Differential associations of central and brachial blood pressure with carotid atherosclerosis and microvascular complications in patients with type 2 diabetes.
Differential associations of central and brachial blood pressure with carotid atherosclerosis and microvascular complications in patients with type 2 diabetes.
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DOI：
10.1186/1471-2261-14-23
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发表时间：
2014-02-20
影响因子：
2.1
通讯作者：
Mok JO
中科院分区：
文献类型：
--
作者：
Jung CH;Jung SH;Kim KJ;Kim BY;Kim CH;Kang SK;Mok JO
目的探讨2型糖尿病（T2 DM）患者中心血压（BP）、肱动脉血压与颈动脉粥样硬化及微血管并发症的关系。我们招募了201名患者，对他们进行了中心血压、肱血压、颈动脉超声、臂踝脉搏波速度（baPWV）、踝臂指数（ABI）和微血管并发症的评估。采用放射状自动眼压测量系统计算中心血压。中心血压和肱动脉血压之间的一致性非常强（中心和肱动脉SBP之间的一致性相关系数= 0.889，中心和肱动脉PP之间的一致性相关系数= 0.816）。中心脉压（PP）与颈动脉内膜中层厚度（CIMT）、baPWV和ABI相关，而肱动脉PP与CIMT呈临界显著相关。根据肱动脉PP三分位数，肾病（DN）和视网膜病变（DR）的患病率增加，微血管并发症的患病率在中央PP三分位数之间没有差异。在多变量分析中，与第一个三分位数相比，肱动脉PP三分位数2和3存在DR的相对危险度（RR）分别为1.2和4.6。此外，与第一个三分位数相比，肱动脉PP三分位数2和3存在DN的RR分别为1.02和3。中心血压和肱动脉血压的一致性非常强。然而，这项研究表明，较高的肱动脉PP水平与微血管并发症（如DR/DN）的发生概率增加相关。然而，中心SBP和中心PP与微血管并发症无关。与肱动脉血压相比，中心血压水平与大血管并发症的替代标志物相关。
We examined the relationship between central blood pressure (BP), brachial BP with carotid atherosclerosis and microvascular complications in type 2 diabetes mellitus (T2DM). We recruited 201 patients who were evaluated for central BP, brachial BP, carotid ultrasonography, brachial-ankle pulse wave velocity (baPWV), ankle-brachial index (ABI) and microvascular complications. Central BP were calculated using a radial automated tonometric system. Agreement between central BP and brachial BP was very strong (concordance correlation coefficient between central and brachial SBP = 0.889, between central and brachial PP = 0.816). Central pulse pressure (PP) was correlated with mean carotid intima-media thickness (CIMT), baPWV and ABI, whereas brachial PP was borderline significantly correlated with CIMT. The prevalence of nephropathy(DN) and retinopathy(DR) according to the brachial PP tertiles increased, the prevalences of microvascular complications were not different across central PP tertiles. In multivariate analysis, the relative risks (RRs) for the presence of DR were 1.2 and 4.6 for the brachial PP tertiles 2 and 3 when compared with the first tertile. Also, the RRs for the presence of DN were 1.02 and 3 for the brachial PP tertiles 2 and 3 when compared with the first tertile. Agreement of central BP and brachial BP was very strong. Nonetheless, this study showed that higher brachial PP levels are associated with increased probability for the presence of microvascular complications such as DR/DN. However, there are no associations with central SBP and central PP with microvascular complications. Central BP levels than brachial BP are correlated with surrogate marker of macrovascular complications.
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影响因子：
8.3
作者：
McEniery, Carmel M.;McDonnell, Barry;Wilkinson, Ian B.
通讯作者：
Wilkinson, Ian B.
影响因子：
5.4
作者：
Takazawa, Kenji;Kobayashi, Hideyuki;Yamashina, Akira
通讯作者：
Yamashina, Akira
影响因子：
39.3
作者：
Vlachopoulos, Charalambos;Aznaouridis, Konstantinos;Stefanadis, Christodoulos
通讯作者：
Stefanadis, Christodoulos
影响因子：
--
作者：
Watkins, PJ
通讯作者：
Watkins, PJ
影响因子：
3.2
作者：
Cockcroft, JR;Wilkinson, IB;Currie, CJ
通讯作者：
Currie, CJ