Department of Nephrology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, ZJ, China.
Nursing College, Nanjing University of Chinese Medicine, Nanjing, JS, China.
Clin Exp Hypertens. 2022 Jul 4;44(5):464-469. doi: 10.1080/10641963.2022.2071917. Epub 2022 May 8.
To explore the relationship between long-term variabilities in different blood pressure variables and diabetic kidney disease (DKD) in patients with type 2 diabetes.
A retrospective study.
This study included 3050 patients with type 2 diabetes whose metabolic parameters were regularly checked. Intrapersonal means and standard deviations (SDs) of all recorded systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and pulse pressure (PP) measurements were calculated. Subjects were divided into four groups: Q1 (SBP-Mean < 130, SBP-SD < 11.06); Q2 (SBP-Mean < 130, SBP-SD ≥ 11.06); Q3 (SBP-Mean ≥ 130, SBP-SD < 11.06); Q4 (SBP-Mean ≥ 130, SBP-SD ≥ 11.06). Similarly, based on whether the PP-Mean was higher or lower than 80 mmHg (average PP-Mean) and the PP-SD was higher or lower than 6.48 mmHg (average PP-SD), the involved patients were redivided into Q1'~ Q4' groups.
Adjusted for age, sex and diabetes duration, results revealed that the SBP-Mean, SBP-SD, PP-Mean and PP-SD were risk factors for DKD. Meanwhile, patients in the Q4 group had the highest DKD prevalence (HR = 1.976, p < .001), while Q1 group had the lowest. In addition, patients in the Q3 group (HR = 1.614, P < .001) had a higher risk of DKD than those in the Q2 group (HR = 1.408, P < .001). After re-stratification by PP-Mean and PP-SD, patients in the Q4' group had the highest risk of DKD (HR = 1.370, p < .001), while those in the Q1' group had the lowest risk. Patients in the Q3' group (HR = 1.266, p < .001) had a higher risk of DKD than those in the Q2' group (HR = 1.212, p < .001).
探讨 2 型糖尿病患者不同血压变量的长期变异性与糖尿病肾病（DKD）的关系。
回顾性研究。
本研究纳入了 3050 名定期检查代谢参数的 2 型糖尿病患者。计算了所有记录的收缩压（SBP）、舒张压（DBP）、平均动脉压（MAP）和脉压（PP）测量的个体内平均值和标准差（SD）。将受试者分为四组：Q1（SBP-Mean < 130，SBP-SD < 11.06）；Q2（SBP-Mean < 130，SBP-SD ≥ 11.06）；Q3（SBP-Mean ≥ 130，SBP-SD < 11.06）；Q4（SBP-Mean ≥ 130，SBP-SD ≥ 11.06）。同样，根据 PP-Mean 是否高于或低于 80mmHg（平均 PP-Mean）以及 PP-SD 是否高于或低于 6.48mmHg（平均 PP-SD），将涉及的患者重新分为 Q1'~Q4'组。
校正年龄、性别和糖尿病病程后，结果显示 SBP-Mean、SBP-SD、PP-Mean 和 PP-SD 是 DKD 的危险因素。同时，Q4 组的 DKD 患病率最高（HR=1.976，p<0.001），而 Q1 组最低。此外，与 Q2 组相比，Q3 组（HR=1.614，P<0.001）发生 DKD 的风险更高。在重新按 PP-Mean 和 PP-SD 分层后，Q4'组发生 DKD 的风险最高（HR=1.370，p<0.001），而 Q1'组风险最低。Q3'组（HR=1.266，p<0.001）发生 DKD 的风险高于 Q2'组（HR=1.212，p<0.001）。
