的变异系数（CV）。然后，我们评估了 SBP 变异性与尿白蛋白排泄率（UAE）、踝肱指数（ABI）和脉搏波速度（PWV）之间的关系，UAE 是心血管疾病以及糖尿病肾病的有用标志物。
结果
SBP 的 CV 与 logUAE（r=0.210，P<0.0001）或 PWV（r=0.409，P<0.0001）呈正相关，而与 ABI（r=-0.098，P=0.0463）呈负相关。多元回归分析表明，SBP 的 CV 与 logUAE（β=0.149，P=0.0072）、PWV（β=0.337，P<0.0001）或 ABI（β=-0.162，P=0.0101）独立相关。
结论
2 型糖尿病患者的平均 SBP 和 SBP 变异性均与糖尿病肾病和动脉粥样硬化有关。
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