1 型糖尿病患者的非卧床血压监测与血管并发症--观察性研究的系统回顾和荟萃分析。

IF 6.1 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice Pub Date : 2024-09-27 DOI:10.1016/j.diabres.2024.111873

Mariana Costa Hoffmeister , Vinicius Hammel Lovison , Eduardo Priesnitz Friedrich , Ticiana da Costa Rodrigues

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引用次数: 0

摘要

目的：本研究旨在评估 24 小时动态血压监测（ABPM）在预测办公室血压正常的 1 型糖尿病（T1DM）患者血管并发症方面的作用：这是一项系统性综述，包括 Embase、PubMed/Medline 和 Web of Science 数据库中关于接受 ABPM 监测的 T1DM 患者的队列研究以及随后的血管并发症评估。通过随机效应模型荟萃分析获得了差异测量值（MD）：我们发现了 364 篇文章，49 篇重复。共纳入 7 项研究，635 名参与者的年龄为 25.8 ± 6.2 岁。大多数（57.5%）为男性，平均糖尿病病程为（11.8 ± 5.3）年，参与者的平均糖化血红蛋白水平为（8.5 ± 1.6）%，平均随访时间为 4.2 年。夜间收缩压 MD - 4.37 mmHg（p = 0.0009）和夜间舒张压 MD - 3.97 mmHg（p 结论：夜间收缩压和舒张压的平均值差异较小：通过 ABPM 测量，T1DM 患者之间血压参数的平均值差异较小，这与肾病和视网膜病变的发生率或进展风险较低有关。

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Ambulatory blood pressure monitoring and vascular complications in patients with type 1 diabetes mellitus – Systematic review and meta-analysis of observational studies

Aims

This study aimed to evaluate the role of the 24-Hour Ambulatory Blood Pressure Monitoring (ABPM) as a possible predictor of vascular outcomes in office normotensive people with type 1 diabetes mellitus (T1DM).

Methods

This is a systematic review including cohort studies from the Embase, PubMed/Medline, and Web of Science databases on people with T1DM undergoing ABPM and subsequent evaluation of vascular complications. Measurements of difference (MD) were obtained using random effect model meta-analysis.

Results

We found 364 articles and 49 duplicates. Seven studies were included, comprising 635 participants aged 25.8 ± 6.2 years. Most (57.5 %) were men, mean duration of diabetes was 11.8 ± 5.3 years, mean glycated hemoglobin level among participants was 8.5 % ± 1.6 %, and mean follow-up time was 4.2 years. Lower night systolic blood pressure MD − 4.37 mmHg (p = 0.0009) and night diastolic blood pressure MD − 3.97 mmHg (p < 0.0001) were associated with lower incidence of albuminuria. People with T1DM who presented no beginning or progression of retinopathy were those with lower night diastolic blood pressure MD − 3.62 mmHg (p = 0.042), diurnal diastolic blood pressure MD − 2.69 mmHg (p = 0.0138), and 24-hour diastolic blood pressure MD − 3.65 mmHg (p = 0.037).

Conclusion

Small mean differences in blood pressure parameters, as measured by ABPM, between people with T1DM are associated with a lower incidence or risk of progression of nephropathy and retinopathy.

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来源期刊

Diabetes research and clinical practice 医学-内分泌学与代谢

CiteScore

10.30

自引率

3.90%

发文量

862

审稿时长

32 days

期刊介绍： Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.