title: Influence of HbA1c on short-term blood pressure variability in type 2 diabetic patients with diabetic nephropathy.
abstract: The aim of this study was to understand the characteristics of blood pressure (BP) variability in subjects with diabetic nephropathy (DN), and identify the probable predictors affecting BP variability. Fifty-one chronic kidney disease (CKD)-hypertensive patients without diabetes (NDN group) and sixty type 2 diabetic patients with overt DN (DN group) were enrolled in this study. The values of short-term BP variability were obtained from 24 h ambulatory BP monitoring (ABPM). Variance analysis or nonparametric analysis revealed that 24-h systolic BP variability and nighttime systolic BP variability of the DN group were significantly higher than those of the NDN group [(12.23±3.66) vs. (10.74±3.83) mmHg, P<0.05; (11.23±4.82) vs. (9.48±3.69) mmHg, P<0.05]. Then the patients of the DN group were divided into two groups according to glycated hemoglobin (HbA1c) level: Group A (HbA1c<7%) and Group B (HbA1c≥7%), and the t-test showed that patients in Group B had larger 24-h diastolic, daytime diastolic, and nighttime systolic/diastolic BP variability compared with Group A. In the DN group, partial correlation analysis revealed that HbA1c exhibited a strong association with 24-h diastolic, daytime diastolic, nighttime systolic and diastolic BP variability (P<0.001, P<0.001, P<0.05, and P<0.001, respectively). Taken together, larger short-term BP variability was detected in hypertensive type 2 diabetic patients with overt nephropathy and renal insufficiency. It may imply that the optimal BP variability level could benefit from a better glycaemic control.
authors.affiliation: Division of Nephrology, West China Hospital of Sichuan University, Chengdu 610041, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Liu
authors.forename: Min
authors.initials: M
authors.lastname: Wu
authors.forename: Yan-huan
authors.initials: YH
authors.lastname: Feng
authors.forename: Hui
authors.initials: H
authors.lastname: Zhong
authors.forename: Tian-lei
authors.initials: TL
authors.lastname: Cui
authors.forename: You-qun
authors.initials: YQ
authors.lastname: Huang
authors.forename: Ya-ping
authors.initials: YP
authors.lastname: Liang
authors.forename: Yong-shu
authors.initials: YS
authors.lastname: Diao
authors.forename: Li
authors.initials: L
authors.lastname: Zang
authors.forename: Ling
authors.initials: L
authors.lastname: Li
authors.forename: Jing
authors.initials: J
authors.lastname: Zang
authors.forename: Hong-yu
authors.initials: HY
authors.lastname: Qiu
authors.forename: Song-min
authors.initials: SM
authors.lastname: Huang
authors.forename: Ping
authors.initials: P
authors.lastname: Fu
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000503:physiopathology*; D003928:Diabetic Nephropathies / Q000097:blood / Q000503:physiopathology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human