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2型糖尿病患者中,哪种血压测量值与蛋白尿的相关性更强:中心血压还是外周血压?

Which Measurement of Blood Pressure Is More Associated With Albuminuria in Patients With Type 2 Diabetes: Central Blood Pressure or Peripheral Blood Pressure?

作者信息

Kitagawa Noriyuki, Okada Hiroshi, Tanaka Muhei, Hashimoto Yoshitaka, Kimura Toshihiro, Nakano Koji, Yamazaki Masahiro, Hasegawa Goji, Nakamura Naoto, Fukui Michiaki

机构信息

Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.

Department of Endocrinology and Metabolism, Kyoto Yamashiro General Medical Center, Kyoto, Japan.

出版信息

J Clin Hypertens (Greenwich). 2016 Aug;18(8):790-5. doi: 10.1111/jch.12764. Epub 2016 Jan 3.

Abstract

The aim of this study was to investigate whether central systolic blood pressure (SBP) was associated with albuminuria, defined as urinary albumin excretion (UAE) ≥30 mg/g creatinine, and, if so, whether the relationship of central SBP with albuminuria was stronger than that of peripheral SBP in patients with type 2 diabetes. The authors performed a cross-sectional study in 294 outpatients with type 2 diabetes. The relationship between peripheral SBP or central SBP and UAE using regression analysis was evaluated, and the odds ratios of peripheral SBP or central SBP were calculated to identify albuminuria using logistic regression model. Moreover, the area under the receiver operating characteristic curve (AUC) of central SBP was compared with that of peripheral SBP to identify albuminuria. Multiple regression analysis demonstrated that peripheral SBP (β=0.255, P<.0001) or central SBP (r=0.227, P<.0001) was associated with UAE. Multiple logistic regression analysis demonstrated that peripheral SBP (odds ratio, 1.029; 95% confidence interval, 1.016-1.043) or central SBP (odds ratio, 1.022; 95% confidence interval, 1.011-1.034) was associated with an increased odds of albuminuria. In addition, AUC of peripheral SBP was significantly greater than that of central SBP to identify albuminuria (P=0.035). Peripheral SBP is superior to central SBP in identifying albuminuria, although both peripheral and central SBP are associated with UAE in patients with type 2 diabetes.

摘要

本研究的目的是调查中心收缩压(SBP)是否与蛋白尿相关(蛋白尿定义为尿白蛋白排泄率[UAE]≥30mg/g肌酐),如果相关,在2型糖尿病患者中,中心SBP与蛋白尿的关系是否比外周SBP与蛋白尿的关系更强。作者对294例2型糖尿病门诊患者进行了一项横断面研究。使用回归分析评估外周SBP或中心SBP与UAE之间的关系,并使用逻辑回归模型计算外周SBP或中心SBP的比值比以识别蛋白尿。此外,比较中心SBP与外周SBP的受试者工作特征曲线下面积(AUC)以识别蛋白尿。多元回归分析表明,外周SBP(β=0.255,P<0.0001)或中心SBP(r=0.227,P<0.0001)与UAE相关。多元逻辑回归分析表明,外周SBP(比值比,1.029;95%置信区间,1.016-1.043)或中心SBP(比值比,1.022;95%置信区间,1.011-1.034)与蛋白尿几率增加相关。此外,外周SBP识别蛋白尿的AUC显著大于中心SBP(P=0.035)。在识别蛋白尿方面,外周SBP优于中心SBP,尽管外周和中心SBP在2型糖尿病患者中均与UAE相关。

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