Ohara Makoto, Kohata Yo, Nagaike Hiroe, Koshibu Masakazu, Gima Hiroya, Hiromura Munenori, Yamamoto Takeshi, Mori Yusaku, Hayashi Toshiyuki, Fukui Tomoyasu, Hirano Tsutomu
Division of Diabetes, Metabolism, and Endocrinology, Department of Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666 Japan.
Diabetol Metab Syndr. 2019 Apr 11;11:29. doi: 10.1186/s13098-019-0425-y. eCollection 2019.
The present study evaluated the effects of glucose and blood pressure (BP) variability on oxidative stress in patients with type 2 diabetes mellitus (T2DM) and hypertension.
A total of 60 inpatients with T2DM underwent continuous glucose monitoring (CGM) and ambulatory BP monitoring (ABPM). Oxidative stress was estimated using the diacron-reactive oxygen metabolites (d-ROMs) test. Glucose variability, mean glucose level, percentage coefficient of variation for glucose, mean amplitude of glycemic excursions (MAGE), and area under the postprandial plasma glucose curve were determined through CGM. BP variability was assessed by measuring average BP, standard deviation (SD) of systolic and diastolic BP, and coefficient of variation (CV) of systolic and diastolic BP during daytime and nighttime ABPM.
Participants had a mean age of 64.5 ± 13.3 years with the duration of the disease 13.9 ± 12.4 years and HbA1c of 8.5 ± 1.2%. Univariate analysis showed that MAGE, nighttime SDs of systolic and diastolic BP, and nighttime CV of systolic BP were significantly correlated with d-ROMs. Further, stepwise multiple regression analysis identified MAGE, nighttime SD and CV of diastolic BP, estimated glomerular filtration rate, and smoking as independent contributors to d-ROMs.
Oxidative stress was associated with daily glucose and nighttime diastolic BP variability in patients with T2DM and hypertension. UMIN Clinical Trial Registry UMIN000035615, Registered January 22, 2019-retrospectively registered.
本研究评估了血糖和血压（BP）变异性对2型糖尿病（T2DM）合并高血压患者氧化应激的影响。
共有60例T2DM住院患者接受了连续血糖监测（CGM）和动态血压监测（ABPM）。使用戴克隆活性氧代谢产物（d-ROMs）试验评估氧化应激。通过CGM测定血糖变异性、平均血糖水平、血糖变异系数百分比、血糖波动幅度平均值（MAGE）以及餐后血浆葡萄糖曲线下面积。通过测量日间和夜间ABPM期间的平均血压、收缩压和舒张压的标准差（SD）以及收缩压和舒张压的变异系数（CV）来评估血压变异性。
参与者的平均年龄为64.5±13.3岁，病程为13.9±12.4年，糖化血红蛋白（HbA1c）为8.5±1.2%。单因素分析显示，MAGE、夜间收缩压和舒张压的SD以及夜间收缩压的CV与d-ROMs显著相关。此外，逐步多元回归分析确定MAGE、夜间舒张压的SD和CV、估计肾小球滤过率以及吸烟是d-ROMs的独立影响因素。
氧化应激与T2DM合并高血压患者的每日血糖和夜间舒张压变异性相关。UMIN临床试验注册中心UMIN000035615，2019年1月22日注册——回顾性注册。
