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1 型糖尿病青少年和年轻成人的血压:来自澳大拉西亚糖尿病数据网络登记处的数据。

Blood pressure in adolescents and young adults with type 1 diabetes: data from the Australasian Diabetes Data Network registry.

机构信息

School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, 1 Moreton Parade, Petrie, 4502, Australia.

Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, 3010, Australia.

出版信息

Acta Diabetol. 2023 Jun;60(6):797-803. doi: 10.1007/s00592-023-02057-4. Epub 2023 Mar 15.

DOI:10.1007/s00592-023-02057-4
PMID:36920547
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10148782/
Abstract

AIM

Hypertension increases complication risk in type 1 diabetes (T1D). We examined blood pressure (BP) in adolescents and young adults with T1D from the Australasian Diabetes Data Network, a prospective clinical diabetes registry in Australia and New Zealand.

METHODS

This was a longitudinal study of prospectively collected registry data.

INCLUSION CRITERIA

T1D (duration ≥ 1 year) and age 16-25 years at last visit (2011-2020). Hypertension was defined as (on ≥ 3 occasions) systolic BP and/or diastolic BP > 95 percentile for age < 18 years, and systolic BP > 130 and/or diastolic BP > 80 mmHg for age ≥ 18 years. Multivariable Generalised Estimating Equations were used to examine demographic and clinical factors associated with BP in the hypertensive range across all visits.

RESULTS

Data from 6338 young people (male 52.6%) attending 24 participating centres across 36,655 T1D healthcare visits were included; 2812 (44.4%) had BP recorded at last visit. Across all visits, 19.4% of youth aged < 18 years and 21.7% of those aged ≥ 18 years met criteria for hypertension. In both age groups, BP in the hypertensive range was associated with male sex, injection (vs. pump) therapy, higher HbA1c, and higher body mass index.

CONCLUSIONS

There is a high proportion of adolescents and young adults reported with BP persistently in hypertensive ranges. Findings flag the additive contribution of hypertension to the well-established body of evidence indicating a need to review healthcare models for adolescents and young adults with T1D.

摘要

目的

高血压会增加 1 型糖尿病(T1D)患者的并发症风险。我们检查了澳大利亚和新西兰的澳大利亚糖尿病数据网络(一个前瞻性临床糖尿病登记处)中 T1D 青少年和年轻人的血压(BP)。

方法

这是一项对前瞻性收集的登记数据进行的纵向研究。

纳入标准

T1D(病程≥1 年)和最后一次就诊时年龄为 16-25 岁(2011-2020 年)。高血压定义为(≥3 次)收缩压和/或舒张压>年龄<18 岁时的第 95 百分位数,以及年龄≥18 岁时收缩压>130mmHg 和/或舒张压>80mmHg。使用多变量广义估计方程检查所有就诊时与高血压范围内 BP 相关的人口统计学和临床因素。

结果

在 36655 次 T1D 医疗就诊中,来自 24 个参与中心的 6338 名年轻人(男性 52.6%)的数据被纳入;最后一次就诊时有 2812 人(44.4%)记录了 BP。在所有就诊中,19.4%的<18 岁青少年和 21.7%的≥18 岁青少年符合高血压标准。在这两个年龄组中,高血压范围内的 BP 与男性、注射(vs. 泵)治疗、更高的 HbA1c 和更高的体重指数相关。

结论

报告的青少年和年轻人中 BP 持续处于高血压范围的比例很高。研究结果表明,高血压对已建立的大量证据表明需要审查 T1D 青少年和年轻人的医疗保健模式具有附加贡献。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3dca/10148782/7262101b6dca/592_2023_2057_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3dca/10148782/7262101b6dca/592_2023_2057_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3dca/10148782/7262101b6dca/592_2023_2057_Fig1_HTML.jpg

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