title: A difference in systolic blood pressure between arms and between lower limbs is a novel risk marker for diabetic nephropathy in patients with type 2 diabetes.
abstract: Recent studies have demonstrated that a difference in systolic blood pressure (SBP) between arms is associated with both vascular disease and mortality. The aim of this study was to investigate the relationship between a difference in SBP between arms and between lower limbs and the degree of albuminuria, which is an established marker for cardiovascular disease and diabetic nephropathy in patients with Type 2 diabetes. We measured blood pressure in the arms and lower limbs of 314 consecutive patients with Type 2 diabetes, and we calculated a difference in SBP between arms and between lower limbs. We then evaluated the relationship of the difference in SBP between arms and between lower limbs to the degree of urinary albumin excretion (UAE). The average difference in SBP between arms and between lower limbs was 3.52±3.94 and 9.66±14.1 mm Hg, respectively. Multiple regression analyses demonstrated that a difference in SBP between arms (β=0.172, P=0.0239) and between lower limbs (β=0.238, P=0.0033) independently correlated with the logarithm of the UAE. Multiple logistic regression analyses showed that a difference in SBP of 10 mm Hg between arms (odds ratio 12.23 (95% CI 1.130-132.35), P<0.0393) and a difference in SBP of 15 mm Hg between lower limbs (odds ratio 4.291 (95% CI 1.403-13.123), P<0.0106) correlated with the risk of albuminuria. A difference in SBP between arms and between lower limbs, therefore, could be a novel risk marker for diabetic nephropathy in patients with Type 2 diabetes.
authors: Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan.
authors: Hiroshi
authors: H
authors: Okada
authors: Michiaki
authors: M
authors: Fukui
authors: Muhei
authors: M
authors: Tanaka
authors: Shinobu
authors: S
authors: Matsumoto
authors: Yusuke
authors: Y
authors: Mineoka
authors: Naoko
authors: N
authors: Nakanishi
authors: Mai
authors: M
authors: Asano
authors: Masahiro
authors: M
authors: Yamazaki
authors: Goji
authors: G
authors: Hasegawa
authors: Naoto
authors: N
authors: Nakamura
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000503:physiopathology*; D001132:Arm / Q000503:physiopathology; D001794:Blood Pressure; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003928:Diabetic Nephropathies / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D018570:Risk Assessment