2型糖尿病患者血压和控制与微血管功能障碍的关系

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2023-10-01 DOI:10.1016/j.deman.2023.100160

Charles F. Hayfron-Benjamin , Theresa Ruby Quartey-Papafio , Tracy Amo-Nyarko , Ewuradwoa A Antwi , Patience Vormatu , Melody Kwatemah Agyei-Fedieley , Kwaku Amponsah Obeng

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引用次数: 1

摘要

背景在2型糖尿病(T2D)中，包括血糖控制在内的心血管危险因素对各种微循环床的影响存在差异。迄今为止，比较血压(BP)对t2dm各种微血管床影响的研究有限。我们评估了血压及其控制与神经、肾脏和视网膜微血管功能障碍的关系。方法对403例成人T2D患者进行横断面研究。微血管功能障碍基于肾病(白蛋白-肌酐比值≥30 mg/g)、神经病变(振动感知阈值≥25 V)和/或糖尿病神经病变症状评分>1)和视网膜病变(基于视网膜摄影)。采用Logistic回归检查高血压、收缩压和舒张压与微血管功能障碍的关系，并调整年龄、性别、糖尿病病程、吸烟年限、HbA1c浓度、总胆固醇浓度和BMI。结果平均年龄(±SD)为56.35(±9.91)岁，女性比例为75.7%，高血压患者比例为49.1%。在完全校正模型中，高血压与神经病变显著相关[优势比3.44,95%可信区间1.96-6.04,P <肾病[2.05(1.09-3.85)，0.026]，而视网膜病变[0.98(0.42-2.31)，0.970]不存在。Z-score收缩压升高与肾病有显著相关性[1.43(1.05-1.97)，0.025]，而与神经病变[1.28(0.98-1.67)，0.075]或视网膜病变[1.27(0.84-1.91)，0.261]无显著相关性。Z-score舒张压升高与肾病显著相关[1.81 (1.32 - 2.49)，<0.001]但视网膜病变[1.38(0.92-2.05)，0.120]或神经病变[0.86(0.67-1.10)，0.230]没有。结论我们的研究显示不同微循环床的高血压、收缩压和舒张压与微血管功能障碍的相关性各不相同。高血压的预防和/或控制可能对微血管疾病，特别是肾病和神经病变的预防/治疗有价值。

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Relationships of blood pressure and control with microvascular dysfunction in type 2 diabetes

Background

In type 2 diabetes mellitus (T2D), cardiovascular risk factors including glycemic control differentially affect various microcirculatory beds. To date, studies comparing the impact of blood pressure (BP) on various microvascular beds in T2D are limited. We assessed the associations of BP and its control with neural, renal, and retinal microvascular dysfunction.

Methods

This was a cross-sectional study among 403 adults with T2D. Microvascular dysfunction was based on nephropathy (albumin-creatinine ratio ≥ 30 mg/g), neuropathy (vibration perception threshold ≥ 25 V and/or Diabetic Neuropathy Symptom score > 1), and retinopathy (based on retinal photography). Logistic regression was used to examine the associations of hypertension, systolic BP, and diastolic BP with microvascular dysfunction with adjustments for age, sex, diabetes duration, smoking pack years, HbA1c concentration, total cholesterol concentration, and BMI.

Results

The mean age (± SD), proportion of females, and proportion of hypertensives were 56.35 (± 9.91) years, 75.7%, and 49.1%, respectively. In a fully adjusted model, hypertension was significantly associated with neuropathy [odds ratio 3.44, 95% confidence interval 1.96–6.04, P < 0.001] and nephropathy [2.05 (1.09–3.85), 0.026] but not for retinopathy [0.98 (0.42–2.31), 0.970]. Increasing Z-score systolic BP was significantly associated with nephropathy [1.43 (1.05–1.97), 0.025] but not for neuropathy [1.28 (0.98–1.67), 0.075] or retinopathy [1.27 (0.84–1.91), 0.261]. Increasing Z-score diastolic BP was significantly associated with nephropathy [1.81 (1.32 – 2.49), < 0.001] but not retinopathy [1.38 (0.92–2.05), 0.120] or neuropathy [0.86 (0.67–1.10), 0.230].

Conclusion

Our study shows varying strengths of associations of hypertension, systolic BP, and diastolic BP with microvascular dysfunction in different microcirculatory beds. Hypertension prevention and/or control may be valuable in the prevention/treatment of microvascular disease, especially nephropathy, and neuropathy.

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.