- 作者：Emi Ushigome ; Michiaki Fukui ; Masahide Hamaguchi ; Shinobu Matsumoto ; Yusuke Mineoka ; Naoko Nakanishi ; Takafumi Senmaru ; Masahiro Yamazaki ; Goji Hasegawa ; Naoto Nakamura
- 关键词：Diabetic nephropathy ; Home blood pressure monitoring ; Arteriosclerosis
- 刊名：Diabetes Research and Clinical Practice
- 出版年：2013
- 出版时间：September, 2013
- 年：2013
- 卷：101
- 期：3
- 页码：270-277
- 全文大小：661 K
Aims
Recently, focus has been directed toward pulse pressure as a potentially independent risk factor for micro- and macrovascular disease. This study was designed to examine the relationship between pulse pressure taken at home and elevated albuminuria in patients with type 2 diabetes.Methods
This study is a post hoc analysis of a cross-sectional multicenter study. Home blood pressure measurements were performed for 14 consecutive days in 858 patients with type 2 diabetes. We investigated the relationship between systolic blood pressure or pulse pressure in the morning or in the evening and urinary albumin excretion using univariate and multivariate analyses. Furthermore, we measured area under the receiver-operating characteristic curve (AUC) to compare the ability to identify elevated albuminuria, defined as urinary albumin excretion equal to or more than 30 mg/g creatinine, of systolic blood pressure or pulse pressure.
Results
Morning systolic blood pressure (¦Â = 0.339, P < 0.001) and morning pulse pressure (¦Â = 0.378, P < 0.001) were significantly associated with logarithm of urinary albumin excretion independent of other potential co-factors. AUC for elevated albuminuria in morning systolic blood pressure and morning pulse pressure were 0.668 (0.632-0.705; P < 0.001) and 0.694 (0.659-0.730; P < 0.001), respectively. AUC of morning pulse pressure was significantly greater than that of morning systolic blood pressure (P = 0.040).
Conclusions
Our findings implicate that morning pulse pressure is associated with elevated albuminuria in patients with type 2 diabetes, which suggests that lowering morning pulse pressure could prevent the development and progression of diabetic nephropathy.