Implications of Nocturnal Hypertension in Children and Adolescents With Type 1 Diabetes
Implications of Nocturnal Hypertension in Children and Adolescents With Type 1 Diabetes
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DOI：
10.2337/dc11-0830
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发表时间：
2011-10-01
期刊：
影响因子：
16.2
通讯作者：
Shin, Choong Ho
中科院分区：
文献类型：
--
作者：
Lee, Sun Hee;Kim, Jae Hyun;Shin, Choong Ho
目的-糖尿病与致动脉粥样硬化的危险因素有关。高血压对糖尿病患者的心血管疾病有重要影响。动态血压监测（ABPM）可用于识别夜间高血压。颈动脉内膜中层厚度（cIMT）是识别亚临床动脉粥样硬化的良好指标。本研究旨在评估夜间高血压是否影响1型糖尿病儿童和青少年的动脉粥样硬化，并探讨动脉粥样硬化危险因素和cIMT之间的关系。研究设计和方法-ABPM和cIMT测定82糖尿病儿童和青少年。我们回顾了血红蛋白AI、水平、24小时尿微量白蛋白排泄、血脂谱和糖尿病病程。夜间高血压定义为仅在夜间观察到的高血压。结果-43名（52%）受试者患有高血压，30名受试者被归类为夜间高血压。夜间高血压组的cIMT高于血压正常组（0.44 ± 0.03 vs. 0.42 ± 0.04 mm，P = 0.026）。在门诊血压监测中无高血压水平的儿童和青少年中，夜间高血压组的cIMT和日间血压较高。所有ABPM参数显着相关CL MT在多元线性回归analysis.CONCLUSIONS-This研究表明，显着增加cIMT和白天的血压在糖尿病儿童和青少年夜间高血压。ABPM可能是检测1型糖尿病大血管并发症的有效方法。需要进行纵向研究，以找到夜间高血压的原因，并评估夜间高血压对1型糖尿病动脉粥样硬化的影响。
OBJECTIVE-Diabetes is associated with atherogenic risk factors. Hypertension has a major influence on cardiovascular disease in diabetic patients. Ambulatory blood pressure monitoring (ABPM) is useful for identifying nocturnal hypertension. Carotid intima-media thickness (cIMT) is a good measure for identifying subclinical atherosclerosis. This study aimed to evaluate whether nocturnal hypertension affects atherosclerosis in children and adolescents with type 1 diabetes and to investigate the relationship between atherogenic risk factors and cIMT.RESEARCH DESIGN AND METHODS-ABPM and cIMT were measured in 82 diabetic children and adolescents. We reviewed the hemoglobin AI, levels, 24-h urine microalbumin excretion, lipid profiles, and duration of diabetes. Nocturnal hypertension was defined as hypertension observed only at night.RESULTS-Forty-three (52%) subjects were hypertensive, and 30 subjects were classified as having nocturnal hypertension. cIMT was higher in the nocturnal hypertensive group than in the normotensive group (0.44 +/- 0.03 vs. 0.42 +/- 0.04 mm, P = 0.026). Among children and adolescents with nonhypertensive blood pressure levels in clinic blood pressure monitoring, cIMT and daytime blood pressure were higher in the nocturnal hypertensive group. All ABPM parameters were significantly related to cl MT in multiple linear regression analysis.CONCLUSIONS-This study showed significantly increased cIMT and daytime blood pressure in diabetic children and adolescents with nocturnal hypertension. ABPM may be a useful method for detecting the macrovascular complications of type 1 diabetes. Longitudinal studies are needed to find the causes of nocturnal hypertension and to evaluate the effect of nocturnal hypertension on atherosclerosis in type 1 diabetes.