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脉压与糖尿病治疗:2型糖尿病患者降糖治疗方式组间的血压及脉压差异

Pulse pressure and diabetes treatments: Blood pressure and pulse pressure difference among glucose lowering modality groups in type 2 diabetes.

作者信息

Alemi Hamid, Khaloo Pegah, Mansournia Mohammad Ali, Rabizadeh Soghra, Salehi Salome Sadat, Mirmiranpour Hossein, Meftah Neda, Esteghamati Alireza, Nakhjavani Manouchehr

机构信息

Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Medicine (Baltimore). 2018 Feb;97(6):e9791. doi: 10.1097/MD.0000000000009791.

Abstract

Type 2 diabetes is associated with higher pulse pressure. In this study, we assessed and compared effects of classic diabetes treatments on pulse pressure (PP), systolic blood pressure (SBP), and diastolic blood pressure (DBP) in patients with type 2 diabetes.In a retrospective cohort study, 718 non-hypertensive patients with type 2 diabetes were selected and divided into 4 groups including metformin, insulin, glibenclamide+metformin, and metformin+insulin. They were followed for 4 consecutive visits lasting about 45.5 months. Effects of drug regimens on pulse and blood pressure over time were assessed separately and compared in regression models with generalized estimating equation method and were adjusted for age, duration of diabetes, sex, smoking, and body mass index (BMI).Studied groups had no significant change in PP, SBP, and DBP over time. No significant difference in PP and DBP among studied groups was observed (PP:P = 0.090; DBP:P = 0.063). Pairwise comparisons of PP, SBP, and DBP showed no statistically significant contrast between any 2 studied groups. Interactions of time and treatment were not different among groups.Our results demonstrate patients using metformin got higher PP and SBP over time. Averagely, pulse and blood pressure among groups were not different. Trends of variation in pulse and blood pressure were not different among studied diabetes treatments.

摘要

2型糖尿病与较高的脉压相关。在本研究中,我们评估并比较了经典糖尿病治疗方法对2型糖尿病患者脉压(PP)、收缩压(SBP)和舒张压(DBP)的影响。

在一项回顾性队列研究中,选取了718例非高血压2型糖尿病患者,分为4组,分别为二甲双胍组、胰岛素组、格列本脲+二甲双胍组和二甲双胍+胰岛素组。对他们进行了连续4次随访,持续约45.5个月。采用广义估计方程法在回归模型中分别评估并比较了药物治疗方案随时间对脉搏和血压的影响,并对年龄、糖尿病病程、性别、吸烟和体重指数(BMI)进行了校正。

研究组的PP、SBP和DBP随时间无显著变化。研究组之间的PP和DBP无显著差异(PP:P = 0.090;DBP:P = 0.063)。PP、SBP和DBP的两两比较显示,任何两个研究组之间均无统计学显著差异。组间时间与治疗的交互作用无差异。

我们的结果表明,使用二甲双胍的患者随时间推移PP和SBP升高。平均而言,各组之间的脉搏和血压无差异。在研究的糖尿病治疗方法中,脉搏和血压的变化趋势无差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/140a/5944681/0c4d7756cb7b/medi-97-e9791-g003.jpg

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