Association between within-visit systolic blood pressure variability and development of pre-diabetes and diabetes among overweight/obese individuals.
Association between within-visit systolic blood pressure variability and development of pre-diabetes and diabetes among overweight/obese individuals.
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DOI：
10.1038/s41371-017-0009-y
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发表时间：
2017-12
影响因子：
2.7
通讯作者：
Zevallos JC
中科院分区：
文献类型：
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作者：
Joshipura KJ;Muñoz-Torres FJ;Campos M;Rivera-Díaz AD;Zevallos JC
短期血压变异性与糖尿病前期/糖尿病横断面相关，但没有纵向研究评估这种关联。本研究的目的是纵向评价访视内收缩压和舒张压变异性与糖尿病前期/糖尿病发展之间的相关性。这项研究是在圣胡安超重成人纵向研究（SOALS）的合格参与者中进行的，他们完成了三年的随访检查。参与者是西班牙裔，40-65岁，基线时没有糖尿病。访视内收缩压和舒张压变异性定义为分别在几分钟内测量的收缩压和舒张压之间的最大差异。糖尿病进展定义为随访期间发生前驱糖尿病/糖尿病。我们计算了校正基线年龄、性别、吸烟、体力活动、腰围和高血压状态后的多变量发病率比。收缩压变异性≥10 mm Hg的受试者比收缩压变异性<10 mm Hg的受试者更容易进展为糖尿病前期/糖尿病（RR=1.77，95% CI：1.30-2.42）。这种联系在从不吸烟者中持续存在。舒张压变异性≥ 10 mm Hg（与< 10 mm Hg相比）与糖尿病状态进展无关（RR=1.20，95% CI：0.71-2.01）。对基线HDL、C-反应蛋白和血脂（报告的血脂异常或基线HDL或甘油三酯）的额外调整未改变估计值。收缩压变异性可能是糖尿病的一个新的独立危险因素和早期预测因子，它可以很容易地纳入一个单一的常规门诊就诊，没有或最小的额外费用。
Short-term blood pressure variability is associated with pre-diabetes/diabetes cross-sectionally, but there are no longitudinal studies evaluating this association. The objective of this study is to evaluate the association between within-visit systolic and diastolic blood pressure variability and development of pre-diabetes/diabetes longitudinally. The study was conducted among eligible participants from the San Juan Overweight Adults Longitudinal Study (SOALS), who completed the three-year follow-up exam. Participants were Hispanics, 40–65 years of age, and free of diabetes at baseline. Within-visit systolic and diastolic blood pressure variability was defined as the maximum difference between three measures, taken a few minutes apart, of systolic and diastolic blood pressure respectively. Diabetes progression was defined as development of pre-diabetes/diabetes over the follow-up period. We computed multivariate incidence rate ratios adjusting for baseline age, gender, smoking, physical activity, waist circumference and hypertension status. Participants with systolic blood pressure variability ≥10 mm Hg compared to those with <10 mm Hg, showed higher progression to pre-diabetes/diabetes (RR=1.77, 95% CI: 1.30–2.42). The association persisted among never smokers. Diastolic blood pressure variability ≥ 10 mm Hg (compared to < 10 mm Hg) did not show an association with diabetes status progression (RR=1.20, 95% CI: 0.71–2.01). Additional adjustment of baseline glycemia, C- reactive protein, and lipids (reported dyslipidemia or baseline HDL or triglycerides) did not change the estimates. Systolic blood pressure variability may be a novel independent risk factor and an early predictor for diabetes, which can be easily incorporated into a single routine outpatient visit at none to minimal additional cost.
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影响因子：
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de Vente W;van Amsterdam JG;Olff M;Kamphuis JH;Emmelkamp PM
通讯作者：
Emmelkamp PM
影响因子：
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