Maternal but not paternal association of ambulatory blood pressure with albumin excretion in young offspring with type 1 diabetes.
OBJECTIVE
Familial predisposition to hypertension has been associated with the development of diabetic nephropathy in adults, but there are limited data in adolescents. Our aim was to assess whether parental ambulatory blood pressure (ABP) was associated with ABP and albumin excretion in young offspring with type 1 diabetes.


METHODS
Twenty-four-hour ABP monitoring was performed in 509 young offspring (mean +/- SD age 15.8 +/- 2.3 years) with type 1 diabetes, 311 fathers, and 444 mothers. Systolic (SBP) and diastolic blood pressure (DBP) measurements during 24 h, daytime, and nighttime were calculated. Three early morning urinary albumin-to-creatinine ratios (ACRs), A1C, and anthropometric parameters were available for the offspring.


RESULTS
All paternal ABP parameters, except for nighttime SBP, were independently related to the offspring's ABP (24-h SBP beta = 0.18, 24-h DBP beta = 0.22, daytime SBP beta = 0.25, daytime DBP beta = 0.23, and nighttime DBP beta = 0.18; all P < 0.01). Maternal 24-h DBP (beta = 0.19, P = 0.004), daytime DBP (beta = 0.09, P = 0.04), and nighttime SBP (beta = 0.24 P = 0.001) were related to the corresponding ABP parameter in the offspring. Significant associations were found between the offspring's logACR and maternal ABP. The association with 24-h DBP (beta = 0.16, P = 0.02), daytime DBP (beta = 0.16 P = 0.02), and nighttime DBP (beta = 0.15 P = 0.03) persisted even after adjustment for the offspring's ABP. Mothers of offspring with microalbuminuria had higher ABP than mothers of offspring without microalbuminuria (all P < 0.05).


CONCLUSIONS
In this cohort, parental ABP significantly influenced offspring blood pressure, therefore confirming familial influences on this trait. In addition, maternal ABP, particularly DBP, was closely related to ACR in the offspring, suggesting a dominant effect of maternal genes or an effect of the intrauterine environment on microalbuminuria risk.
Marcovecchio
M Loredana
ML
Department of Paediatrics, University of Cambridge, Cambridge, UK.
Tossavainen
Paivi H
PH
Acerini
Carlo L
CL
Barrett
Timothy G
TG
Edge
Julie
J
Neil
Andrew
A
Shield
Julian
J
Widmer
Barry
B
Dalton
R Neil
RN
Dunger
David B
DB
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000419:Albuminuria / Q000453:epidemiology*; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D002648:Child; D003404:Creatinine / Q000652:urine; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology* / Q000503:physiopathology / Q000652:urine; D003971:Diastole; D005220:Fathers / Q000706:statistics & numerical data; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D009035:Mothers / Q000706:statistics & numerical data; D013599:Systole
D003404:Creatinine; D006442:Glycated Hemoglobin