• 作者：Isabel Mateo-Gavira^a ; ¹ ; ² ; ^{isamateogavira@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Francisco J. Ví ; lchez-Ló ; pez^a ; ¹ ; ² ; ^{franvilchez1977@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Marí ; a V. Garcí ; a-Palacios^b ; ³ ; ^{jaspitaxx@hotmail.com" class="auth_mail" title="E-mail the corresponding author} ; Florentino Carral-San Laureano^c ; ⁴ ; ^{florencarral@hotmail.com" class="auth_mail" title="E-mail the corresponding author} ; Soledad Jimé ; nez-Carmona^d ; ⁵ ; ^{soledad.jimenez@uca.es" class="auth_mail" title="E-mail the corresponding author} ; Manuel Aguilar-Diosdado^e ; ^{manuelaguilardiosdado.sspa@juntadeandalucia.es" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Hypertension ; Ambulatory blood pressure monitoring ; Retinopathy ; Microalbuminuria ; Type 1 diabetes
• 刊名：Journal of Diabetes and its Complications
• 出版年：2016
• 出版时间：September-October 2016
• 年：2016
• 卷：30
• 期：7
• 页码：1326-1332
• 全文大小：346 K

Methods

In a prospective observational study of 85 normotensive T1DM patients without microalbuminuria, blood pressure (BP) was monitored over 24 h using the ambulatory blood pressure monitoring (ABPM) system at baseline and 7 years later. Development or progression of microalbuminuria, retinopathy and hypertension was evaluated.

Results

Initially, 20 patients (24%) were diagnosed with masked hypertension and 31 (37%) with non-dipper pattern as the only pathological findings. At 7 years: 1) twenty-seven patients (32%) had progression of retinopathy related to the nocturnal diastolic blood pressure (BP_D) (OR:1.122; p = 0.034) and final non-dipper pattern (OR:5.857; p = 0.005); 2) seven patients (10%) developed microalbuminuria for which nocturnal systolic blood pressure (BP_S) was a risk factor (OR:1.129; p = 0.007); 3) five of the normotensive patients (9%) progressed to hypertension; historic HbA1c (OR:2.767; p = 0.046) and nocturnal BP_D (OR:1.243; p = 0.046) being the related risk factors. BP_D level ≥ 65 mmHg was associated with an increase in progression of retinopathy and hypertension.

Conclusions

In T1DM patients there is an elevated prevalence of BP alterations, detected using ABPM. Alterations in nocturnal BP predispose to development/progression of microvascular complications and overt hypertension.