The relationship of urinary albumin excretion rate to ambulatory blood pressure and erythrocyte sodium-lithium countertransport in NIDDM.
Increased erythrocyte sodium-lithium countertransport rate is found in non-diabetic subjects with essential hypertension, and in insulin-dependent diabetic subjects with nephropathy. However, relationships between these variables in non-insulin-dependent diabetic subjects are ill-defined. In order to characterise the relationships between blood pressure, urinary albumin excretion, and erythrocyte sodium-lithium countertransport, 66 subjects with non-insulin-dependent diabetes were studied. Urinary albumin excretion rate correlated with mean 24-h ambulatory systolic blood pressure (r = 0.57; p < 0.001), but not with sodium-lithium countertransport (r = 0.06; p = 0.31). No significant relationship was observed between 24-h systolic blood pressure and erythrocyte sodium-lithium countertransport (r = 0.16; p = 0.17). The principal differences between microalbuminuric and normoalbuminuric subjects (albumin excretion rate > 15 micrograms.min-1 [n = 20], and < 15 micrograms.min-1, [n = 46]) were: higher 24-h systolic blood pressure (145.9 [16.8] mmHg vs 131.9 [16.8] mmHg; p = 0.006), nocturnal heart rate (72.4 [8.9] vs 67.4 [8.9] beats.min-1; p = 0.042), and HbA1 (11.3 [1.5]% vs 10.1 [2.0]%; p = 0.028), and a longer median duration of diabetes (10.0 vs 5.0 years; p = 0.02). In contrast, there was no significant difference in sodium-lithium countertransport rate between microalbuminuric (0.41 [0.18] mmol.l-1.h-1) and normoalbuminuric subjects (0.39 [0.15] mmol.l-1.h-1; p = 0.687).(ABSTRACT TRUNCATED AT 250 WORDS)
Pinkney
J H
JH
Department of Medicine, University College London School of Medicine, Whittington Hospital, UK.
Foyle
W J
WJ
Denver
A E
AE
Mohamed-Ali
V
V
McKinlay
S
S
Yudkin
J S
JS
D017668:Age of Onset; D000419:Albuminuria; D017920:Antiporters / Q000097:blood*; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D002784:Cholesterol / Q000097:blood; D002940:Circadian Rhythm; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000503:physiopathology* / Q000652:urine; D003971:Diastole; D004912:Erythrocytes / Q000378:metabolism*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006339:Heart Rate; D006801:Humans; D007328:Insulin / Q000097:blood; D008094:Lithium / Q000097:blood; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D012964:Sodium / Q000097:blood; D013599:Systole; D014280:Triglycerides / Q000097:blood
D017920:Antiporters; D001786:Blood Glucose; D002784:Cholesterol; D006442:Glycated Hemoglobin; D007328:Insulin; D008094:Lithium; D012964:Sodium; D014280:Triglycerides; C045885:sodium-lithium countertransporter