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AIM To investigate the relationship between circadian variations in blood pressure(BP) and albuminuria at rest,and during exercise in non-hypertensive type 2 diabetes(T2D) patients.METHODS We conducted a cross-sectional study in well controlled T2D patients,non-hypertensive,without clinical proteinuria and normal creatinine clearance.In each participant,we recorded the BP using ambulatory bloodpressure monitoring(ABPM) for 24-h,and albuminuria at rest and after a standardized treadmill exercise.RESULTS We enrolled 27 type 2 patients with a median age of 52;and a mean duration of diabetes and HbA 1c of 3.6 ± 0.8 years and 6.3% ± 0.5% respectively.Using a 24-h ABPM,we recorded a mean diurnal systolic blood pressure(SBP) of 128 ± 17 mmH g vs nocturnal of 123 ± 19 mmH g(P = 0.004),and mean diurnal diastolic blood pressure(DBP) of 83 ± 11 mmH g vs nocturnal 78 ± 14 mmH g(P = 0.002).There was a significant difference between albuminuria at rest [median = 23 mg,interquartile range(IQR) = 10-51] and after exercise(median = 35 mg,IQR = 23-80,P < 0.001).Patients with exercise induced albuminuria had an increase in nocturnal BP values on all three components(128 mmH g vs 110 mmH g,P = 0.03 for SBP;83 mmH g vs 66 mmH g,P = 0.04;106 vs 83,P = 0.02 for mean arterial pressure),as well as albuminuric patients at rest.Moreover,exercise induced albuminuria detect a less increase in nocturnal DBP(83 vs 86,P = 0.03) than resting albuminuria.CONCLUSION Exercise induced albuminuria is associated with an increase in nocturnal BP values in T2D patients.
AIM To investigate the relationship between circadian variations in blood pressure (BP) and albuminuria at rest, and during exercise in non-hypertensive type 2 diabetes (T2D) patients. METHODS We conducted a cross-sectional study in well controlled T2D patients, non- hypertensive, without clinical proteinuria and normal creatinine clearance. In each participant, we recorded the BP using ambulatory blood pressure monitoring (ABPM) for 24-h, and albuminuria at rest and after a standardized treadmill exercise. RESULTS We enrolled 27 type 2 patients with a median age of 52; and a mean duration of diabetes and HbA 1c of 3.6 ± 0.8 years and 6.3% ± 0.5% respectively. Using a 24-h ABPM, we recorded a mean diurnal systolic blood pressure (SBP) of 128 ± 17 mmH g vs nocturnal of 123 ± 19 mmHg (P = 0.004), and mean diurnal diastolic blood pressure (DBP) of 83 ± 11 mmHg vs. nocturnal 78 ± 14 mmHg (P = 0.002). There was a significant difference between albuminuria at rest [median = 23 mg, interquartile range (IQR) Patient with exercise induced albuminuria had an increase in nocturnal BP values on all three components (128 mmH g vs 110 mmHg, n = 10-51] and after exercise (median = 35 mg, IQR = 23-80, P = 0.03 for SBP; 83 mmHg vs 66 mmHg, P = 0.04; 106 vs 83, P = 0.02 for mean arterial pressure) as well as albuminuric patients at rest. Moreover, exercise induced albuminuria detect a less increase in nocturnal DBP (83 vs 86, P = 0.03) than resting albuminuria. CONCLUSION Exercise induced albuminuria is associated with an increase in nocturnal BP values in T2D patients.