最大家庭收缩压是 2 型糖尿病患者动脉僵硬度的有用指标：一项横断面多中心研究的事后分析。
Maximum home systolic blood pressure is a useful indicator of arterial stiffness in patients with type 2 diabetes mellitus: post hoc analysis of a cross-sectional multicenter study.
机构信息
Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
出版信息
Diabetes Res Clin Pract. 2014 Sep;105(3):344-51. doi: 10.1016/j.diabres.2014.05.010. Epub 2014 Jun 17.
AIMS
Maximum (max) home systolic blood pressure (HSBP) as well as mean HSBP or HSBP variability was reported to increase the predictive value of target organ damage. Yet, the association between max HSBP and target organ damage in patients with type 2 diabetes has never been reported. The aim of this study was to investigate the association between max HSBP and pulse wave velocity (PWV), a marker of arterial stiffness which in turn is a marker of target organ damage, in patients with type 2 diabetes.
METHODS
We assessed the relationship of mean HSBP or max HSBP to PWV, and compared area under the receiver-operating characteristic curve (AUC) of mean HSBP or max HSBP for arterial stiffness in 758 patients with type 2 diabetes.
RESULTS
In the univariate analyses, age, duration of diabetes mellitus, body mass index, mean clinic systolic blood pressure (SBP), mean HSBP and max HSBP were associated with PWV. Multivariate linear regression analyses indicated that mean morning SBP (β=0.156, P=0.001) or max morning SBP (β=0.146, P=0.001) were significantly associated with PWV. AUC (95% CI) for arterial stiffness, defined as PWV equal to or more than 1800 cm per second, in mean morning SBP and max morning SBP were 0.622 (0.582-0.662; P<0.001) and 0.631 (0.591-0.670; P<0.001), respectively.
CONCLUSIONS
Our findings implicate that max HSBP as well as mean HSBP was significantly associated with arterial stiffness in patients with type 2 diabetes.
目的
最大（max）家庭收缩压（HSBP）以及平均 HSBP 或 HSBP 变异性已被报道可增加靶器官损伤的预测价值。然而，2 型糖尿病患者的最大 HSBP 与靶器官损伤之间的关系尚未见报道。本研究旨在探讨 2 型糖尿病患者最大 HSBP 与脉搏波速度（PWV）之间的关系，PWV 是动脉僵硬度的标志物，而动脉僵硬度又是靶器官损伤的标志物。
方法
我们评估了平均 HSBP 或 max HSBP 与 PWV 的关系，并比较了 758 例 2 型糖尿病患者中平均 HSBP 或 max HSBP 对动脉僵硬的受试者工作特征曲线（ROC）下面积（AUC）。
结果
在单因素分析中，年龄、糖尿病病程、体重指数、平均诊所收缩压（SBP）、平均 HSBP 和 max HSBP 与 PWV 相关。多元线性回归分析表明，平均早晨 SBP（β=0.156，P=0.001）或最大早晨 SBP（β=0.146，P=0.001）与 PWV 显著相关。平均早晨 SBP 和最大早晨 SBP 预测 PWV 等于或大于 1800cm/s 的动脉僵硬的 AUC（95%CI）分别为 0.622（0.582-0.662；P<0.001）和 0.631（0.591-0.670；P<0.001）。
结论
我们的研究结果表明，2 型糖尿病患者的最大 HSBP 与平均 HSBP 与动脉僵硬显著相关。
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