1型糖尿病患者中，午夜唾液皮质醇分泌与高收缩压相关。

Midnight salivary cortisol secretion associated with high systolic blood pressure in type 1 diabetes.

作者信息

Melin Eva Olga, Hillman Magnus, Landin-Olsson Mona

机构信息

E Melin, BMC, Diabetes Laboratory, Lunds University Faculty of Medicine, Lund, 22362, Sweden.

M Hillman, Clinical Sciences, Diabetes Laboratory, Lunds University Faculty of Medicine, Lund, Sweden.

出版信息

Endocr Connect. 2019 Nov;8(11):1520-1528. doi: 10.1530/EC-19-0407.

DOI:10.1530/EC-19-0407

PMID:31671407

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6893315/

Abstract

OBJECTIVE

To explore associations between high midnight salivary cortisol (MSC) secretion and high blood pressure (BP) in type 1 diabetes (T1D).

METHODS

Cross-sectional study of 196 adult patients with T1D (54% men). Associations between high MSC (≥9.3 nmol/L) and high systolic BP (>130 mmHg), and high diastolic BP (>80 mmHg) were explored for all patients, users and non-users of antihypertensive drugs (AHD). Adjustments were performed for age, sex, diabetes-related variables, p-creatinine, smoking, physical inactivity, depression and medication.

RESULTS

The prevalence of high MSC differed between patients with high and low systolic BP in all 196 patients: 39 vs 13% (P = 0.001); in 60 users of AHD: 37 vs 12% (P = 0.039), and in 136 non-users of AHD: 43 vs 13% (P = 0.012). Significant associations with high systolic BP were for all patients: physical inactivity (adjusted odds ratio (AOR) 6.5), high MSC (AOR 3.9), abdominal obesity (AOR 3.7), AHD (AOR 2.9), age (per year) (AOR 1.07), and p-creatinine (per µmol/L) (AOR 1.03); for 60 users of AHD: high MSC (AOR 4.1) and age (per year) (AOR 1.11); for 136 non-users of AHD: abdominal obesity (AOR 27.4), physical inactivity (AOR 14.7), male sex (AOR 9.0), smoking (AOR 7.9), and age (per year) (AOR 1.08). High MSC was not associated with high DBP.

CONCLUSIONS

In adult patients with T1D, high systolic BP was associated with physical inactivity, high MSC secretion, abdominal obesity, p-creatinine, age, and AHD, the latter indicating treatment failure.

摘要

目的

探讨1型糖尿病（T1D）患者午夜唾液皮质醇（MSC）高分泌与高血压（BP）之间的关联。

方法

对196例成年T1D患者（54%为男性）进行横断面研究。探讨所有患者、使用和未使用抗高血压药物（AHD）者中，高MSC（≥9.3 nmol/L）与收缩压高（>130 mmHg）及舒张压高（>80 mmHg）之间的关联。对年龄、性别、糖尿病相关变量、血肌酐、吸烟、身体活动不足、抑郁和用药情况进行了校正。

结果

在所有196例患者中，收缩压高和低的患者之间高MSC的患病率不同：分别为39%和13%（P = 0.001）；在60例使用AHD的患者中：分别为37%和12%（P = 0.039），在136例未使用AHD的患者中：分别为43%和13%（P = 0.012）。所有患者中，与收缩压高显著相关的因素有：身体活动不足（校正比值比（AOR）6.5）、高MSC（AOR 3.9）、腹型肥胖（AOR 3.7）、AHD（AOR 2.9）、年龄（每年）（AOR 1.07）和血肌酐（每µmol/L）（AOR 1.03）；在60例使用AHD的患者中：高MSC（AOR 4.1）和年龄（每年）（AOR 1.11）；在136例未使用AHD的患者中：腹型肥胖（AOR 27.4）、身体活动不足（AOR 14.7）、男性（AOR 9.0）、吸烟（AOR 7.9）和年龄（每年）（AOR 1.08）。高MSC与舒张压高无关。