2型糖尿病合并高血压患者的血糖和血压变异性与心脏舒张功能的关系:一项回顾性观察研究

S. Goto, Makoto Ohara, Naoya Osaka, Tomoki Fujikawa, Yo Kohata, H. Nagaike, Ayako Fukase, Hideki Kushima, Munenori Hiromura, Takeshi Yamamoto, Toshiyuki Hayashi, Tomoyasu Fukui, T. Hirano
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引用次数: 1

摘要

我们评估了糖代谢和血压(BP)变异性对2型糖尿病(T2DM)合并高血压患者心脏舒张功能的影响。对23例住院T2DM患者进行动态血压监测(ABPM)和超声心动图检查。通过测量24小时内收缩压和舒张压的平均血压和标准差(SD)以及白天和夜间ABPM来评估血压变异性。采用超声心动图E/ E比值评估心脏舒张功能。参与者平均年龄为69.0±10.6岁,病程为11.0±10.5年,糖化血红蛋白(HbA1c)为8.2%±1.3%,糖化白蛋白(GA)为22.0%±4.2%。单因素分析显示,夜间收缩压、夜间收缩压和舒张压SDs、尿白蛋白、估计肾小球滤过率、GA / HbA1c比值均与E/ E′比值显著相关。此外,逐步多元回归分析发现,舒张压夜间SD值、尿白蛋白和GA / HbA1c比值是影响E/ E’比值的独立因素。在T2DM和高血压患者中,心脏舒张功能与夜间舒张压变异性和GA / HbA1c比值相关。
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Associations of Glucose and Blood Pressure Variability with Cardiac Diastolic Function in Patients with Type 2 Diabetes Mellitus and Hypertension: A Retrospective Observational Study
We evaluated the effects of glucose metabolism and blood pressure (BP) variability on cardiac diastolic function in patients with type 2 diabetes mellitus(T2DM) and hypertension. A total of 23 inpatients with T2DM underwent ambulatory BP monitoring(ABPM) and echocardiography. BP variability was assessed by measuring the mean BP and the standard deviation(SD) of systolic and diastolic BP over 24 hours, as well as daytime and nighttime ABPM. Cardiac diastolic function was assessed using the echocardiography E/e′ ratio. Participants had a mean age of 69.0±10.6 years, disease duration of 11.0±10.5 years, glycated hemoglobin(HbA1c) of 8.2%±1.3%, and glycated albumin(GA) of 22.0%± 4.2%. Univariate analysis showed that the nighttime systolic BP, nighttime SDs of systolic and diastolic BP, urinary albumin, estimated glomerular ltration rate, and GA / HbA1c ratio were all signi cantly correlated with the E/e′ ratio. Moreover, stepwise multiple regression analysis identi ed nighttime SD of diastolic BP, urinary albumin, and GA / HbA1c ratio as independent contributors to the E/e′ ratio. In patients with T2DM and hypertension, cardiac diastolic function was associated with nighttime diastolic BP variability and the GA / HbA1c ratio.
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