Chihaoui Melika, Grira Wafa, Chaker Fatma, Oueslati Ibtissem, Ben Amor Zohra, Yazidi Meriem, Feki Moncef
Department of Endocrinology, University Hospital La Rabta, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.
Department of Biochemistry, Faculty of Medicine of Tunis, University Hospital La Rabta, University of Tunis El Manar, Tunis, Tunisia.
Endocrine. 2020 Apr;68(1):210-214. doi: 10.1007/s12020-020-02213-8. Epub 2020 Jan 29.
The risks of Ramadan fasting on blood pressure (BP) in patients with adrenal insufficiency are unknown. This study aimed to evaluate the levels of BP and particularly the risk for hypotension during a fasting day compared with a nonfasting day in patients with corticotrope deficiency.
A prospective case-crossover study on 28 patients with known and treated corticotrope deficiency who were fasting the month of Ramadan. Clinical (eating and sleeping habits, abnormal symptoms, weight, height, and BP) and paraclinical (creatinine, sodium, and cortisol) data were collected. Patients had a 24 h ambulatory BP monitoring during a Ramadan fasting day then again during a nonfasting day.
The data of 25 patients were analyzed; 20 women, median age: 40 years (IQR, 22.5-45.5), median duration of the disease: 6 years (IQR, 2.5-12). The prevalence of hypotension did not differ between the fasting day and the nonfasting day. Hour by hour BP levels comparison showed that both systolic and diastolic BP were significantly lower at 2.00 p.m. during fasting. BP variability was significantly lower during the fasting period compared with the same period during the nonfasting day.
Fasting was not associated with an increased risk for hypotension in patients with known and treated corticotrope deficiency.
肾上腺功能不全患者在斋月禁食期间血压(BP)的风险尚不清楚。本研究旨在评估促肾上腺皮质激素缺乏患者禁食日与非禁食日的血压水平,尤其是低血压风险。
对28例已知且接受治疗的促肾上腺皮质激素缺乏患者进行前瞻性病例交叉研究,这些患者在斋月期间禁食。收集临床(饮食和睡眠习惯、异常症状、体重、身高和血压)和辅助临床(肌酐、钠和皮质醇)数据。患者在斋月禁食日进行24小时动态血压监测,然后在非禁食日再次进行监测。
分析了25例患者的数据;20名女性,中位年龄:40岁(四分位间距,22.5 - 45.5),疾病中位病程:6年(四分位间距,2.5 - 12)。禁食日和非禁食日低血压的患病率无差异。逐小时血压水平比较显示,禁食期间下午2点的收缩压和舒张压均显著降低。与非禁食日同期相比,禁食期间血压变异性显著降低。
对于已知且接受治疗的促肾上腺皮质激素缺乏患者,禁食与低血压风险增加无关。